Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM AMS SACRL COLPO 7240360

Facility

$4,935.25

Hospital Charge Code	270626670
Hospital Revenue Code	272
Min. Negotiated Rate	$641.58
Max. Negotiated Rate	$2,467.62
Rate for Payer: Aetna Commercial	$1,480.58
Rate for Payer: Aetna Medicare Advantage	$1,480.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,258.49
Rate for Payer: Cigna Commercial	$2,467.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.58
Rate for Payer: Oxford Commercial	$2,467.62
Rate for Payer: Qualcare PPO/HMO/WC	$740.29
Rate for Payer: UnitedHealthcare Commercial	$2,467.62

SYSTEM AMS SACRL COLPO 7240360

Facility

$4,935.25

Hospital Charge Code	270626670
Hospital Revenue Code	272
Min. Negotiated Rate	$740.29
Max. Negotiated Rate	$740.29
Rate for Payer: Qualcare PPO/HMO/WC	$740.29

SYSTEM ASPIRATION SEPARATOR 12

Facility

$9,725.00

Hospital Charge Code	270689718
Hospital Revenue Code	272
Min. Negotiated Rate	$1,264.25
Max. Negotiated Rate	$4,862.50
Rate for Payer: Aetna Commercial	$2,917.50
Rate for Payer: Aetna Medicare Advantage	$2,917.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,479.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,479.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,479.88
Rate for Payer: Cigna Commercial	$4,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.25
Rate for Payer: Oxford Commercial	$4,862.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,458.75
Rate for Payer: UnitedHealthcare Commercial	$4,862.50

SYSTEM ASPIRATION SEPARATOR 12

Facility

$9,725.00

Hospital Charge Code	270689718
Hospital Revenue Code	272
Min. Negotiated Rate	$1,458.75
Max. Negotiated Rate	$1,458.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,458.75

SYSTEM AUTOTRANSFUSION

Facility

$1,679.25

Hospital Charge Code	270600339
Hospital Revenue Code	270
Min. Negotiated Rate	$251.89
Max. Negotiated Rate	$251.89
Rate for Payer: Qualcare PPO/HMO/WC	$251.89

SYSTEM AUTOTRANSFUSION

Facility

$1,679.25

Hospital Charge Code	270600339
Hospital Revenue Code	270
Min. Negotiated Rate	$218.30
Max. Negotiated Rate	$839.62
Rate for Payer: Aetna Commercial	$503.77
Rate for Payer: Aetna Medicare Advantage	$503.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.21
Rate for Payer: Cigna Commercial	$839.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.30
Rate for Payer: Oxford Commercial	$839.62
Rate for Payer: Qualcare PPO/HMO/WC	$251.89
Rate for Payer: UnitedHealthcare Commercial	$839.62

SYSTEM AUTOTRANS SOLCOTRANS

Facility

$1,104.85

Hospital Charge Code	270606437
Hospital Revenue Code	272
Min. Negotiated Rate	$143.63
Max. Negotiated Rate	$552.42
Rate for Payer: Aetna Commercial	$331.45
Rate for Payer: Aetna Medicare Advantage	$331.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.74
Rate for Payer: Cigna Commercial	$552.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.63
Rate for Payer: Oxford Commercial	$552.42
Rate for Payer: Qualcare PPO/HMO/WC	$165.73
Rate for Payer: UnitedHealthcare Commercial	$552.42

SYSTEM AUTOTRANS SOLCOTRANS

Facility

$1,104.85

Hospital Charge Code	270606437
Hospital Revenue Code	272
Min. Negotiated Rate	$165.73
Max. Negotiated Rate	$165.73
Rate for Payer: Qualcare PPO/HMO/WC	$165.73

SYSTEM BONE SCREW REMOVAL UNI-

Facility

$6,250.00

Hospital Charge Code	270639843
Hospital Revenue Code	272
Min. Negotiated Rate	$812.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Oxford Commercial	$3,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$3,125.00

