Heights University Hospital

All Charges

Charge

Type

Setting

Price

SNARE POLYPECT DISP *****

Facility

$169.40

Hospital Charge Code	2300705
Hospital Revenue Code	272
Min. Negotiated Rate	$22.02
Max. Negotiated Rate	$84.70
Rate for Payer: Aetna Commercial	$50.82
Rate for Payer: Aetna Medicare Advantage	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.20
Rate for Payer: Cigna Commercial	$84.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Oxford Commercial	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$25.41
Rate for Payer: UnitedHealthcare Commercial	$84.70

SNARE POLYPECT DISP *****

Facility

$169.40

Hospital Charge Code	2300705
Hospital Revenue Code	272
Min. Negotiated Rate	$25.41
Max. Negotiated Rate	$25.41
Rate for Payer: Qualcare PPO/HMO/WC	$25.41

SNARE POLYPECTOMY MICRO 6255

Facility

$193.50

Hospital Charge Code	270627930
Hospital Revenue Code	272
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$29.02
Rate for Payer: Qualcare PPO/HMO/WC	$29.02

SNARE POLYPECTOMY MICRO 6255

Facility

$193.50

Hospital Charge Code	270627930
Hospital Revenue Code	272
Min. Negotiated Rate	$25.16
Max. Negotiated Rate	$96.75
Rate for Payer: Aetna Commercial	$58.05
Rate for Payer: Aetna Medicare Advantage	$58.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.34
Rate for Payer: Cigna Commercial	$96.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.16
Rate for Payer: Oxford Commercial	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$29.02
Rate for Payer: UnitedHealthcare Commercial	$96.75

SNARE POLYPECTOMY SMALL 230CM

Facility

$33.00

Hospital Charge Code	270700614
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.50

SNARE POLYPECTOMY SMALL 230CM

Facility

$33.00

Hospital Charge Code	270700614
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SNARE SENSATION 2.4X27MM240CM

Facility

$44.50

Hospital Charge Code	270675108
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$13.35
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.79
Rate for Payer: Oxford Commercial	$22.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$22.25

SNARE SENSATION 2.4X27MM240CM

Facility

$44.50

Hospital Charge Code	270675108
Hospital Revenue Code	272
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

SNARE SENSATION JUMBO

Facility

$64.44

Hospital Charge Code	270603905
Hospital Revenue Code	272
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$9.67
Rate for Payer: Qualcare PPO/HMO/WC	$9.67

SNARE SENSATION JUMBO

Facility

$64.44

Hospital Charge Code	270603905
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$32.22
Rate for Payer: Aetna Commercial	$19.33
Rate for Payer: Aetna Medicare Advantage	$19.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.43
Rate for Payer: Cigna Commercial	$32.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.38
Rate for Payer: Oxford Commercial	$32.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.67
Rate for Payer: UnitedHealthcare Commercial	$32.22

SNARE SENSATION MICRO OVAL

Facility

$72.50

Hospital Charge Code	270654281
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

SNARE SENSATION MICRO OVAL

Facility

$72.50

Hospital Charge Code	270654281
Hospital Revenue Code	272
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$21.75
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.43
Rate for Payer: Oxford Commercial	$36.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$36.25

SNARE SENSATION OVAL LRG

Facility

$83.68

Hospital Charge Code	270676243
Hospital Revenue Code	272
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.55

SNARE SENSATION OVAL LRG

Facility

$83.68

Hospital Charge Code	270676243
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$41.84
Rate for Payer: Aetna Commercial	$25.10
Rate for Payer: Aetna Medicare Advantage	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.34
Rate for Payer: Cigna Commercial	$41.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.88
Rate for Payer: Oxford Commercial	$41.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.55
Rate for Payer: UnitedHealthcare Commercial	$41.84

SNARE SENSATION STANDARD OVAL

Facility

$72.50

Service Code	HCPCS C1773
Hospital Charge Code	270603903
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

SNARE SENSATION STANDARD OVAL

Facility

$72.50

Service Code	HCPCS C1773
Hospital Charge Code	270603903
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$21.75
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

SNARE WC 3.0 X 6.0 AS-1-MA

Facility

$112.00

Hospital Charge Code	270624934
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$56.00
Rate for Payer: Aetna Commercial	$33.60
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$56.00

SNARE WC 3.0 X 6.0 AS-1-MA

Facility

$112.00

Hospital Charge Code	270624934
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

SNARE WC MINI OVAL ASM-1

Facility

$72.00

Hospital Charge Code	270623498
Hospital Revenue Code	272
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$21.60
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$36.00

SNARE WC MINI OVAL ASM-1

Facility

$72.00

Hospital Charge Code	270623498
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

SNARE WC STD OVAL AS-1

Facility

$86.00

Hospital Charge Code	270623499
Hospital Revenue Code	272
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$25.80
Rate for Payer: Aetna Medicare Advantage	$25.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.93
Rate for Payer: Cigna Commercial	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Commercial	$43.00

SNARE WC STD OVAL AS-1

Facility

$86.00

Hospital Charge Code	270623499
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

S&N CAP-FI

Facility

$2,749.95

Hospital Charge Code	270704951
Hospital Revenue Code	279
Min. Negotiated Rate	$412.49
Max. Negotiated Rate	$412.49
Rate for Payer: Qualcare PPO/HMO/WC	$412.49

S&N CAP-FI

Facility

$2,749.95

Hospital Charge Code	270704951
Hospital Revenue Code	279
Min. Negotiated Rate	$357.49
Max. Negotiated Rate	$1,374.97
Rate for Payer: Aetna Commercial	$824.99
Rate for Payer: Aetna Medicare Advantage	$824.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.24
Rate for Payer: Cigna Commercial	$1,374.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.49
Rate for Payer: Oxford Commercial	$1,374.97
Rate for Payer: Qualcare PPO/HMO/WC	$412.49
Rate for Payer: UnitedHealthcare Commercial	$1,374.97

SNT PRTG EFLX PRB35-07-030-120

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270644086N
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

Know your out-of-pocket cost for care.

All Charges