Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIZER CONTOUR 175CC 350-175S

Facility

$414.45

Hospital Charge Code	270615793
Hospital Revenue Code	272
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$207.22
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$207.22

SIZER CONTOUR 350CC 350-0172S

Facility

$346.45

Hospital Charge Code	270614002
Hospital Revenue Code	272
Min. Negotiated Rate	$45.04
Max. Negotiated Rate	$173.22
Rate for Payer: Aetna Commercial	$103.94
Rate for Payer: Aetna Medicare Advantage	$103.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$173.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.04
Rate for Payer: Oxford Commercial	$173.22
Rate for Payer: Qualcare PPO/HMO/WC	$51.97
Rate for Payer: UnitedHealthcare Commercial	$173.22

SIZER CONTOUR 350CC 350-0172S

Facility

$346.45

Hospital Charge Code	270614002
Hospital Revenue Code	272
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$51.97
Rate for Payer: Qualcare PPO/HMO/WC	$51.97

SIZER CONTOUR CC 350-0711S

Facility

$231.25

Hospital Charge Code	270613848
Hospital Revenue Code	272
Min. Negotiated Rate	$30.06
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$69.38
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$115.62
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$115.62

SIZER CONTOUR CC 350-0711S

Facility

$231.25

Hospital Charge Code	270613848
Hospital Revenue Code	272
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

SIZER CONTR VOL 450cc 3500713S

Facility

$223.25

Hospital Charge Code	270614097
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTR VOL 450cc 3500713S

Facility

$223.25

Hospital Charge Code	270614097
Hospital Revenue Code	272
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.02
Rate for Payer: Oxford Commercial	$111.62
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$111.62

SIZER CONTR VOL 550cc 3500714S

Facility

$223.25

Hospital Charge Code	270614649
Hospital Revenue Code	272
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.02
Rate for Payer: Oxford Commercial	$111.62
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$111.62

SIZER CONTR VOL 550cc 3500714S

Facility

$223.25

Hospital Charge Code	270614649
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTUR VOL 225CC 350225S

Facility

$223.25

Hospital Charge Code	270621088
Hospital Revenue Code	272
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.02
Rate for Payer: Oxford Commercial	$111.62
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$111.62

SIZER CONTUR VOL 225CC 350225S

Facility

$223.25

Hospital Charge Code	270621088
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER EXTRA HIGH PROFILE 500cc

Facility

$1,000.00

Hospital Charge Code	270673558
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SIZER EXTRA HIGH PROFILE 500cc

Facility

$1,000.00

Hospital Charge Code	270673558
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

SIZER EXTRA HIGH PROFILE 550CC

Facility

$1,000.00

Hospital Charge Code	270673559
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SIZER EXTRA HIGH PROFILE 550CC

Facility

$1,000.00

Hospital Charge Code	270673559
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

SIZER EXTRA HIGH PROFILE 600CC

Facility

$1,000.00

Hospital Charge Code	270673560
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

SIZER EXTRA HIGH PROFILE 600CC

Facility

$1,000.00

Hospital Charge Code	270673560
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SIZER FLX HNG TOE 5-0 446-0150

Facility

$421.65

Hospital Charge Code	270622838
Hospital Revenue Code	272
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$126.50
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.81
Rate for Payer: Oxford Commercial	$210.82
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$210.82

SIZER FLX HNG TOE 5-0 446-0150

Facility

$421.65

Hospital Charge Code	270622838
Hospital Revenue Code	272
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SIZER FUSEFORCE STAPLER

Facility

$735.00

Hospital Charge Code	270700797
Hospital Revenue Code	272
Min. Negotiated Rate	$95.55
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$220.50
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.55
Rate for Payer: Oxford Commercial	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Commercial	$367.50

SIZER FUSEFORCE STAPLER

Facility

$735.00

Hospital Charge Code	270700797
Hospital Revenue Code	272
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$110.25
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

SIZER HIGH PROFILE 400cc

Facility

$1,000.00

Hospital Charge Code	270673561
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SIZER HIGH PROFILE 400cc

Facility

$1,000.00

Hospital Charge Code	270673561
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

SIZER HIGH PROFILE 425cc

Facility

$1,000.00

Hospital Charge Code	270673562
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SIZER HIGH PROFILE 425cc

Facility

$1,000.00

Hospital Charge Code	270673562
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