Heights University Hospital

All Charges

Charge

Type

Setting

Price

SURGERY TIME 1ST HOUR

Facility

$5,093.20

Hospital Charge Code	1600010
Hospital Revenue Code	360
Min. Negotiated Rate	$662.12
Max. Negotiated Rate	$2,546.60
Rate for Payer: Aetna Commercial	$1,527.96
Rate for Payer: Aetna Medicare Advantage	$1,527.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,298.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,298.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,298.77
Rate for Payer: Cigna Commercial	$2,546.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$662.12
Rate for Payer: Qualcare PPO/HMO/WC	$763.98

SURGERY TIME 1ST HOUR

Facility

$5,093.20

Hospital Charge Code	1600010
Hospital Revenue Code	360
Min. Negotiated Rate	$763.98
Max. Negotiated Rate	$763.98
Rate for Payer: Qualcare PPO/HMO/WC	$763.98

SURGERY TIME EACH ADDTL 30MIN

Facility

$2,548.00

Hospital Charge Code	1600012
Hospital Revenue Code	360
Min. Negotiated Rate	$382.20
Max. Negotiated Rate	$382.20
Rate for Payer: Qualcare PPO/HMO/WC	$382.20

SURGERY TIME EACH ADDTL 30MIN

Facility

$2,548.00

Hospital Charge Code	1600012
Hospital Revenue Code	360
Min. Negotiated Rate	$331.24
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$764.40
Rate for Payer: Aetna Medicare Advantage	$764.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$649.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$649.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$649.74
Rate for Payer: Cigna Commercial	$1,274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.24
Rate for Payer: Qualcare PPO/HMO/WC	$382.20

SURGI-BRA LARGE LATEX FREE

Facility

$177.95

Hospital Charge Code	270650035
Hospital Revenue Code	270
Min. Negotiated Rate	$26.69
Max. Negotiated Rate	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.69

SURGI-BRA LARGE LATEX FREE

Facility

$177.95

Hospital Charge Code	270650035
Hospital Revenue Code	270
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$88.97
Rate for Payer: Aetna Commercial	$53.38
Rate for Payer: Aetna Medicare Advantage	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.38
Rate for Payer: Cigna Commercial	$88.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.13
Rate for Payer: Oxford Commercial	$88.97
Rate for Payer: Qualcare PPO/HMO/WC	$26.69
Rate for Payer: UnitedHealthcare Commercial	$88.97

SURGI-BRA MEDIUM

Facility

$262.40

Hospital Charge Code	270650034
Hospital Revenue Code	272
Min. Negotiated Rate	$34.11
Max. Negotiated Rate	$131.20
Rate for Payer: Aetna Commercial	$78.72
Rate for Payer: Aetna Medicare Advantage	$78.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.91
Rate for Payer: Cigna Commercial	$131.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.11
Rate for Payer: Oxford Commercial	$131.20
Rate for Payer: Qualcare PPO/HMO/WC	$39.36
Rate for Payer: UnitedHealthcare Commercial	$131.20

SURGI-BRA MEDIUM

Facility

$262.40

Hospital Charge Code	270650034
Hospital Revenue Code	272
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$39.36
Rate for Payer: Qualcare PPO/HMO/WC	$39.36

SURGI-BRA SMALL

Facility

$215.00

Hospital Charge Code	270330834
Hospital Revenue Code	270
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

SURGI-BRA SMALL

Facility

$215.00

Hospital Charge Code	270330834
Hospital Revenue Code	270
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$64.50
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Oxford Commercial	$107.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$107.50

SURGIBRA (SML,MED,LG,X-LG)***

Facility

$214.80

Hospital Charge Code	1605989
Hospital Revenue Code	272
Min. Negotiated Rate	$32.22
Max. Negotiated Rate	$32.22
Rate for Payer: Qualcare PPO/HMO/WC	$32.22

