Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLADE GLIDESCOPE RANGER STAT#3

Facility

$80.00

Hospital Charge Code	270673221
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

BLADE GLIDESCOPE RANGER STAT#3

Facility

$80.00

Hospital Charge Code	270673221
Hospital Revenue Code	272
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$40.00

BLADE GLIDESCOPE RANGER STAT#4

Facility

$90.00

Hospital Charge Code	270668123
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

BLADE GLIDESCOPE RANGER STAT#4

Facility

$90.00

Hospital Charge Code	270668123
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

BLADE GLIDESCOPE STAT #1

Facility

$114.50

Hospital Charge Code	270661546
Hospital Revenue Code	272
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$57.25
Rate for Payer: Aetna Commercial	$34.35
Rate for Payer: Aetna Medicare Advantage	$34.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.20
Rate for Payer: Cigna Commercial	$57.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.88
Rate for Payer: Oxford Commercial	$57.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.18
Rate for Payer: UnitedHealthcare Commercial	$57.25

BLADE GLIDESCOPE STAT #1

Facility

$114.50

Hospital Charge Code	270661546
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$17.18

BLADE GLIDESCOPE STAT #2

Facility

$114.50

Hospital Charge Code	270661547
Hospital Revenue Code	272
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$57.25
Rate for Payer: Aetna Commercial	$34.35
Rate for Payer: Aetna Medicare Advantage	$34.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.20
Rate for Payer: Cigna Commercial	$57.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.88
Rate for Payer: Oxford Commercial	$57.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.18
Rate for Payer: UnitedHealthcare Commercial	$57.25

BLADE GLIDESCOPE STAT #2

Facility

$114.50

Hospital Charge Code	270661547
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$17.18

BLADE GLIDESCOPE STAT #3

Facility

$90.00

Hospital Charge Code	270657740
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

BLADE GLIDESCOPE STAT #3

Facility

$90.00

Hospital Charge Code	270657740
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

BLADE GLIDESCOPE STAT #4

Facility

$90.00

Hospital Charge Code	270654995
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

BLADE GLIDESCOPE STAT #4

Facility

$90.00

Hospital Charge Code	270654995
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

BLADE GREAT WHITE SHAVER 1.2MM

Facility

$272.95

Hospital Charge Code	270677534
Hospital Revenue Code	272
Min. Negotiated Rate	$35.48
Max. Negotiated Rate	$136.47
Rate for Payer: Aetna Commercial	$81.89
Rate for Payer: Aetna Medicare Advantage	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.60
Rate for Payer: Cigna Commercial	$136.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.48
Rate for Payer: Oxford Commercial	$136.47
Rate for Payer: Qualcare PPO/HMO/WC	$40.94
Rate for Payer: UnitedHealthcare Commercial	$136.47

BLADE GREAT WHITE SHAVER 1.2MM

Facility

$272.95

Hospital Charge Code	270677534
Hospital Revenue Code	272
Min. Negotiated Rate	$40.94
Max. Negotiated Rate	$40.94
Rate for Payer: Qualcare PPO/HMO/WC	$40.94

BLADE HD SAG 32x0.6x62 MM

Facility

$515.00

Hospital Charge Code	270684745
Hospital Revenue Code	272
Min. Negotiated Rate	$77.25
Max. Negotiated Rate	$77.25
Rate for Payer: Qualcare PPO/HMO/WC	$77.25

BLADE HD SAG 32x0.6x62 MM

Facility

$515.00

Hospital Charge Code	270684745
Hospital Revenue Code	272
Min. Negotiated Rate	$66.95
Max. Negotiated Rate	$257.50
Rate for Payer: Aetna Commercial	$154.50
Rate for Payer: Aetna Medicare Advantage	$154.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.32
Rate for Payer: Cigna Commercial	$257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.95
Rate for Payer: Oxford Commercial	$257.50
Rate for Payer: Qualcare PPO/HMO/WC	$77.25
Rate for Payer: UnitedHealthcare Commercial	$257.50

BLADE HEAVY RECIPROCATING 74x.

Facility

$545.00

Hospital Charge Code	270689584
Hospital Revenue Code	272
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$272.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$272.50

BLADE HEAVY RECIPROCATING 74x.

Facility

$545.00

Hospital Charge Code	270689584
Hospital Revenue Code	272
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

BLADE HEAVY RECIPROCATING 77MM

Facility

$223.40

Hospital Charge Code	270689585
Hospital Revenue Code	272
Min. Negotiated Rate	$33.51
Max. Negotiated Rate	$33.51
Rate for Payer: Qualcare PPO/HMO/WC	$33.51

BLADE HEAVY RECIPROCATING 77MM

Facility

$223.40

Hospital Charge Code	270689585
Hospital Revenue Code	272
Min. Negotiated Rate	$29.04
Max. Negotiated Rate	$111.70
Rate for Payer: Aetna Commercial	$67.02
Rate for Payer: Aetna Medicare Advantage	$67.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.97
Rate for Payer: Cigna Commercial	$111.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.04
Rate for Payer: Oxford Commercial	$111.70
Rate for Payer: Qualcare PPO/HMO/WC	$33.51
Rate for Payer: UnitedHealthcare Commercial	$111.70

BLADE HEAVY RECIPROCATING 77X1

Facility

$202.55

Hospital Charge Code	270689551
Hospital Revenue Code	272
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$101.28
Rate for Payer: Aetna Commercial	$60.77
Rate for Payer: Aetna Medicare Advantage	$60.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.65
Rate for Payer: Cigna Commercial	$101.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.33
Rate for Payer: Oxford Commercial	$101.28
Rate for Payer: Qualcare PPO/HMO/WC	$30.38
Rate for Payer: UnitedHealthcare Commercial	$101.28

BLADE HEAVY RECIPROCATING 77X1

Facility

$202.55

Hospital Charge Code	270689551
Hospital Revenue Code	272
Min. Negotiated Rate	$30.38
Max. Negotiated Rate	$30.38
Rate for Payer: Qualcare PPO/HMO/WC	$30.38

BLADE HELICAL 100M

Facility

$600.00

Hospital Charge Code	270682304
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$300.00

BLADE HELICAL 100M

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270682260
Hospital Revenue Code	278
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$796.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

BLADE HELICAL 100M

Facility

$600.00

Hospital Charge Code	270682304
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

Know your out-of-pocket cost for care.

All Charges