Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM PEEK ACHILLES SPEEDBRID

Facility

$9,975.00

Hospital Charge Code	270682874
Hospital Revenue Code	272
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$1,496.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SYSTEM PEEK ACHILLES SPEEDBRID

Facility

$9,975.00

Hospital Charge Code	270682874
Hospital Revenue Code	272
Min. Negotiated Rate	$1,296.75
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,296.75
Rate for Payer: Oxford Commercial	$4,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Commercial	$4,987.50

SYSTEM PENUMBRA ENGINE

Facility

$30,000.00

Hospital Charge Code	270689720
Hospital Revenue Code	272
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

SYSTEM PENUMBRA ENGINE

Facility

$30,000.00

Hospital Charge Code	270689720
Hospital Revenue Code	272
Min. Negotiated Rate	$3,900.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,900.00
Rate for Payer: Oxford Commercial	$15,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$15,000.00

SYSTEMPIPELINE SHIELD 3.5X16MM

Facility

$93,765.00

Service Code	HCPCS C1889
Hospital Charge Code	270700365S
Hospital Revenue Code	278
Min. Negotiated Rate	$14,064.75
Max. Negotiated Rate	$22,691.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,753.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,691.13
Rate for Payer: Qualcare PPO/HMO/WC	$14,064.75

SYSTEMPIPELINE SHIELD 3.5X16MM

Facility

$93,765.00

Service Code	HCPCS C1889
Hospital Charge Code	270700365S
Hospital Revenue Code	278
Min. Negotiated Rate	$14,064.75
Max. Negotiated Rate	$46,882.50
Rate for Payer: Aetna Commercial	$28,129.50
Rate for Payer: Aetna Medicare Advantage	$28,129.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,910.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,910.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,910.08
Rate for Payer: Cigna Commercial	$46,882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,691.13
Rate for Payer: Qualcare PPO/HMO/WC	$14,064.75

SYSTEM RETRACTOR TLC 8201175

Facility

$625.00

Hospital Charge Code	270633800
Hospital Revenue Code	272
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.25
Rate for Payer: Oxford Commercial	$312.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$312.50

SYSTEM RETRACTOR TLC 8201175

Facility

$625.00

Hospital Charge Code	270633800
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$832.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SYSTEM SML BON FIX 062 SBFS062

Facility

$1,475.00

Hospital Charge Code	270634780
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

SYSTEM SML BON FIX 062 SBFS062

Facility

$1,475.00

Hospital Charge Code	270634780
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.26
Max. Negotiated Rate	$2,299.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.26
Max. Negotiated Rate	$4,750.88
Rate for Payer: Aetna Commercial	$2,850.53
Rate for Payer: Aetna Medicare Advantage	$2,850.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.95
Rate for Payer: Cigna Commercial	$4,750.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,387.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

SYSTEM SURG STEEL CBL F BO

Facility

$1,588.85

Hospital Charge Code	270607201
Hospital Revenue Code	278
Min. Negotiated Rate	$238.33
Max. Negotiated Rate	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.33

SYSTEM SURG STEEL CBL F BO

Facility

$1,588.85

Hospital Charge Code	270607201
Hospital Revenue Code	278
Min. Negotiated Rate	$238.33
Max. Negotiated Rate	$794.42
Rate for Payer: Aetna Commercial	$476.65
Rate for Payer: Aetna Medicare Advantage	$476.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.16
Rate for Payer: Cigna Commercial	$794.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.33

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$35.52
Rate for Payer: Aetna Commercial	$21.31
Rate for Payer: Aetna Medicare Advantage	$21.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.12
Rate for Payer: Cigna Commercial	$35.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.24
Rate for Payer: Oxford Commercial	$35.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.66
Rate for Payer: UnitedHealthcare Commercial	$35.52

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$10.66

SYSTEM THERM ROOM TEMP

Facility

$99.25

Hospital Charge Code	270600723
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SYSTEM THERM ROOM TEMP

Facility

$99.25

Hospital Charge Code	270600723
Hospital Revenue Code	270
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$49.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$49.62

SYSTEM THROMBECTOMY PROL 86311

Facility

$2,975.00

Hospital Charge Code	270632896V
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SYSTEM THROMBECTOMY PROL 86311

Facility

$2,975.00

Hospital Charge Code	270632896V
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SYSTEM THROMBECTOMY PROL 86511

Facility

$2,975.00

Hospital Charge Code	270632896
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

Know your out-of-pocket cost for care.

All Charges