Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROTAVIRUS VACCINE, LIVE ORAL

Facility

$855.79

Service Code	HCPCS 90680
Hospital Charge Code	606350976
Hospital Revenue Code	636
Min. Negotiated Rate	$49.16
Max. Negotiated Rate	$427.89
Rate for Payer: Aetna Commercial	$256.74
Rate for Payer: Aetna Medicare Advantage	$256.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.23
Rate for Payer: Cigna Commercial	$427.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.37

ROTAVIRUS VACCINE, LIVE ORAL

Facility

$855.79

Service Code	HCPCS 90680
Hospital Charge Code	606350976
Hospital Revenue Code	636
Min. Negotiated Rate	$128.37
Max. Negotiated Rate	$207.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.37

ROTH NET

Facility

$94.00

Hospital Charge Code	270325612
Hospital Revenue Code	272
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$28.20
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$47.00

ROTH NET

Facility

$94.00

Hospital Charge Code	270325612
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270670091
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.25
Rate for Payer: Oxford Commercial	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$262.50

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270670091
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270658151
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.25
Rate for Payer: Oxford Commercial	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$262.50

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270658151
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

ROTICULATOR 55 3.5 4.8 POLY***

Facility

$546.00

Hospital Charge Code	1600964
Hospital Revenue Code	272
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.90

ROTICULATOR 55 3.5 4.8 POLY***

Facility

$546.00

Hospital Charge Code	1600964
Hospital Revenue Code	272
Min. Negotiated Rate	$70.98
Max. Negotiated Rate	$273.00
Rate for Payer: Aetna Commercial	$163.80
Rate for Payer: Aetna Medicare Advantage	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.23
Rate for Payer: Cigna Commercial	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.98
Rate for Payer: Oxford Commercial	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.90
Rate for Payer: UnitedHealthcare Commercial	$273.00

ROTICULATOR 55-3.5 STAPLER

Facility

$948.00

Hospital Charge Code	270334752
Hospital Revenue Code	272
Min. Negotiated Rate	$123.24
Max. Negotiated Rate	$474.00
Rate for Payer: Aetna Commercial	$284.40
Rate for Payer: Aetna Medicare Advantage	$284.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.74
Rate for Payer: Cigna Commercial	$474.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.24
Rate for Payer: Oxford Commercial	$474.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.20
Rate for Payer: UnitedHealthcare Commercial	$474.00

ROTICULATOR 55-3.5 STAPLER

Facility

$948.00

Hospital Charge Code	270334752
Hospital Revenue Code	272
Min. Negotiated Rate	$142.20
Max. Negotiated Rate	$142.20
Rate for Payer: Qualcare PPO/HMO/WC	$142.20

ROTICULATOR ENDO GIA 60-2.5

Facility

$973.03

Hospital Charge Code	270660574
Hospital Revenue Code	272
Min. Negotiated Rate	$126.49
Max. Negotiated Rate	$486.51
Rate for Payer: Aetna Commercial	$291.91
Rate for Payer: Aetna Medicare Advantage	$291.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.12
Rate for Payer: Cigna Commercial	$486.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.49
Rate for Payer: Oxford Commercial	$486.51
Rate for Payer: Qualcare PPO/HMO/WC	$145.95
Rate for Payer: UnitedHealthcare Commercial	$486.51

ROTICULATOR ENDO GIA 60-2.5

Facility

$973.03

Hospital Charge Code	270660574
Hospital Revenue Code	272
Min. Negotiated Rate	$145.95
Max. Negotiated Rate	$145.95
Rate for Payer: Qualcare PPO/HMO/WC	$145.95

ROTICULATOR GIA 60mm 4.5 SULU

Facility

$1,021.63

Hospital Charge Code	270655597
Hospital Revenue Code	271
Min. Negotiated Rate	$132.81
Max. Negotiated Rate	$510.81
Rate for Payer: Aetna Commercial	$306.49
Rate for Payer: Aetna Medicare Advantage	$306.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.81
Rate for Payer: Oxford Commercial	$510.81
Rate for Payer: Qualcare PPO/HMO/WC	$153.24
Rate for Payer: UnitedHealthcare Commercial	$510.81

ROTICULATOR GIA 60mm 4.5 SULU

Facility

$1,021.63

Hospital Charge Code	270655597
Hospital Revenue Code	271
Min. Negotiated Rate	$153.24
Max. Negotiated Rate	$153.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.24

ROTOVIRUS AG

Facility

$75.65

Service Code	HCPCS 87425
Hospital Charge Code	39900450
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

ROTOVIRUS AG

Facility

$75.65

Service Code	HCPCS 87425
Hospital Charge Code	39900450
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

ROUND CERAMIC BOXES

Facility

$64.95

Hospital Charge Code	270663157
Hospital Revenue Code	270
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$32.48
Rate for Payer: Aetna Commercial	$19.48
Rate for Payer: Aetna Medicare Advantage	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.56
Rate for Payer: Cigna Commercial	$32.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.44
Rate for Payer: Oxford Commercial	$32.48
Rate for Payer: Qualcare PPO/HMO/WC	$9.74
Rate for Payer: UnitedHealthcare Commercial	$32.48

ROUND CERAMIC BOXES

Facility

$64.95

Hospital Charge Code	270663157
Hospital Revenue Code	270
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.74

ROUTER ATK FEMORAL

Facility

$2,966.45

Hospital Charge Code	270621076
Hospital Revenue Code	272
Min. Negotiated Rate	$444.97
Max. Negotiated Rate	$444.97
Rate for Payer: Qualcare PPO/HMO/WC	$444.97

ROUTER ATK FEMORAL

Facility

$2,966.45

Hospital Charge Code	270621076
Hospital Revenue Code	272
Min. Negotiated Rate	$385.64
Max. Negotiated Rate	$1,483.22
Rate for Payer: Aetna Commercial	$889.93
Rate for Payer: Aetna Medicare Advantage	$889.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.44
Rate for Payer: Cigna Commercial	$1,483.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.64
Rate for Payer: Oxford Commercial	$1,483.22
Rate for Payer: Qualcare PPO/HMO/WC	$444.97
Rate for Payer: UnitedHealthcare Commercial	$1,483.22

ROUTER STRAIGHT MED 1.2x6MM

Facility

$471.50

Hospital Charge Code	270673356
Hospital Revenue Code	272
Min. Negotiated Rate	$61.30
Max. Negotiated Rate	$235.75
Rate for Payer: Aetna Commercial	$141.45
Rate for Payer: Aetna Medicare Advantage	$141.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.23
Rate for Payer: Cigna Commercial	$235.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.30
Rate for Payer: Oxford Commercial	$235.75
Rate for Payer: Qualcare PPO/HMO/WC	$70.72
Rate for Payer: UnitedHealthcare Commercial	$235.75

ROUTER STRAIGHT MED 1.2x6MM

Facility

$471.50

Hospital Charge Code	270673356
Hospital Revenue Code	272
Min. Negotiated Rate	$70.72
Max. Negotiated Rate	$70.72
Rate for Payer: Qualcare PPO/HMO/WC	$70.72

ROUTER TAPER

Facility

$640.00

Hospital Charge Code	270673070
Hospital Revenue Code	272
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

Know your out-of-pocket cost for care.

All Charges