Heights University Hospital

All Charges

Charge

Type

Setting

Price

BASKET MCV COLON 1058

Facility

$1,168.85

Hospital Charge Code	270606079
Hospital Revenue Code	272
Min. Negotiated Rate	$175.33
Max. Negotiated Rate	$175.33
Rate for Payer: Qualcare PPO/HMO/WC	$175.33

BASKET MCV FLT STN RTR 130530

Facility

$1,940.00

Hospital Charge Code	270606027
Hospital Revenue Code	272
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$291.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

BASKET MCV FLT STN RTR 130530

Facility

$1,940.00

Hospital Charge Code	270606027
Hospital Revenue Code	272
Min. Negotiated Rate	$252.20
Max. Negotiated Rate	$970.00
Rate for Payer: Aetna Commercial	$582.00
Rate for Payer: Aetna Medicare Advantage	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.70
Rate for Payer: Cigna Commercial	$970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.20
Rate for Payer: Oxford Commercial	$970.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.00
Rate for Payer: UnitedHealthcare Commercial	$970.00

BASKET MCV HEL 1.9FR ******

Facility

$812.00

Hospital Charge Code	1604479
Hospital Revenue Code	272
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$121.80
Rate for Payer: Qualcare PPO/HMO/WC	$121.80

BASKET MCV HEL 1.9FR ******

Facility

$812.00

Hospital Charge Code	1604479
Hospital Revenue Code	272
Min. Negotiated Rate	$105.56
Max. Negotiated Rate	$406.00
Rate for Payer: Aetna Commercial	$243.60
Rate for Payer: Aetna Medicare Advantage	$243.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.06
Rate for Payer: Cigna Commercial	$406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.56
Rate for Payer: Oxford Commercial	$406.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.80
Rate for Payer: UnitedHealthcare Commercial	$406.00

BASKET MCV HEL 1.9FR 340121

Facility

$1,382.45

Hospital Charge Code	270601035
Hospital Revenue Code	272
Min. Negotiated Rate	$207.37
Max. Negotiated Rate	$207.37
Rate for Payer: Qualcare PPO/HMO/WC	$207.37

BASKET MCV HEL 1.9FR 340121

Facility

$1,382.45

Hospital Charge Code	270601035
Hospital Revenue Code	272
Min. Negotiated Rate	$179.72
Max. Negotiated Rate	$691.23
Rate for Payer: Aetna Commercial	$414.74
Rate for Payer: Aetna Medicare Advantage	$414.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.52
Rate for Payer: Cigna Commercial	$691.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.72
Rate for Payer: Oxford Commercial	$691.23
Rate for Payer: Qualcare PPO/HMO/WC	$207.37
Rate for Payer: UnitedHealthcare Commercial	$691.23

BASKET MCV HEL 3W BGLY 340122

Facility

$1,791.25

Hospital Charge Code	270606030
Hospital Revenue Code	272
Min. Negotiated Rate	$232.86
Max. Negotiated Rate	$895.62
Rate for Payer: Aetna Commercial	$537.38
Rate for Payer: Aetna Medicare Advantage	$537.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.77
Rate for Payer: Cigna Commercial	$895.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.86
Rate for Payer: Oxford Commercial	$895.62
Rate for Payer: Qualcare PPO/HMO/WC	$268.69
Rate for Payer: UnitedHealthcare Commercial	$895.62

BASKET MCV HEL 3W BGLY 340122

Facility

$1,791.25

Hospital Charge Code	270606030
Hospital Revenue Code	272
Min. Negotiated Rate	$268.69
Max. Negotiated Rate	$268.69
Rate for Payer: Qualcare PPO/HMO/WC	$268.69

BASKET MCV HEL 4W 4.8FR *****

Facility

$763.00

Hospital Charge Code	1605120
Hospital Revenue Code	272
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Qualcare PPO/HMO/WC	$114.45

BASKET MCV HEL 4W 4.8FR *****

Facility

$763.00

Hospital Charge Code	1605120
Hospital Revenue Code	272
Min. Negotiated Rate	$99.19
Max. Negotiated Rate	$381.50
Rate for Payer: Aetna Commercial	$228.90
Rate for Payer: Aetna Medicare Advantage	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.56
Rate for Payer: Cigna Commercial	$381.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.19
Rate for Payer: Oxford Commercial	$381.50
Rate for Payer: Qualcare PPO/HMO/WC	$114.45
Rate for Payer: UnitedHealthcare Commercial	$381.50

BASKET MCV HEL 4W 4.8FR 340100

Facility

$1,175.25

Hospital Charge Code	270601034
Hospital Revenue Code	272
Min. Negotiated Rate	$152.78
Max. Negotiated Rate	$587.62
Rate for Payer: Aetna Commercial	$352.57
Rate for Payer: Aetna Medicare Advantage	$352.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.69
Rate for Payer: Cigna Commercial	$587.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.78
Rate for Payer: Oxford Commercial	$587.62
Rate for Payer: Qualcare PPO/HMO/WC	$176.29
Rate for Payer: UnitedHealthcare Commercial	$587.62

