Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

BIOSORB SUTURES

Facility

$627.00

Hospital Charge Code	270335275
Hospital Revenue Code	272
Min. Negotiated Rate	$94.05
Max. Negotiated Rate	$94.05
Rate for Payer: Qualcare PPO/HMO/WC	$94.05

BIOSORB SUTURES

Facility

$627.00

Hospital Charge Code	270335275
Hospital Revenue Code	272
Min. Negotiated Rate	$81.51
Max. Negotiated Rate	$313.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.88
Rate for Payer: Cigna Commercial	$313.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.51
Rate for Payer: Oxford Commercial	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.05
Rate for Payer: UnitedHealthcare Commercial	$313.50

BIOSPHERE PUTTY 2.5CC

Facility

$4,750.00

Hospital Charge Code	270702961
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

BIOSPHERE PUTTY 2.5CC

Facility

$4,750.00

Hospital Charge Code	270702961
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

BIOSPHERE PUTTY 5CC

Facility

$9,000.00

Hospital Charge Code	270702968
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

BIOSPHERE PUTTY 5CC

Facility

$9,000.00

Hospital Charge Code	270702968
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

BIOSURGE II ALLOSYNC 5CC

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697673
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$2,625.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

BIOSURGE II ALLOSYNC 5CC

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697673
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

BIOSURGE W ALLOSYNC PURE 2.5CC

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693650
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

BIOSURGE W ALLOSYNC PURE 2.5CC

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693650
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

BIO-SUTURETAK SPEAR 3.7MM

Facility

$2,250.00

Hospital Charge Code	270656497
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BIO-SUTURETAK SPEAR 3.7MM

Facility

$2,250.00

Hospital Charge Code	270656497
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

BIOSWVLK 4.75X19.1 FIXATION

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270688423
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

BIOSWVLK 4.75X19.1 FIXATION

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270688423
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,087.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

BIOSYN 3-0 UNDYED 30 SC-2

Facility

$6.85

Hospital Charge Code	270657583
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

BIOSYN 3-0 UNDYED 30 SC-2

Facility

$6.85

Hospital Charge Code	270657583
Hospital Revenue Code	270
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.06
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$3.42

BIOSYNEEDLEFRANSEENLUNG20G 10C

Facility

$105.20

Hospital Charge Code	2709005726
Hospital Revenue Code	272
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$52.60
Rate for Payer: Aetna Commercial	$31.56
Rate for Payer: Aetna Medicare Advantage	$31.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.83
Rate for Payer: Cigna Commercial	$52.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.68
Rate for Payer: Oxford Commercial	$52.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.78
Rate for Payer: UnitedHealthcare Commercial	$52.60

BIOSYNEEDLEFRANSEENLUNG20G 10C

Facility

$105.20

Hospital Charge Code	2709005726
Hospital Revenue Code	272
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$15.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.78

BIO TENDESIS SCREW 11 X 10

Facility

$590.00

Hospital Charge Code	270335619
Hospital Revenue Code	278
Min. Negotiated Rate	$88.50
Max. Negotiated Rate	$295.00
Rate for Payer: Aetna Commercial	$177.00
Rate for Payer: Aetna Medicare Advantage	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: Qualcare PPO/HMO/WC	$88.50

BIO TENDESIS SCREW 11 X 10

Facility

$590.00

Hospital Charge Code	270335619
Hospital Revenue Code	278
Min. Negotiated Rate	$88.50
Max. Negotiated Rate	$142.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: Qualcare PPO/HMO/WC	$88.50

BIOTENE LOZENGE

Facility

$4.00

Service Code	NDC 48582051201
Hospital Charge Code	606390544
Hospital Revenue Code	259
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BIOTENE LOZENGE

Facility

$4.00

Service Code	NDC 48582051201
Hospital Charge Code	606390544
Hospital Revenue Code	259
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

BIO-TENODESIS SCREW INSTS KIT

Facility

$975.00

Hospital Charge Code	270638707
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

BIO-TENODESIS SCREW INSTS KIT

Facility

$975.00

Hospital Charge Code	270638707
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

Know your out-of-pocket cost for care.

All Charges