Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANN TRIPPLEDAM TWIST W/VALVE

Facility

$800.00

Hospital Charge Code	270682242
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

CANNULA 100x22GAX4.0 40562040

Facility

$125.00

Hospital Charge Code	270641686
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA 100x22GAX4.0 40562040

Facility

$125.00

Hospital Charge Code	270641686
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CANNULA 100X22GAX5.0 406620115

Facility

$125.00

Hospital Charge Code	270641687
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA 100X22GAX5.0 406620115

Facility

$125.00

Hospital Charge Code	270641687
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CANNULA 150 CURVED 5MM 20G

Facility

$174.00

Hospital Charge Code	270654840
Hospital Revenue Code	272
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$52.20
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$87.00

CANNULA 150 CURVED 5MM 20G

Facility

$174.00

Hospital Charge Code	270654840
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

CANNULA 5.0MM DISP 275905075

Facility

$123.10

Hospital Charge Code	270622642
Hospital Revenue Code	272
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$61.55
Rate for Payer: Aetna Commercial	$36.93
Rate for Payer: Aetna Medicare Advantage	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.39
Rate for Payer: Cigna Commercial	$61.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.00
Rate for Payer: Oxford Commercial	$61.55
Rate for Payer: Qualcare PPO/HMO/WC	$18.46
Rate for Payer: UnitedHealthcare Commercial	$61.55

CANNULA 5.0MM DISP 275905075

Facility

$123.10

Hospital Charge Code	270622642
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.46

CANNULA 5.75mm X 7cm AR-6564

Facility

$125.00

Hospital Charge Code	270636059
Hospital Revenue Code	270
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CANNULA 5.75mm X 7cm AR-6564

Facility

$125.00

Hospital Charge Code	270636059
Hospital Revenue Code	270
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA 5.8 MM TROCAR

Facility

$605.85

Hospital Charge Code	270688257
Hospital Revenue Code	272
Min. Negotiated Rate	$78.76
Max. Negotiated Rate	$302.93
Rate for Payer: Aetna Commercial	$181.75
Rate for Payer: Aetna Medicare Advantage	$181.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.49
Rate for Payer: Cigna Commercial	$302.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.76
Rate for Payer: Oxford Commercial	$302.93
Rate for Payer: Qualcare PPO/HMO/WC	$90.88
Rate for Payer: UnitedHealthcare Commercial	$302.93

CANNULA 5.8 MM TROCAR

Facility

$605.85

Hospital Charge Code	270688257
Hospital Revenue Code	272
Min. Negotiated Rate	$90.88
Max. Negotiated Rate	$90.88
Rate for Payer: Qualcare PPO/HMO/WC	$90.88

CANNULA 5MM

Facility

$4,500.00

Hospital Charge Code	270664002
Hospital Revenue Code	270
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CANNULA 5MM

Facility

$4,500.00

Hospital Charge Code	270664002
Hospital Revenue Code	270
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$2,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$2,250.00

CANNULA 6 X 55m 214660

Facility

$525.00

Hospital Charge Code	270635850
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.25
Rate for Payer: Oxford Commercial	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$262.50

CANNULA 6 X 55m 214660

Facility

$525.00

Hospital Charge Code	270635850
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CANNULA 7.0 X 72 MM

Facility

$163.80

Hospital Charge Code	270682201
Hospital Revenue Code	272
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$24.57
Rate for Payer: Qualcare PPO/HMO/WC	$24.57

CANNULA 7.0 X 72 MM

Facility

$163.80

Hospital Charge Code	270682201
Hospital Revenue Code	272
Min. Negotiated Rate	$21.29
Max. Negotiated Rate	$81.90
Rate for Payer: Aetna Commercial	$49.14
Rate for Payer: Aetna Medicare Advantage	$49.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.77
Rate for Payer: Cigna Commercial	$81.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.29
Rate for Payer: Oxford Commercial	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.57
Rate for Payer: UnitedHealthcare Commercial	$81.90

CANNULA 7 X 75 214116

Facility

$625.00

Hospital Charge Code	270641698
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CANNULA 7 X 75 214116

Facility

$625.00

Hospital Charge Code	270641698
Hospital Revenue Code	272
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.25
Rate for Payer: Oxford Commercial	$312.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$312.50

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.85
Rate for Payer: Oxford Commercial	$72.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$72.50

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CANNULA 8MM ENDOSCOPE

Facility

$6,500.00

Hospital Charge Code	270664217
Hospital Revenue Code	270
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$975.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CANNULA 8MM ENDOSCOPE

Facility

$6,500.00

Hospital Charge Code	270664217
Hospital Revenue Code	270
Min. Negotiated Rate	$845.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$3,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Commercial	$3,250.00

Know your out-of-pocket cost for care.

All Charges