Heights University Hospital

All Charges

Charge

Type

Setting

Price

BAL MAV MONO 3.75x12 389281237

Facility

$1,295.00

Hospital Charge Code	270638237
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV MONO 3.75x12 389281237

Facility

$1,295.00

Hospital Charge Code	270638237
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5X15M 206201515

Facility

$1,295.00

Hospital Charge Code	270636797
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5X15M 206201515

Facility

$1,295.00

Hospital Charge Code	270636797
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x20m 206202015

Facility

$1,295.00

Hospital Charge Code	270637713
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x20m 206202015

Facility

$1,295.00

Hospital Charge Code	270637713
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x9mm 206200915

Facility

$1,295.00

Hospital Charge Code	270639413
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x9mm 206200915

Facility

$1,295.00

Hospital Charge Code	270639413
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0X12M 206201220

Facility

$1,284.70

Hospital Charge Code	270636612
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$310.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0X12M 206201220

Facility

$1,284.70

Hospital Charge Code	270636612
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$385.41
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0X15M 206201520

Facility

$1,284.70

Hospital Charge Code	270636795
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$310.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0X15M 206201520

Facility

$1,284.70

Hospital Charge Code	270636795
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$385.41
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0x20m 206202020

Facility

$1,295.00

Hospital Charge Code	270637780
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0x20m 206202020

Facility

$1,295.00

Hospital Charge Code	270637780
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0x9m 206200920

Facility

$1,295.00

Hospital Charge Code	270637315
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0x9m 206200920

Facility

$1,295.00

Hospital Charge Code	270637315
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25X12 206201222

Facility

$1,295.00

Hospital Charge Code	270637188
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25X12 206201222

Facility

$1,295.00

Hospital Charge Code	270637188
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25X15M 206201522

Facility

$1,284.70

Hospital Charge Code	270636693
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$310.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.25X15M 206201522

Facility

$1,284.70

Hospital Charge Code	270636693
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$385.41
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.25X20M 206202022

Facility

$1,295.00

Hospital Charge Code	270637338
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25X20M 206202022

Facility

$1,295.00

Hospital Charge Code	270637338
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25x9m 206200922

Facility

$1,295.00

Hospital Charge Code	270637308
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.25x9m 206200922

Facility

$1,295.00

Hospital Charge Code	270637308
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.5X12M 206201225

Facility

$1,284.70

Hospital Charge Code	270636579
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$385.41
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

Know your out-of-pocket cost for care.

All Charges