SURGIBRA (SML,MED,LG,X-LG)***

Facility

$214.80

Hospital Charge Code	1605989
Hospital Revenue Code	272
Min. Negotiated Rate	$27.92
Max. Negotiated Rate	$107.40
Rate for Payer: Aetna Commercial	$64.44
Rate for Payer: Aetna Medicare Advantage	$64.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.77
Rate for Payer: Cigna Commercial	$107.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.92
Rate for Payer: Oxford Commercial	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.22
Rate for Payer: UnitedHealthcare Commercial	$107.40

SURGI-BRA XXL

Facility

$208.70

Hospital Charge Code	270650036
Hospital Revenue Code	270
Min. Negotiated Rate	$31.30
Max. Negotiated Rate	$31.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.30

SURGI-BRA XXL

Facility

$208.70

Hospital Charge Code	270650036
Hospital Revenue Code	270
Min. Negotiated Rate	$27.13
Max. Negotiated Rate	$104.35
Rate for Payer: Aetna Commercial	$62.61
Rate for Payer: Aetna Medicare Advantage	$62.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.22
Rate for Payer: Cigna Commercial	$104.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.13
Rate for Payer: Oxford Commercial	$104.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.30
Rate for Payer: UnitedHealthcare Commercial	$104.35

SURGI-BRA XXXL

Facility

$19.22

Hospital Charge Code	270650037
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.61
Rate for Payer: Aetna Commercial	$5.77
Rate for Payer: Aetna Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.90
Rate for Payer: Cigna Commercial	$9.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.88
Rate for Payer: UnitedHealthcare Commercial	$9.61

SURGI-BRA XXXL

Facility

$19.22

Hospital Charge Code	270650037
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.88

SURGICAL BLADES

Facility

$98.00

Hospital Charge Code	270330831
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

SURGICAL BLADES

Facility

$98.00

Hospital Charge Code	270330831
Hospital Revenue Code	272
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$29.40
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.74
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$49.00

SURGICAL DX EXAM ANORECTAL

Facility

$16,148.00

Service Code	HCPCS 45990
Hospital Charge Code	1600000626
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,609.93
Rate for Payer: Aetna Commercial	$4,844.40
Rate for Payer: Aetna Medicare Advantage	$4,844.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,117.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,117.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,117.74
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,099.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,422.20
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

SURGICAL DX EXAM ANORECTAL

Facility

$16,148.00

Service Code	HCPCS 45990
Hospital Charge Code	1600000626
Hospital Revenue Code	360
Min. Negotiated Rate	$2,422.20
Max. Negotiated Rate	$2,422.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,422.20

SURGICAL MATRIX 7X10CM

Facility

$9,922.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,488.38
Max. Negotiated Rate	$2,401.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,401.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,488.38

SURGICAL MATRIX 7X10CM

Facility

$9,922.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662087
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,976.75
Rate for Payer: Aetna Commercial	$2,976.75
Rate for Payer: Aetna Medicare Advantage	$2,976.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,530.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,530.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,984.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,530.24
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,401.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,488.38

SURGICAL MATRIX 7X10CM/SQCM JW

Facility

$141.75

Hospital Charge Code	270662087W
Hospital Revenue Code	636
Min. Negotiated Rate	$21.26
Max. Negotiated Rate	$34.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.26

SURGICAL MATRIX 7X10CM/SQCM JW

Facility

$141.75

Hospital Charge Code	270662087W
Hospital Revenue Code	636
Min. Negotiated Rate	$21.26
Max. Negotiated Rate	$70.88
Rate for Payer: Aetna Commercial	$42.52
Rate for Payer: Aetna Medicare Advantage	$42.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.15
Rate for Payer: Cigna Commercial	$70.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.26

SURGICAL MATRIX 8X16CM

Facility

$18,144.00

Service Code	HCPCS Q4166
Hospital Charge Code	270662094
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$5,443.20
Rate for Payer: Aetna Commercial	$5,443.20
Rate for Payer: Aetna Medicare Advantage	$5,443.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,626.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,626.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,628.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,626.72
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,390.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,721.60

Know your out-of-pocket cost for care.

All Charges