Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANN 15CM RF 22GA CURV 7210278

Facility

$1,750.00

Hospital Charge Code	270639692
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$279.75
Max. Negotiated Rate	$932.50
Rate for Payer: Aetna Commercial	$559.50
Rate for Payer: Aetna Medicare Advantage	$559.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.57
Rate for Payer: Cigna Commercial	$932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$279.75
Max. Negotiated Rate	$451.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$387.75
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$336.05
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$775.50
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.05
Rate for Payer: Oxford Commercial	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Commercial	$1,292.50

CANN DRILL 4.8X200MM

Facility

$1,800.00

Hospital Charge Code	270680500
Hospital Revenue Code	272
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CANN DRILL 4.8X200MM

Facility

$1,800.00

Hospital Charge Code	270680500
Hospital Revenue Code	272
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$900.00

CANN DRILOCK 6.5

Facility

$140.65

Hospital Charge Code	270681377
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANN DRILOCK 6.5

Facility

$140.65

Hospital Charge Code	270681377
Hospital Revenue Code	272
Min. Negotiated Rate	$18.28
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$42.20
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.28
Rate for Payer: Oxford Commercial	$70.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$70.33

CANN.DRILOK 6.5mm

Facility

$140.65

Hospital Charge Code	270680691
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANN.DRILOK 6.5mm

Facility

$140.65

Hospital Charge Code	270680691
Hospital Revenue Code	272
Min. Negotiated Rate	$18.28
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$42.20
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.28
Rate for Payer: Oxford Commercial	$70.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$70.33

CANN.DRILOK 8mm

Facility

$140.65

Hospital Charge Code	270680692
Hospital Revenue Code	272
Min. Negotiated Rate	$18.28
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$42.20
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.28
Rate for Payer: Oxford Commercial	$70.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$70.33

CANN.DRILOK 8mm

Facility

$140.65

Hospital Charge Code	270680692
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANNISTER 150ML

Facility

$130.00

Hospital Charge Code	270684519
Hospital Revenue Code	272
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$39.00
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.90
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$65.00

CANNISTER 150ML

Facility

$130.00

Hospital Charge Code	270684519
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

CANNISTER GOMCO DISP SUCTION**

Facility

$15.00

Hospital Charge Code	8003006
Hospital Revenue Code	279
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CANNISTER GOMCO DISP SUCTION**

Facility

$15.00

Hospital Charge Code	8003006
Hospital Revenue Code	279
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
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	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

CANNISTER PUMP SZ

Facility

$1,825.00

Hospital Charge Code	270688233
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CANNISTER PUMP SZ

Facility

$1,825.00

Hospital Charge Code	270688233
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CANNISTER THIN WALL 1500CC

Facility

$24.00

Hospital Charge Code	270330966
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

CANNISTER THIN WALL 1500CC

Facility

$24.00

Hospital Charge Code	270330966
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

Know your out-of-pocket cost for care.

All Charges