Heights University Hospital

All Charges

Charge

Type

Setting

Price

VERSAGRAFT

Facility

$6,645.00

Hospital Charge Code	270684371
Hospital Revenue Code	278
Min. Negotiated Rate	$996.75
Max. Negotiated Rate	$1,608.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.09
Rate for Payer: Qualcare PPO/HMO/WC	$996.75

VERSAJET II EXACT

Facility

$2,975.00

Hospital Charge Code	270673074
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

VERSAJET II EXACT

Facility

$2,975.00

Hospital Charge Code	270673074
Hospital Revenue Code	272
Min. Negotiated Rate	$386.75
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.75
Rate for Payer: Oxford Commercial	$1,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$1,487.50

VERSAJET PLUS HANDPIECE 15 DEG

Facility

$3,475.00

Hospital Charge Code	270659460
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

VERSAJET PLUS HANDPIECE 15 DEG

Facility

$3,475.00

Hospital Charge Code	270659460
Hospital Revenue Code	272
Min. Negotiated Rate	$451.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,042.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.75
Rate for Payer: Oxford Commercial	$1,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$1,737.50

VERSAJET PLUS HANDPIECE 45 DEG

Facility

$3,375.00

Hospital Charge Code	270659486
Hospital Revenue Code	270
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$506.25
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

VERSAJET PLUS HANDPIECE 45 DEG

Facility

$3,375.00

Hospital Charge Code	270659486
Hospital Revenue Code	270
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,012.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.75
Rate for Payer: Oxford Commercial	$1,687.50
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Commercial	$1,687.50

VERSAJET PLUS HANDPIECE 45DEG

Facility

$2,975.00

Hospital Charge Code	270659462
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

VERSAJET PLUS HANDPIECE 45DEG

Facility

$2,975.00

Hospital Charge Code	270659462
Hospital Revenue Code	272
Min. Negotiated Rate	$386.75
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.75
Rate for Payer: Oxford Commercial	$1,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$1,487.50

VERSALOK

Facility

$2,055.00

Hospital Charge Code	270657369
Hospital Revenue Code	270
Min. Negotiated Rate	$308.25
Max. Negotiated Rate	$308.25
Rate for Payer: Qualcare PPO/HMO/WC	$308.25

VERSALOK

Facility

$2,055.00

Hospital Charge Code	270657369
Hospital Revenue Code	270
Min. Negotiated Rate	$267.15
Max. Negotiated Rate	$1,027.50
Rate for Payer: Aetna Commercial	$616.50
Rate for Payer: Aetna Medicare Advantage	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$524.02
Rate for Payer: Cigna Commercial	$1,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.15
Rate for Payer: Oxford Commercial	$1,027.50
Rate for Payer: Qualcare PPO/HMO/WC	$308.25
Rate for Payer: UnitedHealthcare Commercial	$1,027.50

VERSAPORT 12MM TROCAR SLEEVE

Facility

$69.22

Hospital Charge Code	270654906
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$34.61
Rate for Payer: Aetna Commercial	$20.77
Rate for Payer: Aetna Medicare Advantage	$20.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.65
Rate for Payer: Cigna Commercial	$34.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$34.61
Rate for Payer: Qualcare PPO/HMO/WC	$10.38
Rate for Payer: UnitedHealthcare Commercial	$34.61

VERSAPORT 12MM TROCAR SLEEVE

Facility

$69.22

Hospital Charge Code	270654906
Hospital Revenue Code	270
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$10.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.38

VERSAPORT 15mm LONG 179078P

Facility

$229.50

Hospital Charge Code	270627427
Hospital Revenue Code	272
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$114.75
Rate for Payer: Aetna Commercial	$68.85
Rate for Payer: Aetna Medicare Advantage	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.52
Rate for Payer: Cigna Commercial	$114.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.84
Rate for Payer: Oxford Commercial	$114.75
Rate for Payer: Qualcare PPO/HMO/WC	$34.42
Rate for Payer: UnitedHealthcare Commercial	$114.75

VERSAPORT 15mm LONG 179078P

Facility

$229.50

Hospital Charge Code	270627427
Hospital Revenue Code	272
Min. Negotiated Rate	$34.42
Max. Negotiated Rate	$34.42
Rate for Payer: Qualcare PPO/HMO/WC	$34.42

VERSAPORT PLUS RPF 5MM-8MM

Facility

$238.15

Hospital Charge Code	270662186
Hospital Revenue Code	270
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

VERSAPORT PLUS RPF 5MM-8MM

Facility

$238.15

Hospital Charge Code	270662186
Hospital Revenue Code	270
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

VERSAPORT PLUS V2 11mm TROCAR

Facility

$142.80

Hospital Charge Code	270642023
Hospital Revenue Code	272
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.41
Rate for Payer: Cigna Commercial	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.56
Rate for Payer: Oxford Commercial	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$71.40

VERSAPORT PLUS V2 11mm TROCAR

Facility

$142.80

Hospital Charge Code	270642023
Hospital Revenue Code	272
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$21.42
Rate for Payer: Qualcare PPO/HMO/WC	$21.42

VERSAPORT RPF TROCAR 10-15MM

Facility

$150.00

Hospital Charge Code	270639246
Hospital Revenue Code	270
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

VERSAPORT RPF TROCAR 10-15MM

Facility

$150.00

Hospital Charge Code	270639246
Hospital Revenue Code	270
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

VERSAPORT V2 5MM

Facility

$102.00

Hospital Charge Code	270600067
Hospital Revenue Code	272
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

VERSAPORT V2 5MM

Facility

$102.00

Hospital Charge Code	270600067
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$51.00
Rate for Payer: Aetna Commercial	$30.60
Rate for Payer: Aetna Medicare Advantage	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.01
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$51.00

VERSAPORT V2 BLDLES OPT 11 STD

Facility

$153.00

Hospital Charge Code	270675469
Hospital Revenue Code	272
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

VERSAPORT V2 BLDLES OPT 11 STD

Facility

$153.00

Hospital Charge Code	270675469
Hospital Revenue Code	272
Min. Negotiated Rate	$19.89
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$45.90
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.89
Rate for Payer: Oxford Commercial	$76.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.95
Rate for Payer: UnitedHealthcare Commercial	$76.50

Know your out-of-pocket cost for care.

All Charges