Heights University Hospital

All Charges

Charge

Type

Setting

Price

CHAMBER FISCHER - PAYKEL

Facility

$93.65

Hospital Charge Code	270600622
Hospital Revenue Code	270
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

CHAMBER FISCHER - PAYKEL

Facility

$93.65

Hospital Charge Code	270600622
Hospital Revenue Code	270
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$46.83
Rate for Payer: Aetna Commercial	$28.09
Rate for Payer: Aetna Medicare Advantage	$28.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.88
Rate for Payer: Cigna Commercial	$46.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.17
Rate for Payer: Oxford Commercial	$46.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$46.83

CHAMBER FISCHER- PAYKEL***

Facility

$67.00

Hospital Charge Code	9501255
Hospital Revenue Code	279
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CHAMBER FISCHER- PAYKEL***

Facility

$67.00

Hospital Charge Code	9501255
Hospital Revenue Code	279
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$33.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$33.50

CHAMBER I/C GRAFT 10CC

Facility

$5,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270655438
Hospital Revenue Code	278
Min. Negotiated Rate	$847.20
Max. Negotiated Rate	$2,824.00
Rate for Payer: Aetna Commercial	$1,694.40
Rate for Payer: Aetna Medicare Advantage	$1,694.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.24
Rate for Payer: Cigna Commercial	$2,824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,366.82
Rate for Payer: Qualcare PPO/HMO/WC	$847.20

CHAMBER I/C GRAFT 10CC

Facility

$5,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270655438
Hospital Revenue Code	278
Min. Negotiated Rate	$847.20
Max. Negotiated Rate	$1,366.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,129.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,366.82
Rate for Payer: Qualcare PPO/HMO/WC	$847.20

CHAMBER I/C GRAFT 15cc

Facility

$7,726.50

Hospital Charge Code	270669951
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.97
Max. Negotiated Rate	$1,869.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.97

CHAMBER I/C GRAFT 15cc

Facility

$7,726.50

Hospital Charge Code	270669951
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.97
Max. Negotiated Rate	$3,863.25
Rate for Payer: Aetna Commercial	$2,317.95
Rate for Payer: Aetna Medicare Advantage	$2,317.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,970.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,970.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,970.26
Rate for Payer: Cigna Commercial	$3,863.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.97

CHAMBER MEMBRANE BALANCING

Facility

$550.00

Hospital Charge Code	270676771
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CHAMBER MEMBRANE BALANCING

Facility

$550.00

Hospital Charge Code	270676771
Hospital Revenue Code	272
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$275.00

CHAMBER OPTI IN RECLOSABLE BAG

Facility

$23.01

Hospital Charge Code	270647384
Hospital Revenue Code	270
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

CHAMBER OPTI IN RECLOSABLE BAG

Facility

$23.01

Hospital Charge Code	270647384
Hospital Revenue Code	270
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.51
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.51
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.51

CHAMBER VALUE OPTICHAMBER LARG

Facility

$75.03

Service Code	HCPCS A4627
Hospital Charge Code	270690908
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CHAMBER VALUE OPTICHAMBER LARG

Facility

$75.03

Service Code	HCPCS A4627
Hospital Charge Code	270690908
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.52
Rate for Payer: Aetna Commercial	$22.51
Rate for Payer: Aetna Medicare Advantage	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$37.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.52

CHAMBER VALUE OPTICHAMBER MED

Facility

$66.67

Service Code	HCPCS A4627
Hospital Charge Code	270690909
Hospital Revenue Code	272
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$33.34
Rate for Payer: Aetna Commercial	$20.00
Rate for Payer: Aetna Medicare Advantage	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.00
Rate for Payer: Cigna Commercial	$33.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.67
Rate for Payer: Oxford Commercial	$33.34
Rate for Payer: Qualcare PPO/HMO/WC	$10.00
Rate for Payer: UnitedHealthcare Commercial	$33.34

CHAMBER VALUE OPTICHAMBER MED

Facility

$66.67

Service Code	HCPCS A4627
Hospital Charge Code	270690909
Hospital Revenue Code	272
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.00

CHAMBER VALUE OPTICHAMBER S

Facility

$26.90

Service Code	HCPCS A4627
Hospital Charge Code	270690907
Hospital Revenue Code	272
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.45
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.45

CHAMBER VALUE OPTICHAMBER S

Facility

$26.90

Service Code	HCPCS A4627
Hospital Charge Code	270690907
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

CH AMIKACIN - PEAK

Facility

$177.00

Service Code	HCPCS 80150
Hospital Charge Code	397073140
Hospital Revenue Code	301
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

CH AMIKACIN - PEAK

Facility

$177.00

Service Code	HCPCS 80150
Hospital Charge Code	397073140
Hospital Revenue Code	301
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$26.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.55

CH AMIKACIN-RANDOM

Facility

$24.00

Service Code	HCPCS 80150
Hospital Charge Code	397073182
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CH AMIKACIN-RANDOM

Facility

$24.00

Service Code	HCPCS 80150
Hospital Charge Code	397073182
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

CH AMIKACIN TROUGH

Facility

$128.00

Service Code	HCPCS 80150
Hospital Charge Code	397071240
Hospital Revenue Code	301
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

CH AMIKACIN TROUGH

Facility

$128.00

Service Code	HCPCS 80150
Hospital Charge Code	397071240
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CH AMINO ACID PLASMA

Facility

$225.00

Service Code	HCPCS 82128
Hospital Charge Code	397073051
Hospital Revenue Code	301
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.94
Rate for Payer: Aetna Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.82
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: Cigna Medicare Advantage	$6.93
Rate for Payer: Clover Medicare Advantage	$13.18
Rate for Payer: EmblemHealth Commercial	$41.61
Rate for Payer: Humana Medicare Advantage	$14.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.70
Rate for Payer: Wellcare Medicare Advantage	$13.87

Know your out-of-pocket cost for care.

All Charges