Heights University Hospital

All Charges

Charge

Type

Setting

Price

BOBCOCK GRASPER 10 MM

Facility

$1,276.31

Hospital Charge Code	270669360
Hospital Revenue Code	272
Min. Negotiated Rate	$165.92
Max. Negotiated Rate	$638.15
Rate for Payer: Aetna Commercial	$382.89
Rate for Payer: Aetna Medicare Advantage	$382.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.46
Rate for Payer: Cigna Commercial	$638.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.92
Rate for Payer: Oxford Commercial	$638.15
Rate for Payer: Qualcare PPO/HMO/WC	$191.45
Rate for Payer: UnitedHealthcare Commercial	$638.15

BOBCOCK GRASPER 5 MM

Facility

$1,251.27

Hospital Charge Code	270669361
Hospital Revenue Code	272
Min. Negotiated Rate	$187.69
Max. Negotiated Rate	$187.69
Rate for Payer: Qualcare PPO/HMO/WC	$187.69

BOBCOCK GRASPER 5 MM

Facility

$1,251.27

Hospital Charge Code	270669361
Hospital Revenue Code	272
Min. Negotiated Rate	$162.67
Max. Negotiated Rate	$625.63
Rate for Payer: Aetna Commercial	$375.38
Rate for Payer: Aetna Medicare Advantage	$375.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.07
Rate for Payer: Cigna Commercial	$625.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.67
Rate for Payer: Oxford Commercial	$625.63
Rate for Payer: Qualcare PPO/HMO/WC	$187.69
Rate for Payer: UnitedHealthcare Commercial	$625.63

BODY FLUID CELL BLOCK.SMEAR***

Facility

$139.00

Hospital Charge Code	3010501
Hospital Revenue Code	309
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

BODY FLUID CELL BLOCK.SMEAR***

Facility

$139.00

Hospital Charge Code	3010501
Hospital Revenue Code	309
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

BODY FLUID LDH (OTHER)***

Facility

$15.00

Hospital Charge Code	3010519
Hospital Revenue Code	309
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

BODY FLUID LDH (OTHER)***

Facility

$15.00

Hospital Charge Code	3010519
Hospital Revenue Code	309
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

BODY MP XXL PROX 126DEG 35MM

Facility

$17,910.00

Service Code	HCPCS C1776
Hospital Charge Code	270677768
Hospital Revenue Code	278
Min. Negotiated Rate	$2,686.50
Max. Negotiated Rate	$4,334.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,582.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,334.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,686.50

BODY MP XXL PROX 126DEG 35MM

Facility

$17,910.00

Service Code	HCPCS C1776
Hospital Charge Code	270677768
Hospital Revenue Code	278
Min. Negotiated Rate	$2,686.50
Max. Negotiated Rate	$8,955.00
Rate for Payer: Aetna Commercial	$5,373.00
Rate for Payer: Aetna Medicare Advantage	$5,373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,567.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,567.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,567.05
Rate for Payer: Cigna Commercial	$8,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,334.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,686.50

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84202015
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GO
Hospital Charge Code	84201141
Hospital Revenue Code	439
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GO
Hospital Charge Code	74203093
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84201123
Hospital Revenue Code	429
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GO
Hospital Charge Code	84201141
Hospital Revenue Code	439
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	9109133
Hospital Revenue Code	420
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84202015
Hospital Revenue Code	420
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84201123
Hospital Revenue Code	429
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GO
Hospital Charge Code	74203093
Hospital Revenue Code	430
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	9109133
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS CH

Facility

$0.01

Service Code	HCPCS G8981GOCH
Hospital Charge Code	74203093CH
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS CH

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84202015CH
Hospital Revenue Code	420
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS CH

Facility

$0.01

Service Code	HCPCS G8981GP
Hospital Charge Code	84202015CH
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BODY POS CURRENT STATUS CH

Facility

$0.01

Service Code	HCPCS G8981GOCH
Hospital Charge Code	74203093CH
Hospital Revenue Code	430
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS CI

Facility

$0.01

Service Code	HCPCS G8981GPCI
Hospital Charge Code	84202015CI
Hospital Revenue Code	420
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

BODY POS CURRENT STATUS CI

Facility

$0.01

Service Code	HCPCS G8981GOCI
Hospital Charge Code	74203093CI
Hospital Revenue Code	430
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges