Heights University Hospital

All Charges

Charge

Type

Setting

Price

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$347.25
Max. Negotiated Rate	$560.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: Qualcare PPO/HMO/WC	$347.25

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$347.25
Max. Negotiated Rate	$1,157.50
Rate for Payer: Aetna Commercial	$694.50
Rate for Payer: Aetna Medicare Advantage	$694.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.33
Rate for Payer: Cigna Commercial	$1,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: Qualcare PPO/HMO/WC	$347.25

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$40.42
Max. Negotiated Rate	$40.42
Rate for Payer: Qualcare PPO/HMO/WC	$40.42

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$35.03
Max. Negotiated Rate	$134.75
Rate for Payer: Aetna Commercial	$80.85
Rate for Payer: Aetna Medicare Advantage	$80.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.72
Rate for Payer: Cigna Commercial	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.03
Rate for Payer: Oxford Commercial	$134.75
Rate for Payer: Qualcare PPO/HMO/WC	$40.42
Rate for Payer: UnitedHealthcare Commercial	$134.75

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$1,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,350.00

CABLE FIBER OPTIC 5MM X 10FT

Facility

$3,150.00

Hospital Charge Code	270662669
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$945.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

CABLE FIBER OPTIC 5MM X 10FT

Facility

$3,150.00

Hospital Charge Code	270662669
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$762.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$858.00
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$109.50
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.45
Rate for Payer: Oxford Commercial	$182.50
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$182.50

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CABLE INTRAUTERINE PRESS

Facility

$903.25

Hospital Charge Code	270600587
Hospital Revenue Code	270
Min. Negotiated Rate	$135.49
Max. Negotiated Rate	$135.49
Rate for Payer: Qualcare PPO/HMO/WC	$135.49

CABLE INTRAUTERINE PRESS

Facility

$903.25

Hospital Charge Code	270600587
Hospital Revenue Code	270
Min. Negotiated Rate	$117.42
Max. Negotiated Rate	$451.62
Rate for Payer: Aetna Commercial	$270.98
Rate for Payer: Aetna Medicare Advantage	$270.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.33
Rate for Payer: Cigna Commercial	$451.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.42
Rate for Payer: Oxford Commercial	$451.62
Rate for Payer: Qualcare PPO/HMO/WC	$135.49
Rate for Payer: UnitedHealthcare Commercial	$451.62

CABLE MONITOR

Facility

$492.75

Hospital Charge Code	270661179
Hospital Revenue Code	270
Min. Negotiated Rate	$64.06
Max. Negotiated Rate	$246.38
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna Medicare Advantage	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.65
Rate for Payer: Cigna Commercial	$246.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.06
Rate for Payer: Oxford Commercial	$246.38
Rate for Payer: Qualcare PPO/HMO/WC	$73.91
Rate for Payer: UnitedHealthcare Commercial	$246.38

CABLE MONITOR

Facility

$492.75

Hospital Charge Code	270661179
Hospital Revenue Code	270
Min. Negotiated Rate	$73.91
Max. Negotiated Rate	$73.91
Rate for Payer: Qualcare PPO/HMO/WC	$73.91

CABLE MONO PYRENEES 28 MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270690740
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

CABLE MONO PYRENEES 28 MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270690740
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$1,956.00
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

CABLE MULTI FUNCTION

Facility

$492.75

Hospital Charge Code	270665808
Hospital Revenue Code	270
Min. Negotiated Rate	$64.06
Max. Negotiated Rate	$246.38
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna Medicare Advantage	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.65
Rate for Payer: Cigna Commercial	$246.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.06
Rate for Payer: Oxford Commercial	$246.38
Rate for Payer: Qualcare PPO/HMO/WC	$73.91
Rate for Payer: UnitedHealthcare Commercial	$246.38

CABLE MULTI FUNCTION

Facility

$492.75

Hospital Charge Code	270665808
Hospital Revenue Code	270
Min. Negotiated Rate	$73.91
Max. Negotiated Rate	$73.91
Rate for Payer: Qualcare PPO/HMO/WC	$73.91

CABLE MULTILEAD TRAIL

Facility

$1,100.00

Hospital Charge Code	270668331
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

CABLE MULTILEAD TRAIL

Facility

$1,100.00

Hospital Charge Code	270668331
Hospital Revenue Code	272
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$550.00

CABLE OR

Facility

$750.00

Hospital Charge Code	270673088
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

Know your out-of-pocket cost for care.

All Charges