Heights University Hospital

All Charges

Charge

Type

Setting

Price

ACCUSTICK II INTRODUCER SYSTEM

Facility

$336.70

Hospital Charge Code	2709001642
Hospital Revenue Code	272
Min. Negotiated Rate	$50.51
Max. Negotiated Rate	$50.51
Rate for Payer: Qualcare PPO/HMO/WC	$50.51

ACCUSTICK SYSTEM INTRODUCER II

Facility

$466.25

Service Code	HCPCS C1894
Hospital Charge Code	270664200
Hospital Revenue Code	278
Min. Negotiated Rate	$69.94
Max. Negotiated Rate	$112.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.83
Rate for Payer: Qualcare PPO/HMO/WC	$69.94

ACCUSTICK SYSTEM INTRODUCER II

Facility

$466.25

Service Code	HCPCS C1894
Hospital Charge Code	270664200
Hospital Revenue Code	278
Min. Negotiated Rate	$69.94
Max. Negotiated Rate	$233.12
Rate for Payer: Aetna Commercial	$139.88
Rate for Payer: Aetna Medicare Advantage	$139.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.89
Rate for Payer: Cigna Commercial	$233.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.83
Rate for Payer: Qualcare PPO/HMO/WC	$69.94

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$224.98
Max. Negotiated Rate	$224.98
Rate for Payer: Qualcare PPO/HMO/WC	$224.98

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$31.98
Max. Negotiated Rate	$234.35
Rate for Payer: Aetna Commercial	$207.23
Rate for Payer: Aetna Medicare Advantage	$63.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$63.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.35
Rate for Payer: Cigna Commercial	$63.96
Rate for Payer: Cigna Medicare Advantage	$31.98
Rate for Payer: Clover Medicare Advantage	$60.76
Rate for Payer: EmblemHealth Commercial	$191.88
Rate for Payer: Humana Medicare Advantage	$65.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.98
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$63.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$67.80
Rate for Payer: Wellcare Medicare Advantage	$63.96

ACCUVISION 18MM

Facility

$2,735.00

Hospital Charge Code	270656640
Hospital Revenue Code	278
Min. Negotiated Rate	$410.25
Max. Negotiated Rate	$661.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$547.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.87
Rate for Payer: Qualcare PPO/HMO/WC	$410.25

ACCUVISION 18MM

Facility

$2,735.00

Hospital Charge Code	270656640
Hospital Revenue Code	278
Min. Negotiated Rate	$410.25
Max. Negotiated Rate	$1,367.50
Rate for Payer: Aetna Commercial	$820.50
Rate for Payer: Aetna Medicare Advantage	$820.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$697.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$697.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$547.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$697.42
Rate for Payer: Cigna Commercial	$1,367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.87
Rate for Payer: Qualcare PPO/HMO/WC	$410.25

ACCUVISION ILLUMINATED 25MM

Facility

$3,340.00

Hospital Charge Code	270656641
Hospital Revenue Code	278
Min. Negotiated Rate	$501.00
Max. Negotiated Rate	$808.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: Qualcare PPO/HMO/WC	$501.00

ACCUVISION ILLUMINATED 25MM

Facility

$3,340.00

Hospital Charge Code	270656641
Hospital Revenue Code	278
Min. Negotiated Rate	$501.00
Max. Negotiated Rate	$1,670.00
Rate for Payer: Aetna Commercial	$1,002.00
Rate for Payer: Aetna Medicare Advantage	$1,002.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$851.70
Rate for Payer: Cigna Commercial	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: Qualcare PPO/HMO/WC	$501.00

ACCUZME OINT

Facility

$155.00

Hospital Charge Code	60635292
Hospital Revenue Code	250
Min. Negotiated Rate	$20.15
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$46.50
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: Oxford Commercial	$77.50
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$77.50

ACCUZME OINT

Facility

$155.00

Hospital Charge Code	60635292
Hospital Revenue Code	250
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

ACD FORMULA A 500ML INJ

Facility

$41.60

Hospital Charge Code	60628958
Hospital Revenue Code	250
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$20.80

ACD FORMULA A 500ML INJ

Facility

$41.60

Hospital Charge Code	60628958
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$6,195.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$6,195.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACE 12A BLADE

Facility

$79.50

Hospital Charge Code	270664809
Hospital Revenue Code	270
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$39.75
Rate for Payer: Aetna Commercial	$23.85
Rate for Payer: Aetna Medicare Advantage	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.27
Rate for Payer: Cigna Commercial	$39.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.34
Rate for Payer: Oxford Commercial	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$11.93
Rate for Payer: UnitedHealthcare Commercial	$39.75

ACE 12A BLADE

Facility

$79.50

Hospital Charge Code	270664809
Hospital Revenue Code	270
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Qualcare PPO/HMO/WC	$11.93

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$1,816.75
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$4,192.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,816.75
Rate for Payer: Oxford Commercial	$6,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$6,987.50

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,816.75
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$4,192.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,816.75
Rate for Payer: Oxford Commercial	$6,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$6,987.50

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

Know your out-of-pocket cost for care.

All Charges