Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM LUMBAR VALVE GREEN

Facility

$6,590.50

Hospital Charge Code	270679117
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE WHITE

Facility

$6,590.50

Hospital Charge Code	270679118
Hospital Revenue Code	272
Min. Negotiated Rate	$856.76
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$1,977.15
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.76
Rate for Payer: Oxford Commercial	$3,295.25
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$3,295.25

SYSTEM LUMBAR VALVE WHITE

Facility

$6,590.50

Hospital Charge Code	270679118
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE YELLOW

Facility

$6,590.50

Hospital Charge Code	270679116
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE YELLOW

Facility

$6,590.50

Hospital Charge Code	270679116
Hospital Revenue Code	272
Min. Negotiated Rate	$856.76
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$1,977.15
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.76
Rate for Payer: Oxford Commercial	$3,295.25
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$3,295.25

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Hospital Charge Code	270639478
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Hospital Charge Code	270639478
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
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) NJ Health	$1,250.00
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	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Service Code	HCPCS C1771
Hospital Charge Code	270639748
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
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) NJ Health	$1,250.00
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	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Service Code	HCPCS C1771
Hospital Charge Code	270639748
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM MAX Bx 14G 10cm MC1410

Facility

$280.00

Hospital Charge Code	270628524
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

SYSTEM MAX Bx 14G 10cm MC1410

Facility

$280.00

Hospital Charge Code	270628524
Hospital Revenue Code	272
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$84.00
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$140.00

SYSTEM MEDICATION LABELING OR

Facility

$13.87

Hospital Charge Code	270643023
Hospital Revenue Code	270
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$6.93
Rate for Payer: Aetna Commercial	$4.16
Rate for Payer: Aetna Medicare Advantage	$4.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.54
Rate for Payer: Cigna Commercial	$6.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$6.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.08
Rate for Payer: UnitedHealthcare Commercial	$6.93

SYSTEM MEDICATION LABELING OR

Facility

$13.87

Hospital Charge Code	270643023
Hospital Revenue Code	270
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.08

SYSTEM MEDICATION LABL OR 3033

Facility

$17.25

Hospital Charge Code	270636688
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$8.62
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna Medicare Advantage	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.40
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.24
Rate for Payer: Oxford Commercial	$8.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.59
Rate for Payer: UnitedHealthcare Commercial	$8.62

SYSTEM MEDICATION LABL OR 3033

Facility

$17.25

Hospital Charge Code	270636688
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.59

SYSTEM MYOSURE XL TISSUE

Facility

$5,500.00

Hospital Charge Code	270684280
Hospital Revenue Code	272
Min. Negotiated Rate	$715.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$715.00
Rate for Payer: Oxford Commercial	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$2,750.00

SYSTEM MYOSURE XL TISSUE

Facility

$5,500.00

Hospital Charge Code	270684280
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SYSTEM ORTHODONTIC BONDING

Facility

$2,401.65

Hospital Charge Code	270610888
Hospital Revenue Code	270
Min. Negotiated Rate	$360.25
Max. Negotiated Rate	$360.25
Rate for Payer: Qualcare PPO/HMO/WC	$360.25

SYSTEM ORTHODONTIC BONDING

Facility

$2,401.65

Hospital Charge Code	270610888
Hospital Revenue Code	270
Min. Negotiated Rate	$312.21
Max. Negotiated Rate	$1,200.83
Rate for Payer: Aetna Commercial	$720.50
Rate for Payer: Aetna Medicare Advantage	$720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.42
Rate for Payer: Cigna Commercial	$1,200.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.21
Rate for Payer: Oxford Commercial	$1,200.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.25
Rate for Payer: UnitedHealthcare Commercial	$1,200.83

SYSTEM OSTEOBOND VAC MIXING

Facility

$571.25

Hospital Charge Code	270600356
Hospital Revenue Code	270
Min. Negotiated Rate	$74.26
Max. Negotiated Rate	$285.62
Rate for Payer: Aetna Commercial	$171.38
Rate for Payer: Aetna Medicare Advantage	$171.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.67
Rate for Payer: Cigna Commercial	$285.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.26
Rate for Payer: Oxford Commercial	$285.62
Rate for Payer: Qualcare PPO/HMO/WC	$85.69
Rate for Payer: UnitedHealthcare Commercial	$285.62

SYSTEM OSTEOBOND VAC MIXING

Facility

$571.25

Hospital Charge Code	270600356
Hospital Revenue Code	270
Min. Negotiated Rate	$85.69
Max. Negotiated Rate	$85.69
Rate for Payer: Qualcare PPO/HMO/WC	$85.69

SYSTEM OSTEO INTROD ADVA T05E

Facility

$5,381.65

Hospital Charge Code	270631259
Hospital Revenue Code	272
Min. Negotiated Rate	$807.25
Max. Negotiated Rate	$807.25
Rate for Payer: Qualcare PPO/HMO/WC	$807.25

SYSTEM OSTEO INTROD ADVA T05E

Facility

$5,381.65

Hospital Charge Code	270631259
Hospital Revenue Code	272
Min. Negotiated Rate	$699.61
Max. Negotiated Rate	$2,690.82
Rate for Payer: Aetna Commercial	$1,614.49
Rate for Payer: Aetna Medicare Advantage	$1,614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,372.32
Rate for Payer: Cigna Commercial	$2,690.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.61
Rate for Payer: Oxford Commercial	$2,690.82
Rate for Payer: Qualcare PPO/HMO/WC	$807.25
Rate for Payer: UnitedHealthcare Commercial	$2,690.82

SYSTEM OSTEO INTROD SZ 3 T05D

Facility

$5,133.65

Hospital Charge Code	270633787
Hospital Revenue Code	272
Min. Negotiated Rate	$667.37
Max. Negotiated Rate	$2,566.82
Rate for Payer: Aetna Commercial	$1,540.10
Rate for Payer: Aetna Medicare Advantage	$1,540.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,309.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,309.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,309.08
Rate for Payer: Cigna Commercial	$2,566.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.37
Rate for Payer: Oxford Commercial	$2,566.82
Rate for Payer: Qualcare PPO/HMO/WC	$770.05
Rate for Payer: UnitedHealthcare Commercial	$2,566.82

SYSTEM OSTEO INTROD SZ 3 T05D

Facility

$5,133.65

Hospital Charge Code	270633787
Hospital Revenue Code	272
Min. Negotiated Rate	$770.05
Max. Negotiated Rate	$770.05
Rate for Payer: Qualcare PPO/HMO/WC	$770.05

Know your out-of-pocket cost for care.

All Charges