Heights University Hospital

All Charges

Charge

Type

Setting

Price

RETRACTOR SURGICAL 3308G******

Facility

$168.00

Hospital Charge Code	608600
Hospital Revenue Code	272
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$50.40
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$84.00

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.23
Rate for Payer: Oxford Commercial	$62.42
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$62.42

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$122.22
Max. Negotiated Rate	$470.10
Rate for Payer: Aetna Commercial	$282.06
Rate for Payer: Aetna Medicare Advantage	$282.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.75
Rate for Payer: Cigna Commercial	$470.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.22
Rate for Payer: Oxford Commercial	$470.10
Rate for Payer: Qualcare PPO/HMO/WC	$141.03
Rate for Payer: UnitedHealthcare Commercial	$470.10

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$141.03
Max. Negotiated Rate	$141.03
Rate for Payer: Qualcare PPO/HMO/WC	$141.03

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$50.22
Max. Negotiated Rate	$193.14
Rate for Payer: Aetna Commercial	$115.88
Rate for Payer: Aetna Medicare Advantage	$115.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.50
Rate for Payer: Cigna Commercial	$193.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.22
Rate for Payer: Oxford Commercial	$193.14
Rate for Payer: Qualcare PPO/HMO/WC	$57.94
Rate for Payer: UnitedHealthcare Commercial	$193.14

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$57.94
Rate for Payer: Qualcare PPO/HMO/WC	$57.94

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$71.77
Max. Negotiated Rate	$71.77
Rate for Payer: Qualcare PPO/HMO/WC	$71.77

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$62.20
Max. Negotiated Rate	$239.24
Rate for Payer: Aetna Commercial	$143.54
Rate for Payer: Aetna Medicare Advantage	$143.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.01
Rate for Payer: Cigna Commercial	$239.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.20
Rate for Payer: Oxford Commercial	$239.24
Rate for Payer: Qualcare PPO/HMO/WC	$71.77
Rate for Payer: UnitedHealthcare Commercial	$239.24

RETRACTOR VAGITRAC VAGINAL

Facility

$576.00

Hospital Charge Code	270602692
Hospital Revenue Code	272
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

RETRACTOR VAGITRAC VAGINAL

Facility

$576.00

Hospital Charge Code	270602692
Hospital Revenue Code	272
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.88
Rate for Payer: Oxford Commercial	$288.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$288.00

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$106.67
Max. Negotiated Rate	$410.25
Rate for Payer: Aetna Commercial	$246.15
Rate for Payer: Aetna Medicare Advantage	$246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.23
Rate for Payer: Cigna Commercial	$410.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.67
Rate for Payer: Oxford Commercial	$410.25
Rate for Payer: Qualcare PPO/HMO/WC	$123.08
Rate for Payer: UnitedHealthcare Commercial	$410.25

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$123.08
Max. Negotiated Rate	$123.08
Rate for Payer: Qualcare PPO/HMO/WC	$123.08

RETRCT DEXTR SM ACCESS FLR01

Facility

$1,350.00

Hospital Charge Code	270640478
Hospital Revenue Code	272
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$405.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$675.00

RETRCT DEXTR SM ACCESS FLR01

Facility

$1,350.00

Hospital Charge Code	270640478
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

RETRIEVAL BALLON

Facility

$172.00

Hospital Charge Code	270325610
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RETRIEVAL BALLON

Facility

$172.00

Hospital Charge Code	270325610
Hospital Revenue Code	272
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

RETRIEVAL BASKET SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684734
Hospital Revenue Code	272
Min. Negotiated Rate	$278.85
Max. Negotiated Rate	$1,072.50
Rate for Payer: Aetna Commercial	$643.50
Rate for Payer: Aetna Medicare Advantage	$643.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.98
Rate for Payer: Cigna Commercial	$1,072.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.85
Rate for Payer: Oxford Commercial	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$321.75
Rate for Payer: UnitedHealthcare Commercial	$1,072.50

RETRIEVAL BASKET SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684734
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$321.75
Rate for Payer: Qualcare PPO/HMO/WC	$321.75

RETRIEVER FIBERTAPE

Facility

$7,475.00

Hospital Charge Code	270675963
Hospital Revenue Code	272
Min. Negotiated Rate	$971.75
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.75
Rate for Payer: Oxford Commercial	$3,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$3,737.50

RETRIEVER FIBERTAPE

Facility

$7,475.00

Hospital Charge Code	270675963
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

RETRIEVER LVT SUTUER LG 9894

Facility

$165.95

Hospital Charge Code	270611100
Hospital Revenue Code	272
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$82.97
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.57
Rate for Payer: Oxford Commercial	$82.97
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$82.97

RETRIEVER LVT SUTUER LG 9894

Facility

$165.95

Hospital Charge Code	270611100
Hospital Revenue Code	272
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

RETRIEVER LVT SUTUER SM 9892

Facility

$165.95

Hospital Charge Code	270611101
Hospital Revenue Code	272
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

RETRIEVER LVT SUTUER SM 9892

Facility

$165.95

Hospital Charge Code	270611101
Hospital Revenue Code	272
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$82.97
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.57
Rate for Payer: Oxford Commercial	$82.97
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$82.97

Know your out-of-pocket cost for care.

All Charges