Heights University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER ENDO GIA 60 4.8 030306

Facility

$2,684.85

Hospital Charge Code	270600106
Hospital Revenue Code	272
Min. Negotiated Rate	$402.73
Max. Negotiated Rate	$402.73
Rate for Payer: Qualcare PPO/HMO/WC	$402.73

STAPLER ENDO GIA 60 4.8 030306

Facility

$2,684.85

Hospital Charge Code	270600106
Hospital Revenue Code	272
Min. Negotiated Rate	$349.03
Max. Negotiated Rate	$1,342.42
Rate for Payer: Aetna Commercial	$805.46
Rate for Payer: Aetna Medicare Advantage	$805.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.64
Rate for Payer: Cigna Commercial	$1,342.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.03
Rate for Payer: Oxford Commercial	$1,342.42
Rate for Payer: Qualcare PPO/HMO/WC	$402.73
Rate for Payer: UnitedHealthcare Commercial	$1,342.42

STAPLER ENDO GIA 60MM ARTI MED

Facility

$2,530.99

Hospital Charge Code	270652107
Hospital Revenue Code	272
Min. Negotiated Rate	$379.65
Max. Negotiated Rate	$379.65
Rate for Payer: Qualcare PPO/HMO/WC	$379.65

STAPLER ENDO GIA 60MM ARTI MED

Facility

$2,530.99

Hospital Charge Code	270652107
Hospital Revenue Code	272
Min. Negotiated Rate	$329.03
Max. Negotiated Rate	$1,265.49
Rate for Payer: Aetna Commercial	$759.30
Rate for Payer: Aetna Medicare Advantage	$759.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.40
Rate for Payer: Cigna Commercial	$1,265.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.03
Rate for Payer: Oxford Commercial	$1,265.49
Rate for Payer: Qualcare PPO/HMO/WC	$379.65
Rate for Payer: UnitedHealthcare Commercial	$1,265.49

STAPLER ENDO GIA 60MM ARTI VAS

Facility

$1,119.05

Hospital Charge Code	270655978
Hospital Revenue Code	272
Min. Negotiated Rate	$167.86
Max. Negotiated Rate	$167.86
Rate for Payer: Qualcare PPO/HMO/WC	$167.86

STAPLER ENDO GIA 60MM ARTI VAS

Facility

$1,119.05

Hospital Charge Code	270655978
Hospital Revenue Code	272
Min. Negotiated Rate	$145.48
Max. Negotiated Rate	$559.52
Rate for Payer: Aetna Commercial	$335.71
Rate for Payer: Aetna Medicare Advantage	$335.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.36
Rate for Payer: Cigna Commercial	$559.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.48
Rate for Payer: Oxford Commercial	$559.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.86
Rate for Payer: UnitedHealthcare Commercial	$559.52

STAPLER ENDO GIA ARTI MED 45MM

Facility

$2,187.03

Service Code	HCPCS C1713
Hospital Charge Code	270665644
Hospital Revenue Code	278
Min. Negotiated Rate	$328.05
Max. Negotiated Rate	$1,093.52
Rate for Payer: Aetna Commercial	$656.11
Rate for Payer: Aetna Medicare Advantage	$656.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$557.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$557.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$557.69
Rate for Payer: Cigna Commercial	$1,093.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.26
Rate for Payer: Qualcare PPO/HMO/WC	$328.05

STAPLER ENDO GIA ARTI MED 45MM

Facility

$2,187.03

Service Code	HCPCS C1713
Hospital Charge Code	270665644
Hospital Revenue Code	278
Min. Negotiated Rate	$328.05
Max. Negotiated Rate	$529.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.26
Rate for Payer: Qualcare PPO/HMO/WC	$328.05

STAPLER ENDO GIA STANDARD

Facility

$529.50

Hospital Charge Code	270691962
Hospital Revenue Code	272
Min. Negotiated Rate	$79.42
Max. Negotiated Rate	$79.42
Rate for Payer: Qualcare PPO/HMO/WC	$79.42

STAPLER ENDO GIA STANDARD

Facility

$529.50

Hospital Charge Code	270691962
Hospital Revenue Code	272
Min. Negotiated Rate	$68.83
Max. Negotiated Rate	$264.75
Rate for Payer: Aetna Commercial	$158.85
Rate for Payer: Aetna Medicare Advantage	$158.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.02
Rate for Payer: Cigna Commercial	$264.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.83
Rate for Payer: Oxford Commercial	$264.75
Rate for Payer: Qualcare PPO/HMO/WC	$79.42
Rate for Payer: UnitedHealthcare Commercial	$264.75

STAPLER ENDOPATH ECHELON FX 60

Facility

$859.17

Hospital Charge Code	270669515
Hospital Revenue Code	272
Min. Negotiated Rate	$128.88
Max. Negotiated Rate	$128.88
Rate for Payer: Qualcare PPO/HMO/WC	$128.88

