Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROBE MCV LITHOC .8 2.4 840202

Facility

$3,025.65

Hospital Charge Code	270624387
Hospital Revenue Code	272
Min. Negotiated Rate	$393.33
Max. Negotiated Rate	$1,512.83
Rate for Payer: Aetna Commercial	$907.70
Rate for Payer: Aetna Medicare Advantage	$907.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.54
Rate for Payer: Cigna Commercial	$1,512.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.33
Rate for Payer: Oxford Commercial	$1,512.83
Rate for Payer: Qualcare PPO/HMO/WC	$453.85
Rate for Payer: UnitedHealthcare Commercial	$1,512.83

PROBE MCV LITHOC .8 2.4 840202

Facility

$3,025.65

Hospital Charge Code	270624387
Hospital Revenue Code	272
Min. Negotiated Rate	$453.85
Max. Negotiated Rate	$453.85
Rate for Payer: Qualcare PPO/HMO/WC	$453.85

PROBE MCV SWISS 1.6 423 840214

Facility

$3,050.00

Hospital Charge Code	270624051
Hospital Revenue Code	272
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$457.50
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

PROBE MCV SWISS 1.6 423 840214

Facility

$3,050.00

Hospital Charge Code	270624051
Hospital Revenue Code	272
Min. Negotiated Rate	$396.50
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$915.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.50
Rate for Payer: Oxford Commercial	$1,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$457.50
Rate for Payer: UnitedHealthcare Commercial	$1,525.00

PROBENECID 500 MG TAB

Facility

$7.71

Service Code	NDC 378015601
Hospital Charge Code	60627982
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

PROBENECID 500 MG TAB

Facility

$7.71

Service Code	NDC 378015601
Hospital Charge Code	60627982
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

PROBE NEURO ALARA NEEDLE KIT

Facility

$1,650.00

Hospital Charge Code	270691876
Hospital Revenue Code	272
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$495.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$825.00

PROBE NEURO ALARA NEEDLE KIT

Facility

$1,650.00

Hospital Charge Code	270691876
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

PROBE NVM5 SINGLE USE

Facility

$2,062.50

Hospital Charge Code	270691827
Hospital Revenue Code	272
Min. Negotiated Rate	$309.38
Max. Negotiated Rate	$309.38
Rate for Payer: Qualcare PPO/HMO/WC	$309.38

PROBE NVM5 SINGLE USE

Facility

$2,062.50

Hospital Charge Code	270691827
Hospital Revenue Code	272
Min. Negotiated Rate	$268.12
Max. Negotiated Rate	$1,031.25
Rate for Payer: Aetna Commercial	$618.75
Rate for Payer: Aetna Medicare Advantage	$618.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$525.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$525.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$525.94
Rate for Payer: Cigna Commercial	$1,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.12
Rate for Payer: Oxford Commercial	$1,031.25
Rate for Payer: Qualcare PPO/HMO/WC	$309.38
Rate for Payer: UnitedHealthcare Commercial	$1,031.25

PROBE OCUTOME PHAC EMUL

Facility

$1,524.85

Hospital Charge Code	270061201
Hospital Revenue Code	276
Min. Negotiated Rate	$228.73
Max. Negotiated Rate	$762.42
Rate for Payer: Aetna Commercial	$457.45
Rate for Payer: Aetna Medicare Advantage	$457.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.84
Rate for Payer: Cigna Commercial	$762.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.01
Rate for Payer: Qualcare PPO/HMO/WC	$228.73

PROBE OCUTOME PHAC EMUL

Facility

$1,524.85

Hospital Charge Code	270061201
Hospital Revenue Code	276
Min. Negotiated Rate	$228.73
Max. Negotiated Rate	$369.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.01
Rate for Payer: Qualcare PPO/HMO/WC	$228.73

PROBE OCUTOME PHACO IRRIG 1006

Facility

$826.65

Hospital Charge Code	270626659
Hospital Revenue Code	272
Min. Negotiated Rate	$107.46
Max. Negotiated Rate	$413.32
Rate for Payer: Aetna Commercial	$248.00
Rate for Payer: Aetna Medicare Advantage	$248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.80
Rate for Payer: Cigna Commercial	$413.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.46
Rate for Payer: Oxford Commercial	$413.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.00
Rate for Payer: UnitedHealthcare Commercial	$413.32

PROBE OCUTOME PHACO IRRIG 1006

Facility

$826.65

Hospital Charge Code	270626659
Hospital Revenue Code	272
Min. Negotiated Rate	$124.00
Max. Negotiated Rate	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.00

PROBE ORTHO-DRI ABSORB

Facility

$170.45

Hospital Charge Code	270600355
Hospital Revenue Code	270
Min. Negotiated Rate	$22.16
Max. Negotiated Rate	$85.22
Rate for Payer: Aetna Commercial	$51.13
Rate for Payer: Aetna Medicare Advantage	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$85.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.16
Rate for Payer: Oxford Commercial	$85.22
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
Rate for Payer: UnitedHealthcare Commercial	$85.22

PROBE ORTHO-DRI ABSORB

Facility

$170.45

Hospital Charge Code	270600355
Hospital Revenue Code	270
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

PROBE ORTHO DRI ABSORB ZIM****

Facility

$64.00

Hospital Charge Code	1606243
Hospital Revenue Code	274
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

PROBE ORTHO DRI ABSORB ZIM****

Facility

$64.00

Hospital Charge Code	1606243
Hospital Revenue Code	274
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

PROBE PEDICLE SCREW

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

PROBE PEDICLE SCREW

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$7,275.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

PROBE PERCUTANEOUS DISCECTOMY

Facility

$11,916.35

Hospital Charge Code	270692007
Hospital Revenue Code	272
Min. Negotiated Rate	$1,549.13
Max. Negotiated Rate	$5,958.18
Rate for Payer: Aetna Commercial	$3,574.91
Rate for Payer: Aetna Medicare Advantage	$3,574.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,038.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,038.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,038.67
Rate for Payer: Cigna Commercial	$5,958.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,549.13
Rate for Payer: Oxford Commercial	$5,958.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,787.45
Rate for Payer: UnitedHealthcare Commercial	$5,958.18

PROBE PERCUTANEOUS DISCECTOMY

Facility

$11,916.35

Hospital Charge Code	270692007
Hospital Revenue Code	272
Min. Negotiated Rate	$1,787.45
Max. Negotiated Rate	$1,787.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,787.45

PROBE POSTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694865
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 POSTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694865
Hospital Revenue Code	272
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

PROBE PRASS NERVE STIMULATOR

Facility

$930.00

Hospital Charge Code	270657321
Hospital Revenue Code	272
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$465.00

Know your out-of-pocket cost for care.

All Charges