Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROBE 1.0MM SWISS LITHOCLAST

Facility

$2,500.00

Hospital Charge Code	270655686
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PROBE 1.0MM SWISS LITHOCLAST

Facility

$2,500.00

Hospital Charge Code	270655686
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PROBE 13 G (MAMMOTOME SYSTEM)

Facility

$1,253.75

Hospital Charge Code	270663457
Hospital Revenue Code	272
Min. Negotiated Rate	$188.06
Max. Negotiated Rate	$188.06
Rate for Payer: Qualcare PPO/HMO/WC	$188.06

PROBE 13 G (MAMMOTOME SYSTEM)

Facility

$1,253.75

Hospital Charge Code	270663457R
Hospital Revenue Code	272
Min. Negotiated Rate	$188.06
Max. Negotiated Rate	$188.06
Rate for Payer: Qualcare PPO/HMO/WC	$188.06

PROBE 13 G (MAMMOTOME SYSTEM)

Facility

$1,253.75

Hospital Charge Code	270663457
Hospital Revenue Code	272
Min. Negotiated Rate	$162.99
Max. Negotiated Rate	$626.88
Rate for Payer: Aetna Commercial	$376.12
Rate for Payer: Aetna Medicare Advantage	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.71
Rate for Payer: Cigna Commercial	$626.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.99
Rate for Payer: Oxford Commercial	$626.88
Rate for Payer: Qualcare PPO/HMO/WC	$188.06
Rate for Payer: UnitedHealthcare Commercial	$626.88

PROBE 13 G (MAMMOTOME SYSTEM)

Facility

$1,253.75

Hospital Charge Code	270663457R
Hospital Revenue Code	272
Min. Negotiated Rate	$162.99
Max. Negotiated Rate	$626.88
Rate for Payer: Aetna Commercial	$376.12
Rate for Payer: Aetna Medicare Advantage	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.71
Rate for Payer: Cigna Commercial	$626.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.99
Rate for Payer: Oxford Commercial	$626.88
Rate for Payer: Qualcare PPO/HMO/WC	$188.06
Rate for Payer: UnitedHealthcare Commercial	$626.88

PROBE 24-HR PH

Facility

$460.85

Hospital Charge Code	270600967
Hospital Revenue Code	270
Min. Negotiated Rate	$59.91
Max. Negotiated Rate	$230.43
Rate for Payer: Aetna Commercial	$138.25
Rate for Payer: Aetna Medicare Advantage	$138.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.52
Rate for Payer: Cigna Commercial	$230.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.91
Rate for Payer: Oxford Commercial	$230.43
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Commercial	$230.43

PROBE 24-HR PH

Facility

$460.85

Hospital Charge Code	270600967
Hospital Revenue Code	270
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$69.13
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

PROBE 3 PERCTNEOUS DISCECTOMY

Facility

$16,000.00

Hospital Charge Code	270644974
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

PROBE 3 PERCTNEOUS DISCECTOMY

Facility

$16,000.00

Hospital Charge Code	270644974
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

PROBE 40CM

Facility

$3,750.00

Hospital Charge Code	270688484
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$1,875.00

PROBE 40CM

Facility

$3,750.00

Hospital Charge Code	270688484
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PROBE 50S XL

Facility

$1,205.00

Hospital Charge Code	270685910
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$180.75
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

PROBE 50S XL

Facility

$1,205.00

Hospital Charge Code	270685910
Hospital Revenue Code	272
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$361.50
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.65
Rate for Payer: Oxford Commercial	$602.50
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Commercial	$602.50

PROBE 5MM LAPAROSCOPIC ABC

Facility

$511.50

Hospital Charge Code	270685469
Hospital Revenue Code	272
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$255.75
Rate for Payer: Aetna Commercial	$153.45
Rate for Payer: Aetna Medicare Advantage	$153.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.43
Rate for Payer: Cigna Commercial	$255.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.50
Rate for Payer: Oxford Commercial	$255.75
Rate for Payer: Qualcare PPO/HMO/WC	$76.72
Rate for Payer: UnitedHealthcare Commercial	$255.75

PROBE 5MM LAPAROSCOPIC ABC

Facility

$511.50

Hospital Charge Code	270685469
Hospital Revenue Code	272
Min. Negotiated Rate	$76.72
Max. Negotiated Rate	$76.72
Rate for Payer: Qualcare PPO/HMO/WC	$76.72

PROBE 6.0F 2.0 SWISS LH 840220

Facility

$2,875.00

Hospital Charge Code	270627732
Hospital Revenue Code	272
Min. Negotiated Rate	$373.75
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$862.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.75
Rate for Payer: Oxford Commercial	$1,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$1,437.50

PROBE 6.0F 2.0 SWISS LH 840220

Facility

$2,875.00

Hospital Charge Code	270627732
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PROBE 90 DEGREE ASSY SM JOINT

Facility

$1,875.50

Hospital Charge Code	270689119
Hospital Revenue Code	272
Min. Negotiated Rate	$281.32
Max. Negotiated Rate	$281.32
Rate for Payer: Qualcare PPO/HMO/WC	$281.32

PROBE 90 DEGREE ASSY SM JOINT

Facility

$1,875.50

Hospital Charge Code	270689119
Hospital Revenue Code	272
Min. Negotiated Rate	$243.81
Max. Negotiated Rate	$937.75
Rate for Payer: Aetna Commercial	$562.65
Rate for Payer: Aetna Medicare Advantage	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.25
Rate for Payer: Cigna Commercial	$937.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.81
Rate for Payer: Oxford Commercial	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.32
Rate for Payer: UnitedHealthcare Commercial	$937.75

PROBE 90-S XL

Facility

$876.85

Hospital Charge Code	270685569
Hospital Revenue Code	272
Min. Negotiated Rate	$131.53
Max. Negotiated Rate	$131.53
Rate for Payer: Qualcare PPO/HMO/WC	$131.53

PROBE 90-S XL

Facility

$876.85

Hospital Charge Code	270685569
Hospital Revenue Code	272
Min. Negotiated Rate	$113.99
Max. Negotiated Rate	$438.43
Rate for Payer: Aetna Commercial	$263.06
Rate for Payer: Aetna Medicare Advantage	$263.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.60
Rate for Payer: Cigna Commercial	$438.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.99
Rate for Payer: Oxford Commercial	$438.43
Rate for Payer: Qualcare PPO/HMO/WC	$131.53
Rate for Payer: UnitedHealthcare Commercial	$438.43

PROBE ANTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694866
Hospital Revenue Code	272
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

PROBE ANTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694866
Hospital Revenue Code	272
Min. Negotiated Rate	$416.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: Aetna Commercial	$960.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Oxford Commercial	$1,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Commercial	$1,600.00

PROBE APC ERBE 2.3/6MM

Facility

$1,595.25

Hospital Charge Code	270607682
Hospital Revenue Code	272
Min. Negotiated Rate	$239.29
Max. Negotiated Rate	$239.29
Rate for Payer: Qualcare PPO/HMO/WC	$239.29

Know your out-of-pocket cost for care.

All Charges