BASKET MCV HEL 4W 4.8FR 340100

Facility

$1,175.25

Hospital Charge Code	270601034
Hospital Revenue Code	272
Min. Negotiated Rate	$176.29
Max. Negotiated Rate	$176.29
Rate for Payer: Qualcare PPO/HMO/WC	$176.29

BASKET MCV SEQUIRA MINI *****

Facility

$768.00

Hospital Charge Code	1604230
Hospital Revenue Code	272
Min. Negotiated Rate	$99.84
Max. Negotiated Rate	$384.00
Rate for Payer: Aetna Commercial	$230.40
Rate for Payer: Aetna Medicare Advantage	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.84
Rate for Payer: Cigna Commercial	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.84
Rate for Payer: Oxford Commercial	$384.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.20
Rate for Payer: UnitedHealthcare Commercial	$384.00

BASKET MCV SEQUIRA MINI *****

Facility

$768.00

Hospital Charge Code	1604230
Hospital Revenue Code	272
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$115.20
Rate for Payer: Qualcare PPO/HMO/WC	$115.20

BASKET MCV SEQUIRA MINI 310105

Facility

$1,299.25

Hospital Charge Code	270601038
Hospital Revenue Code	272
Min. Negotiated Rate	$168.90
Max. Negotiated Rate	$649.62
Rate for Payer: Aetna Commercial	$389.77
Rate for Payer: Aetna Medicare Advantage	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.31
Rate for Payer: Cigna Commercial	$649.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.90
Rate for Payer: Oxford Commercial	$649.62
Rate for Payer: Qualcare PPO/HMO/WC	$194.89
Rate for Payer: UnitedHealthcare Commercial	$649.62

BASKET MCV SEQUIRA MINI 310105

Facility

$1,299.25

Hospital Charge Code	270601038
Hospital Revenue Code	272
Min. Negotiated Rate	$194.89
Max. Negotiated Rate	$194.89
Rate for Payer: Qualcare PPO/HMO/WC	$194.89

BASKET RETRIEVAL FB 00711152

Facility

$525.00

Hospital Charge Code	270637475
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.25
Rate for Payer: Oxford Commercial	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$262.50

BASKET RETRIEVAL FB 00711152

Facility

$525.00

Hospital Charge Code	270637475
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

BASKET RETRIEVAL ZERO 1.9FX90

Facility

$1,878.95

Hospital Charge Code	270698287
Hospital Revenue Code	272
Min. Negotiated Rate	$281.84
Max. Negotiated Rate	$281.84
Rate for Payer: Qualcare PPO/HMO/WC	$281.84

BASKET RETRIEVAL ZERO 1.9FX90

Facility

$1,878.95

Hospital Charge Code	270698287
Hospital Revenue Code	272
Min. Negotiated Rate	$244.26
Max. Negotiated Rate	$939.48
Rate for Payer: Aetna Commercial	$563.68
Rate for Payer: Aetna Medicare Advantage	$563.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.13
Rate for Payer: Cigna Commercial	$939.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.26
Rate for Payer: Oxford Commercial	$939.48
Rate for Payer: Qualcare PPO/HMO/WC	$281.84
Rate for Payer: UnitedHealthcare Commercial	$939.48

BASKET ROTATABLE RETRIEVAL

Facility

$575.00

Hospital Charge Code	270664340
Hospital Revenue Code	270
Min. Negotiated Rate	$74.75
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.75
Rate for Payer: Oxford Commercial	$287.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$287.50

BASKET ROTATABLE RETRIEVAL

Facility

$575.00

Hospital Charge Code	270664340
Hospital Revenue Code	270
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$86.25
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

BASKET RX 3x1.5 LITHOTRIP 1086

Facility

$1,433.50

Hospital Charge Code	270627947
Hospital Revenue Code	272
Min. Negotiated Rate	$215.03
Max. Negotiated Rate	$215.03
Rate for Payer: Qualcare PPO/HMO/WC	$215.03

BASKET RX 3x1.5 LITHOTRIP 1086

Facility

$1,433.50

Hospital Charge Code	270627947
Hospital Revenue Code	272
Min. Negotiated Rate	$186.35
Max. Negotiated Rate	$716.75
Rate for Payer: Aetna Commercial	$430.05
Rate for Payer: Aetna Medicare Advantage	$430.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.54
Rate for Payer: Cigna Commercial	$716.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.35
Rate for Payer: Oxford Commercial	$716.75
Rate for Payer: Qualcare PPO/HMO/WC	$215.03
Rate for Payer: UnitedHealthcare Commercial	$716.75

Know your out-of-pocket cost for care.

All Charges