Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SLEEVE USSC VERASTEP VS101000

Facility

$262.45

Hospital Charge Code	270624150
Hospital Revenue Code	272
Min. Negotiated Rate	$39.37
Max. Negotiated Rate	$39.37
Rate for Payer: Qualcare PPO/HMO/WC	$39.37

SLEEVE USSC VERASTEP VS101000

Facility

$262.45

Hospital Charge Code	270624150
Hospital Revenue Code	272
Min. Negotiated Rate	$34.12
Max. Negotiated Rate	$131.22
Rate for Payer: Aetna Commercial	$78.73
Rate for Payer: Aetna Medicare Advantage	$78.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.92
Rate for Payer: Cigna Commercial	$131.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.12
Rate for Payer: Oxford Commercial	$131.22
Rate for Payer: Qualcare PPO/HMO/WC	$39.37
Rate for Payer: UnitedHealthcare Commercial	$131.22

SLEEVE VENODYNE STANDARD

Facility

$202.96

Hospital Charge Code	270653362
Hospital Revenue Code	272
Min. Negotiated Rate	$30.44
Max. Negotiated Rate	$30.44
Rate for Payer: Qualcare PPO/HMO/WC	$30.44

SLEEVE VENODYNE STANDARD

Facility

$202.96

Hospital Charge Code	270653362
Hospital Revenue Code	272
Min. Negotiated Rate	$26.38
Max. Negotiated Rate	$101.48
Rate for Payer: Aetna Commercial	$60.89
Rate for Payer: Aetna Medicare Advantage	$60.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.75
Rate for Payer: Cigna Commercial	$101.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.38
Rate for Payer: Oxford Commercial	$101.48
Rate for Payer: Qualcare PPO/HMO/WC	$30.44
Rate for Payer: UnitedHealthcare Commercial	$101.48

SLENDER GLIDESHEALTH 5FR 10x4C

Facility

$2,600.00

Hospital Charge Code	270705457
Hospital Revenue Code	279
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$390.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

SLENDER GLIDESHEALTH 5FR 10x4C

Facility

$2,600.00

Hospital Charge Code	270705457
Hospital Revenue Code	279
Min. Negotiated Rate	$338.00
Max. Negotiated Rate	$1,300.00
Rate for Payer: Aetna Commercial	$780.00
Rate for Payer: Aetna Medicare Advantage	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$663.00
Rate for Payer: Cigna Commercial	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.00
Rate for Payer: Oxford Commercial	$1,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00
Rate for Payer: UnitedHealthcare Commercial	$1,300.00

SLIMLINE FIBER LUMENIS 365

Facility

$2,018.75

Hospital Charge Code	270659482
Hospital Revenue Code	270
Min. Negotiated Rate	$302.81
Max. Negotiated Rate	$302.81
Rate for Payer: Qualcare PPO/HMO/WC	$302.81

SLIMLINE FIBER LUMENIS 365

Facility

$2,018.75

Hospital Charge Code	270659482
Hospital Revenue Code	270
Min. Negotiated Rate	$262.44
Max. Negotiated Rate	$1,009.38
Rate for Payer: Aetna Commercial	$605.62
Rate for Payer: Aetna Medicare Advantage	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$514.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$514.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$514.78
Rate for Payer: Cigna Commercial	$1,009.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.44
Rate for Payer: Oxford Commercial	$1,009.38
Rate for Payer: Qualcare PPO/HMO/WC	$302.81
Rate for Payer: UnitedHealthcare Commercial	$1,009.38

SLIMLINE LASER FIBER LEMENIS

Facility

$4,462.50

Hospital Charge Code	270659488
Hospital Revenue Code	270
Min. Negotiated Rate	$580.12
Max. Negotiated Rate	$2,231.25
Rate for Payer: Aetna Commercial	$1,338.75
Rate for Payer: Aetna Medicare Advantage	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.94
Rate for Payer: Cigna Commercial	$2,231.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.12
Rate for Payer: Oxford Commercial	$2,231.25
Rate for Payer: Qualcare PPO/HMO/WC	$669.38
Rate for Payer: UnitedHealthcare Commercial	$2,231.25

SLIMLINE LASER FIBER LEMENIS

Facility

$4,462.50

Hospital Charge Code	270659488
Hospital Revenue Code	270
Min. Negotiated Rate	$669.38
Max. Negotiated Rate	$669.38
Rate for Payer: Qualcare PPO/HMO/WC	$669.38

SLIMPORT LO PROFILE W/6FR CATH

Facility

$1.00

Hospital Charge Code	270644686
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

SLIMPORT LO PROFILE W/6FR CATH

Facility

$1.00

Hospital Charge Code	270644686
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

SLIM TIP DRG LEAD TRIAL KIT

Facility

$35,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270697674
Hospital Revenue Code	278
Min. Negotiated Rate	$5,325.00
Max. Negotiated Rate	$17,750.00
Rate for Payer: Aetna Commercial	$10,650.00
Rate for Payer: Aetna Medicare Advantage	$10,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,052.50
Rate for Payer: Cigna Commercial	$17,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,325.00

SLIM TIP DRG LEAD TRIAL KIT

Facility

$35,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270697674
Hospital Revenue Code	278
Min. Negotiated Rate	$5,325.00
Max. Negotiated Rate	$8,591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,325.00

SLING ALTIS SNGL INCISION SYST

Facility

$6,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270676744
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SLING ALTIS SNGL INCISION SYST

Facility

$6,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270676744
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SLING ARM LARGE

Facility

$7.55

Hospital Charge Code	270649357
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$3.77

SLING ARM LARGE

Facility

$7.55

Hospital Charge Code	270649357
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM MEDIUM

Facility

$7.55

Hospital Charge Code	270649358
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$3.77

SLING ARM MEDIUM

Facility

$7.55

Hospital Charge Code	270649358
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM SMALL

Facility

$7.55

Hospital Charge Code	270649359
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM SMALL

Facility

$7.55

Hospital Charge Code	270649359
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$3.77

SLING ARM X-LARGE

Facility

$7.55

Hospital Charge Code	270649360
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM X-LARGE

Facility

$7.55

Hospital Charge Code	270649360
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$3.77

Know your out-of-pocket cost for care.

All Charges