Heights University Hospital

All Charges

Charge

Type

Setting

Price

RETRIEVER MCV BALLN 11.5 4545

Facility

$739.25

Hospital Charge Code	270627943
Hospital Revenue Code	272
Min. Negotiated Rate	$110.89
Max. Negotiated Rate	$110.89
Rate for Payer: Qualcare PPO/HMO/WC	$110.89

RETRIEVER MCV BALLN 11.5 4545

Facility

$739.25

Hospital Charge Code	270627943
Hospital Revenue Code	272
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$369.62
Rate for Payer: Aetna Commercial	$221.78
Rate for Payer: Aetna Medicare Advantage	$221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.51
Rate for Payer: Cigna Commercial	$369.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.10
Rate for Payer: Oxford Commercial	$369.62
Rate for Payer: Qualcare PPO/HMO/WC	$110.89
Rate for Payer: UnitedHealthcare Commercial	$369.62

RETRIEVER MCV BALLN 8.5 4544

Facility

$739.10

Hospital Charge Code	270627944
Hospital Revenue Code	272
Min. Negotiated Rate	$110.86
Max. Negotiated Rate	$110.86
Rate for Payer: Qualcare PPO/HMO/WC	$110.86

RETRIEVER MCV BALLN 8.5 4544

Facility

$739.10

Hospital Charge Code	270627944
Hospital Revenue Code	272
Min. Negotiated Rate	$96.08
Max. Negotiated Rate	$369.55
Rate for Payer: Aetna Commercial	$221.73
Rate for Payer: Aetna Medicare Advantage	$221.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.47
Rate for Payer: Cigna Commercial	$369.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.08
Rate for Payer: Oxford Commercial	$369.55
Rate for Payer: Qualcare PPO/HMO/WC	$110.86
Rate for Payer: UnitedHealthcare Commercial	$369.55

RETRIEVER NET ROTH 2.5mm 230cm

Facility

$500.00

Hospital Charge Code	270684082
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

RETRIEVER NET ROTH 2.5mm 230cm

Facility

$500.00

Hospital Charge Code	270684082
Hospital Revenue Code	272
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

RETRIEVER SUTURE HEWSON 10.1L

Facility

$324.00

Hospital Charge Code	270644147
Hospital Revenue Code	272
Min. Negotiated Rate	$42.12
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$97.20
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$162.00

RETRIEVER SUTURE HEWSON 10.1L

Facility

$324.00

Hospital Charge Code	270644147
Hospital Revenue Code	272
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

RETRIEV POSITRAP BASKET

Facility

$456.00

Hospital Charge Code	270606230
Hospital Revenue Code	270
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Qualcare PPO/HMO/WC	$68.40

RETRIEV POSITRAP BASKET

Facility

$456.00

Hospital Charge Code	270606230
Hospital Revenue Code	270
Min. Negotiated Rate	$59.28
Max. Negotiated Rate	$228.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$136.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.28
Rate for Payer: Cigna Commercial	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.28
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.40
Rate for Payer: UnitedHealthcare Commercial	$228.00

RETRIVAL SNARE SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684733
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

RETRIVAL SNARE SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684733
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$321.75
Rate for Payer: Qualcare PPO/HMO/WC	$321.75

RETROBULBAR NEEDLE 25G.

Facility

$48.00

Hospital Charge Code	270331702
Hospital Revenue Code	272
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.00

RETROBULBAR NEEDLE 25G.

Facility

$48.00

Hospital Charge Code	270331702
Hospital Revenue Code	272
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

RETROGRADE PYELOGRAM

Facility

$2,469.00

Service Code	HCPCS 74420
Hospital Charge Code	1600000439
Hospital Revenue Code	360
Min. Negotiated Rate	$320.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$740.70
Rate for Payer: Aetna Medicare Advantage	$740.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.60
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.97
Rate for Payer: Qualcare PPO/HMO/WC	$370.35

RETROGRADE PYELOGRAM

Facility

$2,469.00

Service Code	HCPCS 74420
Hospital Charge Code	1600000439
Hospital Revenue Code	360
Min. Negotiated Rate	$370.35
Max. Negotiated Rate	$370.35
Rate for Payer: Qualcare PPO/HMO/WC	$370.35

RETRO INJ URETHRA

Facility

$988.84

Service Code	HCPCS 51610
Hospital Charge Code	16000996
Hospital Revenue Code	360
Min. Negotiated Rate	$148.33
Max. Negotiated Rate	$148.33
Rate for Payer: Qualcare PPO/HMO/WC	$148.33

RETRO INJ URETHRA

Facility

$988.84

Service Code	HCPCS 51610
Hospital Charge Code	16000996
Hospital Revenue Code	360
Min. Negotiated Rate	$63.36
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$296.65
Rate for Payer: Aetna Medicare Advantage	$296.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.15
Rate for Payer: Cigna Commercial	$63.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.55
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.33
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RETROPERITONEUM/RENAL

Facility

$6,700.00

Service Code	HCPCS 76770
Hospital Charge Code	94061167
Hospital Revenue Code	402
Min. Negotiated Rate	$123.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

RETROPERITONEUM/RENAL

Facility

$6,700.00

Service Code	HCPCS 76770
Hospital Charge Code	94061167
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

RETROVIR/100MG/CAP

Facility

$9.00

Hospital Charge Code	60633822
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

RETROVIR/100MG/CAP

Facility

$14.00

Hospital Charge Code	60633823
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

RETROVIR/100MG/CAP

Facility

$14.00

Hospital Charge Code	60633823
Hospital Revenue Code	250
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$7.00

RETROVIR/100MG/CAP

Facility

$9.00

Hospital Charge Code	60633822
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

RETROVIR/10MG/1ML

Facility

$4.00

Service Code	NDC 65862004824
Hospital Charge Code	60633821
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges