Heights University Hospital

All Charges

Charge

Type

Setting

Price

BIOPSY OF THE VAGINA SIMPLE

Facility

$3,267.85

Service Code	HCPCS 57100
Hospital Charge Code	412357100
Hospital Revenue Code	361
Min. Negotiated Rate	$490.18
Max. Negotiated Rate	$490.18
Rate for Payer: Qualcare PPO/HMO/WC	$490.18

BIOPSY OF THE VAGINA SIMPLE

Facility

$3,267.85

Service Code	HCPCS 57100
Hospital Charge Code	412357100
Hospital Revenue Code	361
Min. Negotiated Rate	$424.82
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$980.36
Rate for Payer: Aetna Medicare Advantage	$980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$833.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$833.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$833.30
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.82
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$490.18
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

BIOPSY PETITE 14G MAMMOSTAR

Facility

$1,968.00

Hospital Charge Code	270663459
Hospital Revenue Code	272
Min. Negotiated Rate	$295.20
Max. Negotiated Rate	$295.20
Rate for Payer: Qualcare PPO/HMO/WC	$295.20

BIOPSY PETITE 14G MAMMOSTAR

Facility

$393.60

Hospital Charge Code	270663459R
Hospital Revenue Code	272
Min. Negotiated Rate	$51.17
Max. Negotiated Rate	$196.80
Rate for Payer: Aetna Commercial	$118.08
Rate for Payer: Aetna Medicare Advantage	$118.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.37
Rate for Payer: Cigna Commercial	$196.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.17
Rate for Payer: Oxford Commercial	$196.80
Rate for Payer: Qualcare PPO/HMO/WC	$59.04
Rate for Payer: UnitedHealthcare Commercial	$196.80

BIOPSY PETITE 14G MAMMOSTAR

Facility

$1,968.00

Hospital Charge Code	270663459
Hospital Revenue Code	272
Min. Negotiated Rate	$255.84
Max. Negotiated Rate	$984.00
Rate for Payer: Aetna Commercial	$590.40
Rate for Payer: Aetna Medicare Advantage	$590.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.84
Rate for Payer: Cigna Commercial	$984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.84
Rate for Payer: Oxford Commercial	$984.00
Rate for Payer: Qualcare PPO/HMO/WC	$295.20
Rate for Payer: UnitedHealthcare Commercial	$984.00

BIOPSY PETITE 14G MAMMOSTAR

Facility

$393.60

Hospital Charge Code	270663459R
Hospital Revenue Code	272
Min. Negotiated Rate	$59.04
Max. Negotiated Rate	$59.04
Rate for Payer: Qualcare PPO/HMO/WC	$59.04

BIOPSY SITE IDENTIFIER 14G

Facility

$471.50

Hospital Charge Code	270645827
Hospital Revenue Code	271
Min. Negotiated Rate	$61.30
Max. Negotiated Rate	$235.75
Rate for Payer: Aetna Commercial	$141.45
Rate for Payer: Aetna Medicare Advantage	$141.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.23
Rate for Payer: Cigna Commercial	$235.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.30
Rate for Payer: Oxford Commercial	$235.75
Rate for Payer: Qualcare PPO/HMO/WC	$70.72
Rate for Payer: UnitedHealthcare Commercial	$235.75

BIOPSY SITE IDENTIFIER 14G

Facility

$471.50

Hospital Charge Code	270645827
Hospital Revenue Code	271
Min. Negotiated Rate	$70.72
Max. Negotiated Rate	$70.72
Rate for Payer: Qualcare PPO/HMO/WC	$70.72

BIOPSY SKIN 1 LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	93950007
Hospital Revenue Code	761
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

BIOPSY SKIN 1 LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	93950007
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

BIOPSY SYS E/ECHOGENIC NDL 18G

Facility

$210.00

Hospital Charge Code	270655408
Hospital Revenue Code	271
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

BIOPSY SYS E/ECHOGENIC NDL 18G

Facility

$210.00

Hospital Charge Code	270655408
Hospital Revenue Code	271
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$105.00

BIOPSY SYSTEM ASAP

Facility

$871.25

Hospital Charge Code	270655636
Hospital Revenue Code	271
Min. Negotiated Rate	$113.26
Max. Negotiated Rate	$435.62
Rate for Payer: Aetna Commercial	$261.38
Rate for Payer: Aetna Medicare Advantage	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.17
Rate for Payer: Cigna Commercial	$435.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Oxford Commercial	$435.62
Rate for Payer: Qualcare PPO/HMO/WC	$130.69
Rate for Payer: UnitedHealthcare Commercial	$435.62

BIOPSY SYSTEM ASAP

Facility

$871.25

Hospital Charge Code	270655636
Hospital Revenue Code	271
Min. Negotiated Rate	$130.69
Max. Negotiated Rate	$130.69
Rate for Payer: Qualcare PPO/HMO/WC	$130.69

BIORAPTOR KNOTLESS ANCHOR SH

Facility

$2,005.00

Hospital Charge Code	270673947
Hospital Revenue Code	272
Min. Negotiated Rate	$260.65
Max. Negotiated Rate	$1,002.50
Rate for Payer: Aetna Commercial	$601.50
Rate for Payer: Aetna Medicare Advantage	$601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.27
Rate for Payer: Cigna Commercial	$1,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.65
Rate for Payer: Oxford Commercial	$1,002.50
Rate for Payer: Qualcare PPO/HMO/WC	$300.75
Rate for Payer: UnitedHealthcare Commercial	$1,002.50

BIORAPTOR KNOTLESS ANCHOR SH

Facility

$2,005.00

Hospital Charge Code	270673947
Hospital Revenue Code	272
Min. Negotiated Rate	$300.75
Max. Negotiated Rate	$300.75
Rate for Payer: Qualcare PPO/HMO/WC	$300.75

BIORAPTOR SUTURE ANCHOR HIP

Facility

$1,980.00

Hospital Charge Code	270668361
Hospital Revenue Code	272
Min. Negotiated Rate	$257.40
Max. Negotiated Rate	$990.00
Rate for Payer: Aetna Commercial	$594.00
Rate for Payer: Aetna Medicare Advantage	$594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$504.90
Rate for Payer: Cigna Commercial	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.40
Rate for Payer: Oxford Commercial	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.00
Rate for Payer: UnitedHealthcare Commercial	$990.00

BIORAPTOR SUTURE ANCHOR HIP

Facility

$1,980.00

Hospital Charge Code	270668361
Hospital Revenue Code	272
Min. Negotiated Rate	$297.00
Max. Negotiated Rate	$297.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.00

BIOREIGN BIOACTIVE MATRIX 10CC

Facility

$29,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696723
Hospital Revenue Code	278
Min. Negotiated Rate	$4,496.25
Max. Negotiated Rate	$7,253.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,253.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,496.25

BIOREIGN BIOACTIVE MATRIX 10CC

Facility

$29,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696723
Hospital Revenue Code	278
Min. Negotiated Rate	$4,496.25
Max. Negotiated Rate	$14,987.50
Rate for Payer: Aetna Commercial	$8,992.50
Rate for Payer: Aetna Medicare Advantage	$8,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,643.62
Rate for Payer: Cigna Commercial	$14,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,253.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,496.25

BIOREIGN BIOACTIVE MATRIX 5CC

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697829
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

BIOREIGN BIOACTIVE MATRIX 5CC

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697829
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$4,942.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

BIOSHIELD IRRIGATOR

Facility

$1,425.00

Hospital Charge Code	270654399
Hospital Revenue Code	272
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

BIOSHIELD IRRIGATOR

Facility

$1,425.00

Hospital Charge Code	270654399
Hospital Revenue Code	272
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Oxford Commercial	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Commercial	$712.50

BIOSHIELD UNIVERSAL IRRIGATION

Facility

$8.00

Hospital Charge Code	270657674
Hospital Revenue Code	270
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

Know your out-of-pocket cost for care.

All Charges