Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLEAN KIT D

Facility

$939.20

Hospital Charge Code	270665979
Hospital Revenue Code	270
Min. Negotiated Rate	$140.88
Max. Negotiated Rate	$140.88
Rate for Payer: Qualcare PPO/HMO/WC	$140.88

CLEANSER CART WASHER

Facility

$755.10

Hospital Charge Code	270666126
Hospital Revenue Code	270
Min. Negotiated Rate	$98.16
Max. Negotiated Rate	$377.55
Rate for Payer: Aetna Commercial	$226.53
Rate for Payer: Aetna Medicare Advantage	$226.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.55
Rate for Payer: Cigna Commercial	$377.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.16
Rate for Payer: Oxford Commercial	$377.55
Rate for Payer: Qualcare PPO/HMO/WC	$113.27
Rate for Payer: UnitedHealthcare Commercial	$377.55

CLEANSER CART WASHER

Facility

$755.10

Hospital Charge Code	270666126
Hospital Revenue Code	270
Min. Negotiated Rate	$113.27
Max. Negotiated Rate	$113.27
Rate for Payer: Qualcare PPO/HMO/WC	$113.27

CLEANSER DM WD 8oz 50484492000

Facility

$26.15

Hospital Charge Code	270631760
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$13.07
Rate for Payer: Aetna Commercial	$7.84
Rate for Payer: Aetna Medicare Advantage	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.67
Rate for Payer: Cigna Commercial	$13.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.40
Rate for Payer: Oxford Commercial	$13.07
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$13.07

CLEANSER DM WD 8oz 50484492000

Facility

$26.15

Hospital Charge Code	270631760
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

CLEANSER FOAM ALOE VESTA 8OZ

Facility

$13.52

Hospital Charge Code	270649372
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$6.76
Rate for Payer: Aetna Commercial	$4.06
Rate for Payer: Aetna Medicare Advantage	$4.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.45
Rate for Payer: Cigna Commercial	$6.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$6.76
Rate for Payer: Qualcare PPO/HMO/WC	$2.03
Rate for Payer: UnitedHealthcare Commercial	$6.76

CLEANSER FOAM ALOE VESTA 8OZ

Facility

$13.52

Hospital Charge Code	270649372
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.03

CLEANSER SKINTEGY 16oz MSC6016

Facility

$20.11

Hospital Charge Code	270640866
Hospital Revenue Code	272
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$10.05
Rate for Payer: Aetna Commercial	$6.03
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.13
Rate for Payer: Cigna Commercial	$10.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.61
Rate for Payer: Oxford Commercial	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.02
Rate for Payer: UnitedHealthcare Commercial	$10.05

CLEANSER SKINTEGY 16oz MSC6016

Facility

$20.11

Hospital Charge Code	270640866
Hospital Revenue Code	272
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02

CLEANSER WOUND DERMAL 12oz

Facility

$27.94

Hospital Charge Code	270649371
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CLEANSER WOUND DERMAL 12oz

Facility

$27.94

Hospital Charge Code	270649371
Hospital Revenue Code	272
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$13.97
Rate for Payer: Aetna Commercial	$8.38
Rate for Payer: Aetna Medicare Advantage	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$13.97
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$13.97

CLEARCHEST COMFORT BAND EACH

Facility

$314.50

Hospital Charge Code	270692620
Hospital Revenue Code	271
Min. Negotiated Rate	$40.88
Max. Negotiated Rate	$157.25
Rate for Payer: Aetna Commercial	$94.35
Rate for Payer: Aetna Medicare Advantage	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.20
Rate for Payer: Cigna Commercial	$157.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.88
Rate for Payer: Oxford Commercial	$157.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.17
Rate for Payer: UnitedHealthcare Commercial	$157.25

CLEARCHEST COMFORT BAND EACH

Facility

$314.50

Hospital Charge Code	270692620
Hospital Revenue Code	271
Min. Negotiated Rate	$47.17
Max. Negotiated Rate	$47.17
Rate for Payer: Qualcare PPO/HMO/WC	$47.17

CLEARCHEST DISP HOSE 1 PR

Facility

$80.00

Hospital Charge Code	270692623
Hospital Revenue Code	271
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$40.00

CLEARCHEST DISP HOSE 1 PR

Facility

$80.00

Hospital Charge Code	270692623
Hospital Revenue Code	271
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

CLEARCUT SLIT KNIFE

Facility

$245.00

Hospital Charge Code	270659720
Hospital Revenue Code	272
Min. Negotiated Rate	$31.85
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$122.50

CLEARCUT SLIT KNIFE

Facility

$245.00

Hospital Charge Code	270659720
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CLEARMIX SINGLE DOUBLE MIX

Facility

$625.00

Hospital Charge Code	270683515
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CLEARMIX SINGLE DOUBLE MIX

Facility

$625.00

Hospital Charge Code	270683515
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

CLEARMIX TRIPLE MIX

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270686539
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

CLEARMIX TRIPLE MIX

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270686539
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

CLEFT LIP AND PALATE REPAIR

Facility

$12,807.96

Service Code	APR-DRG 0952
Min. Negotiated Rate	$8,728.50
Max. Negotiated Rate	$12,807.96
Rate for Payer: Aetna Better Health Medicaid	$12,556.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,807.96
Rate for Payer: Wellpoint Medicaid Managed Care	$8,728.50

CLEFT LIP AND PALATE REPAIR

Facility

$18,272.39

Service Code	APR-DRG 0953
Min. Negotiated Rate	$13,377.85
Max. Negotiated Rate	$18,272.39
Rate for Payer: Aetna Better Health Medicaid	$17,914.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,272.39
Rate for Payer: Wellpoint Medicaid Managed Care	$13,377.85

CLEFT LIP AND PALATE REPAIR

Facility

$30,409.09

Service Code	APR-DRG 0954
Min. Negotiated Rate	$27,609.26
Max. Negotiated Rate	$30,409.09
Rate for Payer: Aetna Better Health Medicaid	$29,812.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,409.09
Rate for Payer: Wellpoint Medicaid Managed Care	$27,609.26

CLEFT LIP AND PALATE REPAIR

Facility

$11,410.64

Service Code	APR-DRG 0951
Min. Negotiated Rate	$7,515.87
Max. Negotiated Rate	$11,410.64
Rate for Payer: Aetna Better Health Medicaid	$11,186.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,410.64
Rate for Payer: Wellpoint Medicaid Managed Care	$7,515.87

Know your out-of-pocket cost for care.

All Charges