Heights University Hospital

All Charges

Charge

Type

Setting

Price

SEALANT DURASEAL SYTEM 5ML

Facility

$3,450.00

Hospital Charge Code	270659411
Hospital Revenue Code	270
Min. Negotiated Rate	$448.50
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,035.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.50
Rate for Payer: Oxford Commercial	$1,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.50
Rate for Payer: UnitedHealthcare Commercial	$1,725.00

SEALANT DURASEAL SYTEM 5ML

Facility

$3,450.00

Hospital Charge Code	270659411
Hospital Revenue Code	270
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$517.50
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

SEALANT FIBRIN 1501238 10ML

Facility

$2,674.00

Hospital Charge Code	270612219
Hospital Revenue Code	272
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$1,337.00
Rate for Payer: Aetna Commercial	$802.20
Rate for Payer: Aetna Medicare Advantage	$802.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$681.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$681.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$681.87
Rate for Payer: Cigna Commercial	$1,337.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.62
Rate for Payer: Oxford Commercial	$1,337.00
Rate for Payer: Qualcare PPO/HMO/WC	$401.10
Rate for Payer: UnitedHealthcare Commercial	$1,337.00

SEALANT FIBRIN 1501238 10ML

Facility

$2,674.00

Hospital Charge Code	270612219
Hospital Revenue Code	272
Min. Negotiated Rate	$401.10
Max. Negotiated Rate	$401.10
Rate for Payer: Qualcare PPO/HMO/WC	$401.10

SEALANT FIBRIN TISSEAL 4ML

Facility

$1,126.90

Hospital Charge Code	270617194
Hospital Revenue Code	272
Min. Negotiated Rate	$146.50
Max. Negotiated Rate	$563.45
Rate for Payer: Aetna Commercial	$338.07
Rate for Payer: Aetna Medicare Advantage	$338.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.36
Rate for Payer: Cigna Commercial	$563.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.50
Rate for Payer: Oxford Commercial	$563.45
Rate for Payer: Qualcare PPO/HMO/WC	$169.03
Rate for Payer: UnitedHealthcare Commercial	$563.45

SEALANT FIBRIN TISSEAL 4ML

Facility

$1,126.90

Hospital Charge Code	270617194
Hospital Revenue Code	272
Min. Negotiated Rate	$169.03
Max. Negotiated Rate	$169.03
Rate for Payer: Qualcare PPO/HMO/WC	$169.03

SEALANT PLATELET ANGL ANPLA100

Facility

$2,340.00

Hospital Charge Code	270639728
Hospital Revenue Code	278
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$566.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

SEALANT PLATELET ANGL ANPLA100

Facility

$2,340.00

Hospital Charge Code	270639728
Hospital Revenue Code	278
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$702.00
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

SEAL CANNULA 8 MM

Facility

$75.00

Hospital Charge Code	270666216
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SEAL CANNULA 8 MM

Facility

$75.00

Hospital Charge Code	270666216
Hospital Revenue Code	270
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

SEAL CANNULA STAPLER

Facility

$100.00

Hospital Charge Code	270666138
Hospital Revenue Code	270
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

SEAL CANNULA STAPLER

Facility

$100.00

Hospital Charge Code	270666138
Hospital Revenue Code	270
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

SEAL CCN CYSTO BIOPSY CS-W7S

Facility

$63.25

Hospital Charge Code	270629071
Hospital Revenue Code	272
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$18.98
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$31.62

SEAL CCN CYSTO BIOPSY CS-W7S

Facility

$63.25

Hospital Charge Code	270629071
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

SEAL EAKIN COHESIVE 2

Facility

$11.85

Hospital Charge Code	270631880
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$3.56
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.54
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$5.92

SEAL EAKIN COHESIVE 2

Facility

$11.85

Hospital Charge Code	270631880
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

SEAL EAKIN COHESIVE 4

Facility

$12.03

Hospital Charge Code	270631879
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.01
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$3.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.07
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.01

SEAL EAKIN COHESIVE 4

Facility

$12.03

Hospital Charge Code	270631879
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SEALED CONTAINER W/LID LONG SI

Facility

$3,405.00

Hospital Charge Code	270665558
Hospital Revenue Code	270
Min. Negotiated Rate	$442.65
Max. Negotiated Rate	$1,702.50
Rate for Payer: Aetna Commercial	$1,021.50
Rate for Payer: Aetna Medicare Advantage	$1,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.27
Rate for Payer: Cigna Commercial	$1,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.65
Rate for Payer: Oxford Commercial	$1,702.50
Rate for Payer: Qualcare PPO/HMO/WC	$510.75
Rate for Payer: UnitedHealthcare Commercial	$1,702.50

SEALED CONTAINER W/LID LONG SI

Facility

$3,405.00

Hospital Charge Code	270665558
Hospital Revenue Code	270
Min. Negotiated Rate	$510.75
Max. Negotiated Rate	$510.75
Rate for Payer: Qualcare PPO/HMO/WC	$510.75

SEALED LEAD ACID BATTERY

Facility

$345.60

Hospital Charge Code	27065603
Hospital Revenue Code	271
Min. Negotiated Rate	$51.84
Max. Negotiated Rate	$51.84
Rate for Payer: Qualcare PPO/HMO/WC	$51.84

SEALED LEAD ACID BATTERY

Facility

$345.60

Hospital Charge Code	27065603
Hospital Revenue Code	271
Min. Negotiated Rate	$44.93
Max. Negotiated Rate	$172.80
Rate for Payer: Aetna Commercial	$103.68
Rate for Payer: Aetna Medicare Advantage	$103.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.13
Rate for Payer: Cigna Commercial	$172.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.93
Rate for Payer: Oxford Commercial	$172.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.84
Rate for Payer: UnitedHealthcare Commercial	$172.80

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.25
Rate for Payer: Oxford Commercial	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$1,312.50

SEALING DUETT 624227

Facility

$1,000.00

Service Code	HCPCS C1760
Hospital Charge Code	270624227
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges