Heights University Hospital

All Charges

Charge

Type

Setting

Price

URETERAL ACCESS SHEATH 35 CM

Facility

$577.50

Hospital Charge Code	270682484
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

URETERAL ACCESS SHEATH 35 CM

Facility

$577.50

Hospital Charge Code	270682484
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$173.25
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Commercial	$288.75

URETERAL ACCESS SHEATH 45 CM

Facility

$577.50

Hospital Charge Code	270682485
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$173.25
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Commercial	$288.75

URETERAL ACCESS SHEATH 45 CM

Facility

$577.50

Hospital Charge Code	270682485
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

URETERAL CATH CONE TIP 10FR

Facility

$195.00

Hospital Charge Code	270331130
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$58.50
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

URETERAL CATH CONE TIP 10FR

Facility

$195.00

Hospital Charge Code	270331130
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$30.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$37.80
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$354.50
Rate for Payer: Aetna Commercial	$212.70
Rate for Payer: Aetna Medicare Advantage	$212.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.79
Rate for Payer: Cigna Commercial	$354.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.17
Rate for Payer: Oxford Commercial	$354.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.35
Rate for Payer: UnitedHealthcare Commercial	$354.50

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$106.35
Max. Negotiated Rate	$106.35
Rate for Payer: Qualcare PPO/HMO/WC	$106.35

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$327.32
Max. Negotiated Rate	$528.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: Qualcare PPO/HMO/WC	$327.32

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$327.32
Max. Negotiated Rate	$1,091.08
Rate for Payer: Aetna Commercial	$654.64
Rate for Payer: Aetna Medicare Advantage	$654.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.45
Rate for Payer: Cigna Commercial	$1,091.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: Qualcare PPO/HMO/WC	$327.32

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$421.20
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$972.00
Rate for Payer: Aetna Medicare Advantage	$972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.20
Rate for Payer: Cigna Commercial	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.20
Rate for Payer: Oxford Commercial	$1,620.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00
Rate for Payer: UnitedHealthcare Commercial	$1,620.00

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$486.00
Max. Negotiated Rate	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$76.44
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$176.40
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.44
Rate for Payer: Oxford Commercial	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Commercial	$294.00

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$88.20
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

URETEX TO3 SLING 485053

Facility

$3,670.45

Hospital Charge Code	270636198
Hospital Revenue Code	272
Min. Negotiated Rate	$550.57
Max. Negotiated Rate	$550.57
Rate for Payer: Qualcare PPO/HMO/WC	$550.57

URETEX TO3 SLING 485053

Facility

$3,670.45

Hospital Charge Code	270636198
Hospital Revenue Code	272
Min. Negotiated Rate	$477.16
Max. Negotiated Rate	$1,835.22
Rate for Payer: Aetna Commercial	$1,101.13
Rate for Payer: Aetna Medicare Advantage	$1,101.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.96
Rate for Payer: Cigna Commercial	$1,835.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.16
Rate for Payer: Oxford Commercial	$1,835.22
Rate for Payer: Qualcare PPO/HMO/WC	$550.57
Rate for Payer: UnitedHealthcare Commercial	$1,835.22

URETEX TO SLING 485050

Facility

$3,670.45

Hospital Charge Code	270634047
Hospital Revenue Code	272
Min. Negotiated Rate	$550.57
Max. Negotiated Rate	$550.57
Rate for Payer: Qualcare PPO/HMO/WC	$550.57

URETEX TO SLING 485050

Facility

$3,670.45

Hospital Charge Code	270634047
Hospital Revenue Code	272
Min. Negotiated Rate	$477.16
Max. Negotiated Rate	$1,835.22
Rate for Payer: Aetna Commercial	$1,101.13
Rate for Payer: Aetna Medicare Advantage	$1,101.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.96
Rate for Payer: Cigna Commercial	$1,835.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.16
Rate for Payer: Oxford Commercial	$1,835.22
Rate for Payer: Qualcare PPO/HMO/WC	$550.57
Rate for Payer: UnitedHealthcare Commercial	$1,835.22

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$38,232.84

Service Code	APR-DRG 4464
Min. Negotiated Rate	$29,657.49
Max. Negotiated Rate	$38,232.84
Rate for Payer: Aetna Better Health Medicaid	$37,483.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$38,232.84
Rate for Payer: Wellpoint Medicaid Managed Care	$29,657.49

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$21,850.75

Service Code	APR-DRG 4463
Min. Negotiated Rate	$13,705.50
Max. Negotiated Rate	$21,850.75
Rate for Payer: Aetna Better Health Medicaid	$21,422.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,850.75
Rate for Payer: Wellpoint Medicaid Managed Care	$13,705.50

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$11,412.01

Service Code	APR-DRG 4461
Min. Negotiated Rate	$6,777.13
Max. Negotiated Rate	$11,412.01
Rate for Payer: Aetna Better Health Medicaid	$11,188.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,412.01
Rate for Payer: Wellpoint Medicaid Managed Care	$6,777.13

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$13,857.02

Service Code	APR-DRG 4462
Min. Negotiated Rate	$8,381.48
Max. Negotiated Rate	$13,857.02
Rate for Payer: Aetna Better Health Medicaid	$13,585.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,857.02
Rate for Payer: Wellpoint Medicaid Managed Care	$8,381.48

URETHRAL PROCEDURES WITH CC/MCC

Facility

$63,923.43

Service Code	MSDRG 671
Min. Negotiated Rate	$19,588.09
Max. Negotiated Rate	$63,923.43
Rate for Payer: Aetna Commercial	$60,527.20
Rate for Payer: Aetna Medicare Advantage	$19,588.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,139.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,139.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,307.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,139.57
Rate for Payer: Cigna Commercial	$38,630.19
Rate for Payer: Cigna Medicare Advantage	$21,307.81
Rate for Payer: Clover Medicare Advantage	$20,242.42
Rate for Payer: EmblemHealth Commercial	$63,923.43
Rate for Payer: Humana Medicare Advantage	$21,947.04
Rate for Payer: Oxford Commercial	$24,142.75
Rate for Payer: UnitedHealthcare Commercial	$27,404.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,307.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,586.28
Rate for Payer: Wellcare Medicare Advantage	$21,307.81

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