Heights University Hospital

All Charges

Charge

Type

Setting

Price

RETRACTOR LONEST COLORECT DISP

Facility

$817.08

Hospital Charge Code	270695673
Hospital Revenue Code	272
Min. Negotiated Rate	$106.22
Max. Negotiated Rate	$408.54
Rate for Payer: Aetna Commercial	$245.12
Rate for Payer: Aetna Medicare Advantage	$245.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.36
Rate for Payer: Cigna Commercial	$408.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.22
Rate for Payer: Oxford Commercial	$408.54
Rate for Payer: Qualcare PPO/HMO/WC	$122.56
Rate for Payer: UnitedHealthcare Commercial	$408.54

RETRACTOR LONEST COLORECT DISP

Facility

$817.08

Hospital Charge Code	270695673
Hospital Revenue Code	272
Min. Negotiated Rate	$122.56
Max. Negotiated Rate	$122.56
Rate for Payer: Qualcare PPO/HMO/WC	$122.56

RETRACTOR MEDT 22 9 9560709

Facility

$1,440.00

Hospital Charge Code	270629192
Hospital Revenue Code	272
Min. Negotiated Rate	$187.20
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$432.00
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Commercial	$720.00

RETRACTOR MEDT 22 9 9560709

Facility

$1,440.00

Hospital Charge Code	270629192
Hospital Revenue Code	272
Min. Negotiated Rate	$216.00
Max. Negotiated Rate	$216.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00

RETRACTOR MEDT 22 9 9560709**

Facility

$1,800.00

Hospital Charge Code	270629198
Hospital Revenue Code	272
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$900.00

RETRACTOR MEDT 22 9 9560709**

Facility

$1,800.00

Hospital Charge Code	270629198
Hospital Revenue Code	272
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

RETRACTOR MICRO TEK 711 *****

Facility

$33.00

Hospital Charge Code	1606227
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.50

RETRACTOR MICRO TEK 711 *****

Facility

$33.00

Hospital Charge Code	1606227
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

RETRACTOR MOB ELAST MED 900515

Facility

$325.00

Hospital Charge Code	270633016
Hospital Revenue Code	272
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

RETRACTOR MOB ELAST MED 900515

Facility

$325.00

Hospital Charge Code	270633016
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

RETRACTOR MOBIUS 900-520

Facility

$620.00

Hospital Charge Code	270633148
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

RETRACTOR MOBIUS 900-520

Facility

$620.00

Hospital Charge Code	270633148
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

RETRACTOR RIGHT ANGLED 18MM

Facility

$1,005.00

Hospital Charge Code	270692073
Hospital Revenue Code	272
Min. Negotiated Rate	$150.75
Max. Negotiated Rate	$150.75
Rate for Payer: Qualcare PPO/HMO/WC	$150.75

RETRACTOR RIGHT ANGLED 18MM

Facility

$1,005.00

Hospital Charge Code	270692073
Hospital Revenue Code	272
Min. Negotiated Rate	$130.65
Max. Negotiated Rate	$502.50
Rate for Payer: Aetna Commercial	$301.50
Rate for Payer: Aetna Medicare Advantage	$301.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.27
Rate for Payer: Cigna Commercial	$502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.65
Rate for Payer: Oxford Commercial	$502.50
Rate for Payer: Qualcare PPO/HMO/WC	$150.75
Rate for Payer: UnitedHealthcare Commercial	$502.50

RETRACTOR RIGHT ANGLED 43MM

Facility

$1,105.00

Hospital Charge Code	270692074
Hospital Revenue Code	272
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

RETRACTOR RIGHT ANGLED 43MM

Facility

$1,105.00

Hospital Charge Code	270692074
Hospital Revenue Code	272
Min. Negotiated Rate	$143.65
Max. Negotiated Rate	$552.50
Rate for Payer: Aetna Commercial	$331.50
Rate for Payer: Aetna Medicare Advantage	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.77
Rate for Payer: Cigna Commercial	$552.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.65
Rate for Payer: Oxford Commercial	$552.50
Rate for Payer: Qualcare PPO/HMO/WC	$165.75
Rate for Payer: UnitedHealthcare Commercial	$552.50

RETRACTOR RING 14.1 CM X 14.1C

Facility

$376.52

Hospital Charge Code	270679363
Hospital Revenue Code	272
Min. Negotiated Rate	$56.48
Max. Negotiated Rate	$56.48
Rate for Payer: Qualcare PPO/HMO/WC	$56.48

RETRACTOR RING 14.1 CM X 14.1C

Facility

$376.52

Hospital Charge Code	270679363
Hospital Revenue Code	272
Min. Negotiated Rate	$48.95
Max. Negotiated Rate	$188.26
Rate for Payer: Aetna Commercial	$112.96
Rate for Payer: Aetna Medicare Advantage	$112.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.01
Rate for Payer: Cigna Commercial	$188.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.95
Rate for Payer: Oxford Commercial	$188.26
Rate for Payer: Qualcare PPO/HMO/WC	$56.48
Rate for Payer: UnitedHealthcare Commercial	$188.26

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$23.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.39

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$20.27
Max. Negotiated Rate	$77.97
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$46.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.77
Rate for Payer: Cigna Commercial	$77.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.27
Rate for Payer: Oxford Commercial	$77.97
Rate for Payer: Qualcare PPO/HMO/WC	$23.39
Rate for Payer: UnitedHealthcare Commercial	$77.97

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$49.75
Max. Negotiated Rate	$49.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.75

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$43.11
Max. Negotiated Rate	$165.82
Rate for Payer: Aetna Commercial	$99.50
Rate for Payer: Aetna Medicare Advantage	$99.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.57
Rate for Payer: Cigna Commercial	$165.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.11
Rate for Payer: Oxford Commercial	$165.82
Rate for Payer: Qualcare PPO/HMO/WC	$49.75
Rate for Payer: UnitedHealthcare Commercial	$165.82

RETRACTOR SURGICAL 3308G

Facility

$323.25

Hospital Charge Code	270608600
Hospital Revenue Code	272
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

RETRACTOR SURGICAL 3308G

Facility

$323.25

Hospital Charge Code	270608600
Hospital Revenue Code	272
Min. Negotiated Rate	$42.02
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$96.97
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.02
Rate for Payer: Oxford Commercial	$161.62
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$161.62

RETRACTOR SURGICAL 3308G******

Facility

$168.00

Hospital Charge Code	608600
Hospital Revenue Code	272
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

Know your out-of-pocket cost for care.

All Charges