Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROBE INCUTEMP III 503-0112

Facility

$29.65

Hospital Charge Code	270609683
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

PROBE INJECTION GOLD 6

Facility

$1,801.65

Hospital Charge Code	270603941
Hospital Revenue Code	272
Min. Negotiated Rate	$234.21
Max. Negotiated Rate	$900.83
Rate for Payer: Aetna Commercial	$540.50
Rate for Payer: Aetna Medicare Advantage	$540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.42
Rate for Payer: Cigna Commercial	$900.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.21
Rate for Payer: Oxford Commercial	$900.83
Rate for Payer: Qualcare PPO/HMO/WC	$270.25
Rate for Payer: UnitedHealthcare Commercial	$900.83

PROBE INJECTION GOLD 6

Facility

$1,801.65

Hospital Charge Code	270603941
Hospital Revenue Code	272
Min. Negotiated Rate	$270.25
Max. Negotiated Rate	$270.25
Rate for Payer: Qualcare PPO/HMO/WC	$270.25

PROBE INJECTION GOLD 6015

Facility

$1,075.00

Hospital Charge Code	270603932
Hospital Revenue Code	272
Min. Negotiated Rate	$139.75
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.75
Rate for Payer: Oxford Commercial	$537.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$537.50

PROBE INJECTION GOLD 6015

Facility

$1,075.00

Hospital Charge Code	270603932
Hospital Revenue Code	272
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PROBE INJECTION GOLD 7 6017

Facility

$1,801.65

Hospital Charge Code	270603942
Hospital Revenue Code	272
Min. Negotiated Rate	$270.25
Max. Negotiated Rate	$270.25
Rate for Payer: Qualcare PPO/HMO/WC	$270.25

PROBE INJECTION GOLD 7 6017

Facility

$1,801.65

Hospital Charge Code	270603942
Hospital Revenue Code	272
Min. Negotiated Rate	$234.21
Max. Negotiated Rate	$900.83
Rate for Payer: Aetna Commercial	$540.50
Rate for Payer: Aetna Medicare Advantage	$540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.42
Rate for Payer: Cigna Commercial	$900.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.21
Rate for Payer: Oxford Commercial	$900.83
Rate for Payer: Qualcare PPO/HMO/WC	$270.25
Rate for Payer: UnitedHealthcare Commercial	$900.83

PROBE INJECTION GOLD 8

Facility

$1,801.65

Hospital Charge Code	270603943
Hospital Revenue Code	272
Min. Negotiated Rate	$234.21
Max. Negotiated Rate	$900.83
Rate for Payer: Aetna Commercial	$540.50
Rate for Payer: Aetna Medicare Advantage	$540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.42
Rate for Payer: Cigna Commercial	$900.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.21
Rate for Payer: Oxford Commercial	$900.83
Rate for Payer: Qualcare PPO/HMO/WC	$270.25
Rate for Payer: UnitedHealthcare Commercial	$900.83

PROBE INJECTION GOLD 8

Facility

$1,801.65

Hospital Charge Code	270603943
Hospital Revenue Code	272
Min. Negotiated Rate	$270.25
Max. Negotiated Rate	$270.25
Rate for Payer: Qualcare PPO/HMO/WC	$270.25

PROBE IRRIGATING OCUTOME *****

Facility

$620.00

Hospital Charge Code	1600881
Hospital Revenue Code	272
Min. Negotiated Rate	$80.60
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$186.00
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$310.00

PROBE IRRIGATING OCUTOME *****

Facility

$620.00

Hospital Charge Code	1600881
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

PROBE KIT HIP SYSTEM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673016
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PROBE KIT HIP SYSTEM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673016
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
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) NJ Health	$750.00
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	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PROBE KIT RF ABLATION

Facility

$21,075.00

Service Code	HCPCS C1886
Hospital Charge Code	270690464
Hospital Revenue Code	278
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$5,100.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,100.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

PROBE KIT RF ABLATION

Facility

$21,075.00

Service Code	HCPCS C1886
Hospital Charge Code	270690464
Hospital Revenue Code	278
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$6,322.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,100.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

PROBE LAPARASOPIC 5MM

Facility

$618.00

Hospital Charge Code	270664983
Hospital Revenue Code	272
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$309.00
Rate for Payer: Aetna Commercial	$185.40
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.59
Rate for Payer: Cigna Commercial	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: Oxford Commercial	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$309.00

PROBE LAPARASOPIC 5MM

Facility

$618.00

Hospital Charge Code	270664983
Hospital Revenue Code	272
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

PROBE LAVEEN 4.0 14/15 26213

Facility

$6,045.00

Hospital Charge Code	270630812
Hospital Revenue Code	272
Min. Negotiated Rate	$785.85
Max. Negotiated Rate	$3,022.50
Rate for Payer: Aetna Commercial	$1,813.50
Rate for Payer: Aetna Medicare Advantage	$1,813.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,541.47
Rate for Payer: Cigna Commercial	$3,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$785.85
Rate for Payer: Oxford Commercial	$3,022.50
Rate for Payer: Qualcare PPO/HMO/WC	$906.75
Rate for Payer: UnitedHealthcare Commercial	$3,022.50

PROBE LAVEEN 4.0 14/15 26213

Facility

$6,572.00

Hospital Charge Code	270631812
Hospital Revenue Code	272
Min. Negotiated Rate	$985.80
Max. Negotiated Rate	$985.80
Rate for Payer: Qualcare PPO/HMO/WC	$985.80

PROBE LAVEEN 4.0 14/15 26213

Facility

$6,572.00

Hospital Charge Code	270631812
Hospital Revenue Code	272
Min. Negotiated Rate	$854.36
Max. Negotiated Rate	$3,286.00
Rate for Payer: Aetna Commercial	$1,971.60
Rate for Payer: Aetna Medicare Advantage	$1,971.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,675.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,675.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,675.86
Rate for Payer: Cigna Commercial	$3,286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.36
Rate for Payer: Oxford Commercial	$3,286.00
Rate for Payer: Qualcare PPO/HMO/WC	$985.80
Rate for Payer: UnitedHealthcare Commercial	$3,286.00

PROBE LAVEEN 4.0 14/15 26213

Facility

$6,045.00

Hospital Charge Code	270630812
Hospital Revenue Code	272
Min. Negotiated Rate	$906.75
Max. Negotiated Rate	$906.75
Rate for Payer: Qualcare PPO/HMO/WC	$906.75

PROBE LITHOTRIPLE ELECTROHYDRA

Facility

$3,250.00

Hospital Charge Code	270658476
Hospital Revenue Code	272
Min. Negotiated Rate	$422.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$1,625.00

PROBE LITHOTRIPLE ELECTROHYDRA

Facility

$3,250.00

Hospital Charge Code	270658476
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PROBE MCV GOLD 7FR 6007

Facility

$231.25

Hospital Charge Code	270603908
Hospital Revenue Code	272
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

PROBE MCV GOLD 7FR 6007

Facility

$231.25

Hospital Charge Code	270603908
Hospital Revenue Code	272
Min. Negotiated Rate	$30.06
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$69.38
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$115.62
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$115.62

Know your out-of-pocket cost for care.

All Charges