Heights University Hospital

All Charges

Charge

Type

Setting

Price

CIRCUIT HEATED F/VENTILATOR

Facility

$96.07

Hospital Charge Code	270643694
Hospital Revenue Code	272
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$48.03
Rate for Payer: Aetna Commercial	$28.82
Rate for Payer: Aetna Medicare Advantage	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.50
Rate for Payer: Cigna Commercial	$48.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.49
Rate for Payer: Oxford Commercial	$48.03
Rate for Payer: Qualcare PPO/HMO/WC	$14.41
Rate for Payer: UnitedHealthcare Commercial	$48.03

CIRCUIT HEATED F/VENTILATOR

Facility

$76.85

Hospital Charge Code	700643694
Hospital Revenue Code	272
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

CIRCUIT HEATED F/VENTILATOR

Facility

$76.85

Hospital Charge Code	700643694
Hospital Revenue Code	272
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$23.05
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.99
Rate for Payer: Oxford Commercial	$38.42
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$38.42

CIRCUIT IPPB***

Facility

$110.00

Service Code	HCPCS 94650
Hospital Charge Code	9500018
Hospital Revenue Code	419
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

CIRCUIT IPPB***

Facility

$16.00

Hospital Charge Code	9501156
Hospital Revenue Code	279
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$8.00

CIRCUIT IPPB***

Facility

$110.00

Service Code	HCPCS 94650
Hospital Charge Code	9500018
Hospital Revenue Code	419
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CIRCUIT IPPB***

Facility

$16.00

Hospital Charge Code	9501156
Hospital Revenue Code	279
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

CIRCUIT M2M OT CRCT W/O PEEP

Facility

$49.13

Hospital Charge Code	270689055
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$24.57
Rate for Payer: Aetna Commercial	$14.74
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Oxford Commercial	$24.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$24.57

CIRCUIT M2M OT CRCT W/O PEEP

Facility

$49.13

Hospital Charge Code	270689055
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

CIRCUIT M2M OT CRCT W PEEP

Facility

$49.13

Hospital Charge Code	270689046
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

CIRCUIT M2M OT CRCT W PEEP

Facility

$49.13

Hospital Charge Code	270689046
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$24.57
Rate for Payer: Aetna Commercial	$14.74
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Oxford Commercial	$24.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$24.57

CIRCUIT MONITORING W/SZ.6 MASK

Facility

$2,183.60

Hospital Charge Code	270657360
Hospital Revenue Code	272
Min. Negotiated Rate	$327.54
Max. Negotiated Rate	$327.54
Rate for Payer: Qualcare PPO/HMO/WC	$327.54

CIRCUIT MONITORING W/SZ.6 MASK

Facility

$2,183.60

Hospital Charge Code	270657360
Hospital Revenue Code	272
Min. Negotiated Rate	$283.87
Max. Negotiated Rate	$1,091.80
Rate for Payer: Aetna Commercial	$655.08
Rate for Payer: Aetna Medicare Advantage	$655.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.82
Rate for Payer: Cigna Commercial	$1,091.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.87
Rate for Payer: Oxford Commercial	$1,091.80
Rate for Payer: Qualcare PPO/HMO/WC	$327.54
Rate for Payer: UnitedHealthcare Commercial	$1,091.80

CIRCUIT PATIENT HIGH FLOW DISP

Facility

$510.00

Hospital Charge Code	270664879
Hospital Revenue Code	270
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$76.50
Rate for Payer: Qualcare PPO/HMO/WC	$76.50

CIRCUIT PATIENT HIGH FLOW DISP

Facility

$510.00

Hospital Charge Code	270664879
Hospital Revenue Code	270
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$255.00
Rate for Payer: Aetna Commercial	$153.00
Rate for Payer: Aetna Medicare Advantage	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.05
Rate for Payer: Cigna Commercial	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.30
Rate for Payer: Oxford Commercial	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.50
Rate for Payer: UnitedHealthcare Commercial	$255.00

CIRCUIT PATIENT LOW FLOW DISP

Facility

$500.00

Hospital Charge Code	270664880
Hospital Revenue Code	270
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

CIRCUIT PATIENT LOW FLOW DISP

Facility

$500.00

Hospital Charge Code	270664880
Hospital Revenue Code	270
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CIRCUIT PORT VNT 36HS

Facility

$15.25

Hospital Charge Code	270689036
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$4.58
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$7.62

CIRCUIT PORT VNT 36HS

Facility

$15.25

Hospital Charge Code	270689036
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

CIRCUIT PT W/ PEPP 22MM

Facility

$118.00

Hospital Charge Code	270688987
Hospital Revenue Code	272
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

CIRCUIT PT W/ PEPP 22MM

Facility

$118.00

Hospital Charge Code	270688987
Hospital Revenue Code	272
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

CIRCUIT RESP HEATED INFANT

Facility

$183.73

Hospital Charge Code	270651823
Hospital Revenue Code	270
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$91.86
Rate for Payer: Aetna Commercial	$55.12
Rate for Payer: Aetna Medicare Advantage	$55.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.85
Rate for Payer: Cigna Commercial	$91.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.88
Rate for Payer: Oxford Commercial	$91.86
Rate for Payer: Qualcare PPO/HMO/WC	$27.56
Rate for Payer: UnitedHealthcare Commercial	$91.86

CIRCUIT RESP HEATED INFANT

Facility

$183.73

Hospital Charge Code	270651823
Hospital Revenue Code	270
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$27.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.56

CIRCUIT SMOOTH BORE AIRLIFE

Facility

$34.16

Hospital Charge Code	270652282
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.12

CIRCUIT SMOOTH BORE AIRLIFE

Facility

$34.16

Hospital Charge Code	270652282
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$17.08
Rate for Payer: Aetna Commercial	$10.25
Rate for Payer: Aetna Medicare Advantage	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.71
Rate for Payer: Cigna Commercial	$17.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.44
Rate for Payer: Oxford Commercial	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$5.12
Rate for Payer: UnitedHealthcare Commercial	$17.08

Know your out-of-pocket cost for care.

All Charges