Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIZE 3 C,D 10MM MONOBLOCK TM

Facility

$12,048.30

Hospital Charge Code	270657097
Hospital Revenue Code	278
Min. Negotiated Rate	$1,807.24
Max. Negotiated Rate	$6,024.15
Rate for Payer: Aetna Commercial	$3,614.49
Rate for Payer: Aetna Medicare Advantage	$3,614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,072.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,072.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,072.32
Rate for Payer: Cigna Commercial	$6,024.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,915.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,807.24

SIZE .5 (A105-20122118-0/0)

Facility

$4,475.00

Hospital Charge Code	270662434
Hospital Revenue Code	270
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

SIZE .5 (A105-20122118-0/0)

Facility

$4,475.00

Hospital Charge Code	270662434
Hospital Revenue Code	270
Min. Negotiated Rate	$581.75
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$581.75
Rate for Payer: Oxford Commercial	$2,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$2,237.50

SIZE 6 LEFT LPS FLEX

Facility

$11,724.30

Hospital Charge Code	270657099
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$2,837.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE 6 LEFT LPS FLEX

Facility

$11,724.30

Hospital Charge Code	270657099
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$3,517.29
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE 8 OR 10 **********

Facility

$34.00

Hospital Charge Code	8002792
Hospital Revenue Code	279
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

SIZE 8 OR 10 **********

Facility

$34.00

Hospital Charge Code	8002792
Hospital Revenue Code	279
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$17.00

SIZE C 6ST GSF-FLEX

Facility

$12,166.15

Hospital Charge Code	270657100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE C 6ST GSF-FLEX

Facility

$12,166.15

Hospital Charge Code	270657100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$3,649.84
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE C,D 17MM 3,4 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657104
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C,D 17MM 3,4 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657104
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C D 17MM POLY IMMUT -5, 6

Facility

$5,862.10

Hospital Charge Code	270657101
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C D 17MM POLY IMMUT -5, 6

Facility

$5,862.10

Hospital Charge Code	270657101
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C,D 20MM 1,2 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657105
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C,D 20MM 1,2 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657105
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$2,837.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE C LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$3,517.29
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE C RIGHT 9SF

Facility

$12,166.15

Hospital Charge Code	270657103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE C RIGHT 9SF

Facility

$12,166.15

Hospital Charge Code	270657103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$3,649.84
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE D LEFT LCCK

Facility

$28,661.45

Hospital Charge Code	270657106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$6,936.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

SIZE D LEFT LCCK

Facility

$28,661.45

Hospital Charge Code	270657106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$14,330.73
Rate for Payer: Aetna Commercial	$8,598.43
Rate for Payer: Aetna Medicare Advantage	$8,598.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,308.67
Rate for Payer: Cigna Commercial	$14,330.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

SIZE D RIGHT 65F

Facility

$12,166.15

Hospital Charge Code	270657107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE D RIGHT 65F

Facility

$12,166.15

Hospital Charge Code	270657107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$3,649.84
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE D RIGHT LCCK

Facility

$28,661.45

Hospital Charge Code	270657109
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$6,936.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

SIZE D RIGHT LCCK

Facility

$28,661.45

Hospital Charge Code	270657109
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$14,330.73
Rate for Payer: Aetna Commercial	$8,598.43
Rate for Payer: Aetna Medicare Advantage	$8,598.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,308.67
Rate for Payer: Cigna Commercial	$14,330.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

Know your out-of-pocket cost for care.

All Charges