Heights University Hospital

All Charges

Charge

Type

Setting

Price

TROCAR LAPRSC 10-12 MM *****

Facility

$144.00

Hospital Charge Code	1607019
Hospital Revenue Code	272
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

TROCAR LAPRSC 10-12MM *****

Facility

$219.00

Hospital Charge Code	1606607
Hospital Revenue Code	272
Min. Negotiated Rate	$28.47
Max. Negotiated Rate	$109.50
Rate for Payer: Aetna Commercial	$65.70
Rate for Payer: Aetna Medicare Advantage	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.84
Rate for Payer: Cigna Commercial	$109.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.47
Rate for Payer: Oxford Commercial	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.85
Rate for Payer: UnitedHealthcare Commercial	$109.50

TROCAR LAPRSC 10-12MM *****

Facility

$219.00

Hospital Charge Code	1606607
Hospital Revenue Code	272
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

TROCAR LAPRSC 10-12MM LONG ***

Facility

$154.00

Hospital Charge Code	1606656
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

TROCAR LAPRSC 10-12MM LONG ***

Facility

$154.00

Hospital Charge Code	1606656
Hospital Revenue Code	272
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$77.00

TROCAR LEVER 5.5mm

Facility

$233.33

Hospital Charge Code	270655428
Hospital Revenue Code	271
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.00

TROCAR LEVER 5.5mm

Facility

$233.33

Hospital Charge Code	270655428
Hospital Revenue Code	271
Min. Negotiated Rate	$30.33
Max. Negotiated Rate	$116.67
Rate for Payer: Aetna Commercial	$70.00
Rate for Payer: Aetna Medicare Advantage	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.50
Rate for Payer: Cigna Commercial	$116.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.33
Rate for Payer: Oxford Commercial	$116.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.00
Rate for Payer: UnitedHealthcare Commercial	$116.67

TROCAR LONG 5MM

Facility

$97.00

Hospital Charge Code	270335696
Hospital Revenue Code	272
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

TROCAR LONG 5MM

Facility

$97.00

Hospital Charge Code	270335696
Hospital Revenue Code	272
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$48.50
Rate for Payer: Aetna Commercial	$29.10
Rate for Payer: Aetna Medicare Advantage	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.73
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.61
Rate for Payer: Oxford Commercial	$48.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Commercial	$48.50

TROCAR N/BLADE 5mm 2299035NLT

Facility

$195.57

Hospital Charge Code	270628302
Hospital Revenue Code	272
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$29.34
Rate for Payer: Qualcare PPO/HMO/WC	$29.34

TROCAR N/BLADE 5mm 2299035NLT

Facility

$195.57

Hospital Charge Code	270628302
Hospital Revenue Code	272
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$97.78
Rate for Payer: Aetna Commercial	$58.67
Rate for Payer: Aetna Medicare Advantage	$58.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.87
Rate for Payer: Cigna Commercial	$97.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.42
Rate for Payer: Oxford Commercial	$97.78
Rate for Payer: Qualcare PPO/HMO/WC	$29.34
Rate for Payer: UnitedHealthcare Commercial	$97.78

TROCAR N/BLDE 10/12 22990512HT

Facility

$770.98

Hospital Charge Code	270628101
Hospital Revenue Code	272
Min. Negotiated Rate	$115.65
Max. Negotiated Rate	$115.65
Rate for Payer: Qualcare PPO/HMO/WC	$115.65

TROCAR N/BLDE 10/12 22990512HT

Facility

$770.98

Hospital Charge Code	270628101
Hospital Revenue Code	272
Min. Negotiated Rate	$100.23
Max. Negotiated Rate	$385.49
Rate for Payer: Aetna Commercial	$231.29
Rate for Payer: Aetna Medicare Advantage	$231.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.60
Rate for Payer: Cigna Commercial	$385.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.23
Rate for Payer: Oxford Commercial	$385.49
Rate for Payer: Qualcare PPO/HMO/WC	$115.65
Rate for Payer: UnitedHealthcare Commercial	$385.49

TROCAR N/BLDE 10/12 22990512HT

Facility

$616.85

Hospital Charge Code	270628301
Hospital Revenue Code	272
Min. Negotiated Rate	$92.53
Max. Negotiated Rate	$92.53
Rate for Payer: Qualcare PPO/HMO/WC	$92.53

TROCAR N/BLDE 10/12 22990512HT

Facility

$616.85

Hospital Charge Code	270628301
Hospital Revenue Code	272
Min. Negotiated Rate	$80.19
Max. Negotiated Rate	$308.43
Rate for Payer: Aetna Commercial	$185.06
Rate for Payer: Aetna Medicare Advantage	$185.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.30
Rate for Payer: Cigna Commercial	$308.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.19
Rate for Payer: Oxford Commercial	$308.43
Rate for Payer: Qualcare PPO/HMO/WC	$92.53
Rate for Payer: UnitedHealthcare Commercial	$308.43

TROCAR OPT BLADELESS 12x100MM

Facility

$125.00

Hospital Charge Code	270676769
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

TROCAR OPT BLADELESS 12x100MM

Facility

$125.00

Hospital Charge Code	270676769
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TROCAR OPTICAL 5MM W/2 SLEEVES

Facility

$213.16

Hospital Charge Code	270669883
Hospital Revenue Code	272
Min. Negotiated Rate	$31.97
Max. Negotiated Rate	$31.97
Rate for Payer: Qualcare PPO/HMO/WC	$31.97

TROCAR OPTICAL 5MM W/2 SLEEVES

Facility

$213.16

Hospital Charge Code	270669883
Hospital Revenue Code	272
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$106.58
Rate for Payer: Aetna Commercial	$63.95
Rate for Payer: Aetna Medicare Advantage	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.36
Rate for Payer: Cigna Commercial	$106.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.71
Rate for Payer: Oxford Commercial	$106.58
Rate for Payer: Qualcare PPO/HMO/WC	$31.97
Rate for Payer: UnitedHealthcare Commercial	$106.58

TROCAR OPTICAL VERSA CANNULA 5

Facility

$140.95

Hospital Charge Code	270697814
Hospital Revenue Code	272
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$70.47
Rate for Payer: Aetna Commercial	$42.28
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.94
Rate for Payer: Cigna Commercial	$70.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.32
Rate for Payer: Oxford Commercial	$70.47
Rate for Payer: Qualcare PPO/HMO/WC	$21.14
Rate for Payer: UnitedHealthcare Commercial	$70.47

TROCAR OPTICAL VERSA CANNULA 5

Facility

$140.95

Hospital Charge Code	270697814
Hospital Revenue Code	272
Min. Negotiated Rate	$21.14
Max. Negotiated Rate	$21.14
Rate for Payer: Qualcare PPO/HMO/WC	$21.14

TROCAR OPTIVIEW 5 MM 75 MM

Facility

$115.00

Hospital Charge Code	270690127
Hospital Revenue Code	272
Min. Negotiated Rate	$14.95
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$57.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$57.50

TROCAR OPTIVIEW 5 MM 75 MM

Facility

$115.00

Hospital Charge Code	270690127
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

TROCAR POINT PIN 3.2MM SZ 2.6

Facility

$650.00

Hospital Charge Code	270673733
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

TROCAR POINT PIN 3.2MM SZ 2.6

Facility

$650.00

Hospital Charge Code	270673733
Hospital Revenue Code	272
Min. Negotiated Rate	$84.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

Know your out-of-pocket cost for care.

All Charges