Heights University Hospital

All Charges

Charge

Type

Setting

Price

SLEEVES SEQUENTIAL KNEE 5329

Facility

$89.10

Hospital Charge Code	270628822
Hospital Revenue Code	271
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$44.55
Rate for Payer: Aetna Commercial	$26.73
Rate for Payer: Aetna Medicare Advantage	$26.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.72
Rate for Payer: Cigna Commercial	$44.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.58
Rate for Payer: Oxford Commercial	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$13.37
Rate for Payer: UnitedHealthcare Commercial	$44.55

SLEEVES SEQUENTIAL KNEE 5329

Facility

$89.10

Hospital Charge Code	270628822
Hospital Revenue Code	271
Min. Negotiated Rate	$13.37
Max. Negotiated Rate	$13.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.37

SLEEVE STABILITY 5Dx100L CB5LT

Facility

$80.00

Hospital Charge Code	270641083
Hospital Revenue Code	272
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$40.00

SLEEVE STABILITY 5Dx100L CB5LT

Facility

$80.00

Hospital Charge Code	270641083
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

SLEEVE STABILITY XCEL 5mm

Facility

$381.90

Hospital Charge Code	270655638
Hospital Revenue Code	271
Min. Negotiated Rate	$49.65
Max. Negotiated Rate	$190.95
Rate for Payer: Aetna Commercial	$114.57
Rate for Payer: Aetna Medicare Advantage	$114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.38
Rate for Payer: Cigna Commercial	$190.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.65
Rate for Payer: Oxford Commercial	$190.95
Rate for Payer: Qualcare PPO/HMO/WC	$57.28
Rate for Payer: UnitedHealthcare Commercial	$190.95

SLEEVE STABILITY XCEL 5mm

Facility

$381.90

Hospital Charge Code	270655638
Hospital Revenue Code	271
Min. Negotiated Rate	$57.28
Max. Negotiated Rate	$57.28
Rate for Payer: Qualcare PPO/HMO/WC	$57.28

SLEEVE SUCTION 165 MM

Facility

$207.40

Hospital Charge Code	270689275
Hospital Revenue Code	272
Min. Negotiated Rate	$26.96
Max. Negotiated Rate	$103.70
Rate for Payer: Aetna Commercial	$62.22
Rate for Payer: Aetna Medicare Advantage	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.89
Rate for Payer: Cigna Commercial	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.96
Rate for Payer: Oxford Commercial	$103.70
Rate for Payer: Qualcare PPO/HMO/WC	$31.11
Rate for Payer: UnitedHealthcare Commercial	$103.70

SLEEVE SUCTION 165 MM

Facility

$207.40

Hospital Charge Code	270689275
Hospital Revenue Code	272
Min. Negotiated Rate	$31.11
Max. Negotiated Rate	$31.11
Rate for Payer: Qualcare PPO/HMO/WC	$31.11

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$17.15
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$17.15

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$17.15
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$17.15

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	2709002931
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	2709002931
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$17.15
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$17.15

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$17.15
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$17.15

SLEEVE SYN LOCK 120DEG 456012S

Facility

$1,349.65

Hospital Charge Code	270611966
Hospital Revenue Code	272
Min. Negotiated Rate	$202.45
Max. Negotiated Rate	$202.45
Rate for Payer: Qualcare PPO/HMO/WC	$202.45

SLEEVE SYN LOCK 120DEG 456012S

Facility

$1,349.65

Hospital Charge Code	270611966
Hospital Revenue Code	272
Min. Negotiated Rate	$175.45
Max. Negotiated Rate	$674.83
Rate for Payer: Aetna Commercial	$404.89
Rate for Payer: Aetna Medicare Advantage	$404.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.16
Rate for Payer: Cigna Commercial	$674.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Oxford Commercial	$674.83
Rate for Payer: Qualcare PPO/HMO/WC	$202.45
Rate for Payer: UnitedHealthcare Commercial	$674.83

SLEEVE TIBIA MOD PROX OSS 30

Facility

$19,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697009
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$5,850.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

SLEEVE TIBIA MOD PROX OSS 30

Facility

$19,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697009
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

SLEEVE TROCAR 5 VERSAPT 177092

Facility

$49.65

Hospital Charge Code	270635098
Hospital Revenue Code	272
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

SLEEVE TROCAR 5 VERSAPT 177092

Facility

$49.65

Hospital Charge Code	270635098
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$24.82
Rate for Payer: Aetna Commercial	$14.89
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.45
Rate for Payer: Oxford Commercial	$24.82
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$24.82

SLEEVE TROCAR XCEL STABIL 12MM

Facility

$90.00

Hospital Charge Code	270641082
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SLEEVE TROCAR XCEL STABIL 12MM

Facility

$90.00

Hospital Charge Code	270641082
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

SLEEVE UNIPOLAR L-SERIES +0MM

Facility

$1,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270677229
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

Know your out-of-pocket cost for care.

All Charges