SYSTEM BONE SCREW REMOVAL UNI-

Facility

$6,250.00

Hospital Charge Code	270639843
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM BX AUTO 18G 15CM 43-207

Facility

$564.00

Hospital Charge Code	270600448
Hospital Revenue Code	272
Min. Negotiated Rate	$73.32
Max. Negotiated Rate	$282.00
Rate for Payer: Aetna Commercial	$169.20
Rate for Payer: Aetna Medicare Advantage	$169.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.82
Rate for Payer: Cigna Commercial	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.32
Rate for Payer: Oxford Commercial	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.60
Rate for Payer: UnitedHealthcare Commercial	$282.00

SYSTEM BX AUTO 18G 15CM 43-207

Facility

$564.00

Hospital Charge Code	270600448
Hospital Revenue Code	272
Min. Negotiated Rate	$84.60
Max. Negotiated Rate	$84.60
Rate for Payer: Qualcare PPO/HMO/WC	$84.60

SYSTEM CABLE 2.0MM COB 120005

Facility

$1,110.00

Hospital Charge Code	270645421
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Aetna Commercial	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SYSTEM CABLE 2.0MM COB 120005

Facility

$1,110.00

Hospital Charge Code	270645421
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

SYSTEM CHARGING

Facility

$6,450.00

Service Code	HCPCS C1820
Hospital Charge Code	270665900
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

SYSTEM CHARGING

Facility

$6,450.00

Service Code	HCPCS C1820
Hospital Charge Code	270665900
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

SYSTEM CHARGING 37752

Facility

$11,950.00

Hospital Charge Code	270640324
Hospital Revenue Code	272
Min. Negotiated Rate	$1,553.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,553.50
Rate for Payer: Oxford Commercial	$5,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50
Rate for Payer: UnitedHealthcare Commercial	$5,975.00

SYSTEM CHARGING 37752

Facility

$11,950.00

Hospital Charge Code	270640324
Hospital Revenue Code	272
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$1,792.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

SYSTEM COLOS/ILEOST 45MM

Facility

$72.85

Hospital Charge Code	270600412
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SYSTEM COLOS/ILEOST 45MM

Facility

$72.85

Hospital Charge Code	270600412
Hospital Revenue Code	272
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$21.86
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.47
Rate for Payer: Oxford Commercial	$36.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$36.42

SYSTEM COLOS/ILEOST 70MM

Facility

$72.85

Hospital Charge Code	270600413
Hospital Revenue Code	272
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$21.86
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.47
Rate for Payer: Oxford Commercial	$36.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$36.42

SYSTEM COLOS/ILEOST 70MM

Facility

$72.85

Hospital Charge Code	270600413
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SYSTEM DEEP SCROTAL RETRACTION

Facility

$2,105.00

Hospital Charge Code	270641451
Hospital Revenue Code	272
Min. Negotiated Rate	$315.75
Max. Negotiated Rate	$315.75
Rate for Payer: Qualcare PPO/HMO/WC	$315.75

SYSTEM DEEP SCROTAL RETRACTION

Facility

$2,105.00

Hospital Charge Code	270641451
Hospital Revenue Code	272
Min. Negotiated Rate	$273.65
Max. Negotiated Rate	$1,052.50
Rate for Payer: Aetna Commercial	$631.50
Rate for Payer: Aetna Medicare Advantage	$631.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.77
Rate for Payer: Cigna Commercial	$1,052.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.65
Rate for Payer: Oxford Commercial	$1,052.50
Rate for Payer: Qualcare PPO/HMO/WC	$315.75
Rate for Payer: UnitedHealthcare Commercial	$1,052.50

SYSTEM DISPOSABLE AC JOINT

Facility

$4,360.00

Hospital Charge Code	270665365
Hospital Revenue Code	278
Min. Negotiated Rate	$654.00
Max. Negotiated Rate	$1,055.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$872.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,055.12
Rate for Payer: Qualcare PPO/HMO/WC	$654.00

Know your out-of-pocket cost for care.

All Charges