STAPLER ENDOPATH ECHELON FX 60

Facility

$859.17

Hospital Charge Code	270669515
Hospital Revenue Code	272
Min. Negotiated Rate	$111.69
Max. Negotiated Rate	$429.58
Rate for Payer: Aetna Commercial	$257.75
Rate for Payer: Aetna Medicare Advantage	$257.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.09
Rate for Payer: Cigna Commercial	$429.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.69
Rate for Payer: Oxford Commercial	$429.58
Rate for Payer: Qualcare PPO/HMO/WC	$128.88
Rate for Payer: UnitedHealthcare Commercial	$429.58

STAPLER ENDO ROTIC MINI 174309

Facility

$746.45

Hospital Charge Code	270600109
Hospital Revenue Code	272
Min. Negotiated Rate	$111.97
Max. Negotiated Rate	$111.97
Rate for Payer: Qualcare PPO/HMO/WC	$111.97

STAPLER ENDO ROTIC MINI 174309

Facility

$746.45

Hospital Charge Code	270600109
Hospital Revenue Code	272
Min. Negotiated Rate	$97.04
Max. Negotiated Rate	$373.23
Rate for Payer: Aetna Commercial	$223.94
Rate for Payer: Aetna Medicare Advantage	$223.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.34
Rate for Payer: Cigna Commercial	$373.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.04
Rate for Payer: Oxford Commercial	$373.23
Rate for Payer: Qualcare PPO/HMO/WC	$111.97
Rate for Payer: UnitedHealthcare Commercial	$373.23

STAPLER ENDO TA ********

Facility

$12.00

Hospital Charge Code	1605856
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STAPLER ENDO TA ********

Facility

$12.00

Hospital Charge Code	1605856
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

STAPLER ENDO TA 30 2.5 010901

Facility

$2,323.25

Hospital Charge Code	270600126
Hospital Revenue Code	272
Min. Negotiated Rate	$302.02
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$696.98
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.02
Rate for Payer: Oxford Commercial	$1,161.62
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Commercial	$1,161.62

STAPLER ENDO TA 30 2.5 010901

Facility

$2,323.25

Hospital Charge Code	270600126
Hospital Revenue Code	272
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$348.49
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

STAPLER ENDO TA-30 2.5 MF WHT

Facility

$425.87

Hospital Charge Code	270658617
Hospital Revenue Code	272
Min. Negotiated Rate	$63.88
Max. Negotiated Rate	$63.88
Rate for Payer: Qualcare PPO/HMO/WC	$63.88

STAPLER ENDO TA-30 2.5 MF WHT

Facility

$425.87

Hospital Charge Code	270658617
Hospital Revenue Code	272
Min. Negotiated Rate	$55.36
Max. Negotiated Rate	$212.94
Rate for Payer: Aetna Commercial	$127.76
Rate for Payer: Aetna Medicare Advantage	$127.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.60
Rate for Payer: Cigna Commercial	$212.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.36
Rate for Payer: Oxford Commercial	$212.94
Rate for Payer: Qualcare PPO/HMO/WC	$63.88
Rate for Payer: UnitedHealthcare Commercial	$212.94

STAPLER ENDO TA 30 3.5 010903

Facility

$2,323.25

Hospital Charge Code	270600128
Hospital Revenue Code	272
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$348.49
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

STAPLER ENDO TA 30 3.5 010903

Facility

$2,323.25

Hospital Charge Code	270600128
Hospital Revenue Code	272
Min. Negotiated Rate	$302.02
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$696.98
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.02
Rate for Payer: Oxford Commercial	$1,161.62
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Commercial	$1,161.62

STAPLER ENDO UNI 65 4.8 173052

Facility

$940.40

Hospital Charge Code	270600084
Hospital Revenue Code	272
Min. Negotiated Rate	$141.06
Max. Negotiated Rate	$141.06
Rate for Payer: Qualcare PPO/HMO/WC	$141.06

STAPLER ENDO UNI 65 4.8 173052

Facility

$940.40

Hospital Charge Code	270600084
Hospital Revenue Code	272
Min. Negotiated Rate	$122.25
Max. Negotiated Rate	$470.20
Rate for Payer: Aetna Commercial	$282.12
Rate for Payer: Aetna Medicare Advantage	$282.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.80
Rate for Payer: Cigna Commercial	$470.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.25
Rate for Payer: Oxford Commercial	$470.20
Rate for Payer: Qualcare PPO/HMO/WC	$141.06
Rate for Payer: UnitedHealthcare Commercial	$470.20

STAPLER ENDO UNIVERSAL 65 DEG

Facility

$774.59

Hospital Charge Code	270655604
Hospital Revenue Code	272
Min. Negotiated Rate	$116.19
Max. Negotiated Rate	$116.19
Rate for Payer: Qualcare PPO/HMO/WC	$116.19

Know your out-of-pocket cost for care.

All Charges