Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM WMT RAD HEAD 2496KITXL

Facility

$11,780.00

Hospital Charge Code	270628230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,767.00
Max. Negotiated Rate	$1,767.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00

SYSTEM WMT RAD HEAD 2496KITXL

Facility

$11,780.00

Hospital Charge Code	270628230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,531.40
Max. Negotiated Rate	$5,890.00
Rate for Payer: Aetna Commercial	$3,534.00
Rate for Payer: Aetna Medicare Advantage	$3,534.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,003.90
Rate for Payer: Cigna Commercial	$5,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,531.40
Rate for Payer: Oxford Commercial	$5,890.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00
Rate for Payer: UnitedHealthcare Commercial	$5,890.00

SYSTEM ZIM CBL GRIP 2232-50-19

Facility

$2,905.65

Hospital Charge Code	270616630
Hospital Revenue Code	278
Min. Negotiated Rate	$435.85
Max. Negotiated Rate	$703.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: Qualcare PPO/HMO/WC	$435.85

SYSTEM ZIM CBL GRIP 2232-50-19

Facility

$2,905.65

Hospital Charge Code	270616630
Hospital Revenue Code	278
Min. Negotiated Rate	$435.85
Max. Negotiated Rate	$1,452.83
Rate for Payer: Aetna Commercial	$871.70
Rate for Payer: Aetna Medicare Advantage	$871.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.94
Rate for Payer: Cigna Commercial	$1,452.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: Qualcare PPO/HMO/WC	$435.85

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$256.75
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.75
Rate for Payer: Oxford Commercial	$987.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$987.50

SYSTM CLLCTION DUAL HYGIENIKIT

Facility

$557.25

Hospital Charge Code	270662661
Hospital Revenue Code	270
Min. Negotiated Rate	$83.59
Max. Negotiated Rate	$83.59
Rate for Payer: Qualcare PPO/HMO/WC	$83.59

SYSTM CLLCTION DUAL HYGIENIKIT

Facility

$557.25

Hospital Charge Code	270662661
Hospital Revenue Code	270
Min. Negotiated Rate	$72.44
Max. Negotiated Rate	$278.62
Rate for Payer: Aetna Commercial	$167.18
Rate for Payer: Aetna Medicare Advantage	$167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.10
Rate for Payer: Cigna Commercial	$278.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.44
Rate for Payer: Oxford Commercial	$278.62
Rate for Payer: Qualcare PPO/HMO/WC	$83.59
Rate for Payer: UnitedHealthcare Commercial	$278.62

SYSTM MIXNG CMPACT 50493501

Facility

$891.90

Hospital Charge Code	270635863
Hospital Revenue Code	272
Min. Negotiated Rate	$133.78
Max. Negotiated Rate	$133.78
Rate for Payer: Qualcare PPO/HMO/WC	$133.78

SYSTM MIXNG CMPACT 50493501

Facility

$891.90

Hospital Charge Code	270635863
Hospital Revenue Code	272
Min. Negotiated Rate	$115.95
Max. Negotiated Rate	$445.95
Rate for Payer: Aetna Commercial	$267.57
Rate for Payer: Aetna Medicare Advantage	$267.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.43
Rate for Payer: Cigna Commercial	$445.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.95
Rate for Payer: Oxford Commercial	$445.95
Rate for Payer: Qualcare PPO/HMO/WC	$133.78
Rate for Payer: UnitedHealthcare Commercial	$445.95

SYSTM TRNSVAGINL ANCHOR 820145

Facility

$1,724.00

Hospital Charge Code	270629480
Hospital Revenue Code	272
Min. Negotiated Rate	$224.12
Max. Negotiated Rate	$862.00
Rate for Payer: Aetna Commercial	$517.20
Rate for Payer: Aetna Medicare Advantage	$517.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.62
Rate for Payer: Cigna Commercial	$862.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.12
Rate for Payer: Oxford Commercial	$862.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.60
Rate for Payer: UnitedHealthcare Commercial	$862.00

SYSTM TRNSVAGINL ANCHOR 820145

Facility

$1,724.00

Hospital Charge Code	270629480
Hospital Revenue Code	272
Min. Negotiated Rate	$258.60
Max. Negotiated Rate	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$258.60

SYST PICO NEG PRESS 10X20CM

Facility

$1,149.50

Hospital Charge Code	270678297
Hospital Revenue Code	272
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.44
Rate for Payer: Oxford Commercial	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$574.75

SYST PICO NEG PRESS 10X20CM

Facility

$1,149.50

Hospital Charge Code	270678297
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST PICO NEG PRESS 15x15CM

Facility

$1,149.50

Hospital Charge Code	270677028
Hospital Revenue Code	272
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.44
Rate for Payer: Oxford Commercial	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$574.75

SYST PICO NEG PRESS 15x15CM

Facility

$1,149.50

Hospital Charge Code	270677028
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST PICO NEG PRESS 15x30CM

Facility

$1,149.50

Hospital Charge Code	270678298
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST PICO NEG PRESS 15x30CM

Facility

$1,149.50

Hospital Charge Code	270678298
Hospital Revenue Code	272
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.44
Rate for Payer: Oxford Commercial	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$574.75

SYST PICO NEG PRESS 4x11

Facility

$3,448.50

Hospital Charge Code	270678394
Hospital Revenue Code	272
Min. Negotiated Rate	$448.31
Max. Negotiated Rate	$1,724.25
Rate for Payer: Aetna Commercial	$1,034.55
Rate for Payer: Aetna Medicare Advantage	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.37
Rate for Payer: Cigna Commercial	$1,724.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.31
Rate for Payer: Oxford Commercial	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$517.27
Rate for Payer: UnitedHealthcare Commercial	$1,724.25

SYST PICO NEG PRESS 4x11

Facility

$3,448.50

Hospital Charge Code	270678394
Hospital Revenue Code	272
Min. Negotiated Rate	$517.27
Max. Negotiated Rate	$517.27
Rate for Payer: Qualcare PPO/HMO/WC	$517.27

SYST PICO NEG PRESS 4x16x3/4

Facility

$1,149.50

Hospital Charge Code	270678395
Hospital Revenue Code	272
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.44
Rate for Payer: Oxford Commercial	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$574.75

SYST PICO NEG PRESS 4x16x3/4

Facility

$1,149.50

Hospital Charge Code	270678395
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST UPHOLD LITE W/CAPIO SLIM

Facility

$11,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270677082
Hospital Revenue Code	278
Min. Negotiated Rate	$1,740.00
Max. Negotiated Rate	$2,807.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00

SYST UPHOLD LITE W/CAPIO SLIM

Facility

$11,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270677082
Hospital Revenue Code	278
Min. Negotiated Rate	$1,740.00
Max. Negotiated Rate	$5,800.00
Rate for Payer: Aetna Commercial	$3,480.00
Rate for Payer: Aetna Medicare Advantage	$3,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,958.00
Rate for Payer: Cigna Commercial	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00

SYTHROID/0.088MG

Facility

$3.00

Hospital Charge Code	60634782
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

Know your out-of-pocket cost for care.

All Charges