Heights University Hospital

All Charges

Charge

Type

Setting

Price

COLLAR STIFNECK EXTRICATN PEDS

Facility

$70.00

Hospital Charge Code	270645110
Hospital Revenue Code	271
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: Aetna Commercial	$21.00
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: UnitedHealthcare Commercial	$35.00

COLL BLOOD VAD IMPLANT

Facility

$259.00

Service Code	HCPCS 36591
Hospital Charge Code	3400072
Hospital Revenue Code	761
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Oxford Commercial	$129.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$129.50

COLL BLOOD VAD IMPLANT

Facility

$259.00

Service Code	HCPCS 36591
Hospital Charge Code	3400072
Hospital Revenue Code	761
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

COLLECT BLOOD CVL/PICC

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	73662007
Hospital Revenue Code	361
Min. Negotiated Rate	$81.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$187.06
Rate for Payer: Aetna Medicare Advantage	$187.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.01
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLLECT BLOOD CVL/PICC

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	321736592
Hospital Revenue Code	361
Min. Negotiated Rate	$93.53
Max. Negotiated Rate	$93.53
Rate for Payer: Qualcare PPO/HMO/WC	$93.53

COLLECT BLOOD CVL/PICC

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	321736592
Hospital Revenue Code	361
Min. Negotiated Rate	$81.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$187.06
Rate for Payer: Aetna Medicare Advantage	$187.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.01
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLLECT BLOOD CVL/PICC

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	73662007
Hospital Revenue Code	361
Min. Negotiated Rate	$93.53
Max. Negotiated Rate	$93.53
Rate for Payer: Qualcare PPO/HMO/WC	$93.53

Collect Blood From Picc or CVC

Facility

$335.40

Service Code	HCPCS 36592
Hospital Charge Code	5600136
Hospital Revenue Code	361
Min. Negotiated Rate	$43.60
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$100.62
Rate for Payer: Aetna Medicare Advantage	$100.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.31
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Collect Blood From Picc or CVC

Facility

$335.40

Service Code	HCPCS 36592
Hospital Charge Code	5600136
Hospital Revenue Code	361
Min. Negotiated Rate	$50.31
Max. Negotiated Rate	$50.31
Rate for Payer: Qualcare PPO/HMO/WC	$50.31

COLLECT BLOOD FROM PICC OR CVC

Facility

$335.40

Service Code	HCPCS 36592
Hospital Charge Code	7411473
Hospital Revenue Code	361
Min. Negotiated Rate	$50.31
Max. Negotiated Rate	$50.31
Rate for Payer: Qualcare PPO/HMO/WC	$50.31

COLLECT BLOOD FROM PICC OR CVC

Facility

$335.40

Service Code	HCPCS 36592
Hospital Charge Code	7411473
Hospital Revenue Code	361
Min. Negotiated Rate	$43.60
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$100.62
Rate for Payer: Aetna Medicare Advantage	$100.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.31
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLLECTION BLOODSTREAM CP210

Facility

$450.45

Hospital Charge Code	270610534
Hospital Revenue Code	270
Min. Negotiated Rate	$67.57
Max. Negotiated Rate	$67.57
Rate for Payer: Qualcare PPO/HMO/WC	$67.57

COLLECTION BLOODSTREAM CP210

Facility

$450.45

Hospital Charge Code	270610534
Hospital Revenue Code	270
Min. Negotiated Rate	$58.56
Max. Negotiated Rate	$225.22
Rate for Payer: Aetna Commercial	$135.13
Rate for Payer: Aetna Medicare Advantage	$135.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.86
Rate for Payer: Cigna Commercial	$225.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.56
Rate for Payer: Oxford Commercial	$225.22
Rate for Payer: Qualcare PPO/HMO/WC	$67.57
Rate for Payer: UnitedHealthcare Commercial	$225.22

COLLECTION BONE DUST BONE VAC

Facility

$6,420.00

Hospital Charge Code	270691627
Hospital Revenue Code	272
Min. Negotiated Rate	$834.60
Max. Negotiated Rate	$3,210.00
Rate for Payer: Aetna Commercial	$1,926.00
Rate for Payer: Aetna Medicare Advantage	$1,926.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.10
Rate for Payer: Cigna Commercial	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.60
Rate for Payer: Oxford Commercial	$3,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00
Rate for Payer: UnitedHealthcare Commercial	$3,210.00

COLLECTION BONE DUST BONE VAC

Facility

$6,420.00

Hospital Charge Code	270691627
Hospital Revenue Code	272
Min. Negotiated Rate	$963.00
Max. Negotiated Rate	$963.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

COLLECTION BOTTLE CAPS

Facility

$27.00

Hospital Charge Code	270653359
Hospital Revenue Code	270
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

COLLECTION BOTTLE CAPS

Facility

$27.00

Hospital Charge Code	270653359
Hospital Revenue Code	270
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

COLLECTION CAP BLOOD SPECIMEN

Facility

$390.00

Service Code	HCPCS 36416
Hospital Charge Code	980833
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLLECTION CAP BLOOD SPECIMEN

Facility

$390.00

Service Code	HCPCS 36416
Hospital Charge Code	980833
Hospital Revenue Code	300
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

COLLECTION REPLACEMENT ZIM****

Facility

$144.00

Hospital Charge Code	1606367
Hospital Revenue Code	279
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna Commercial	$43.20
Rate for Payer: Aetna Medicare Advantage	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$72.00

COLLECTION REPLACEMENT ZIM****

Facility

$144.00

Hospital Charge Code	1606367
Hospital Revenue Code	279
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

COLLECTION RESERVOIR SOR300

Facility

$328.75

Hospital Charge Code	270616335
Hospital Revenue Code	272
Min. Negotiated Rate	$42.74
Max. Negotiated Rate	$164.38
Rate for Payer: Aetna Commercial	$98.62
Rate for Payer: Aetna Medicare Advantage	$98.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.83
Rate for Payer: Cigna Commercial	$164.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.74
Rate for Payer: Oxford Commercial	$164.38
Rate for Payer: Qualcare PPO/HMO/WC	$49.31
Rate for Payer: UnitedHealthcare Commercial	$164.38

COLLECTION RESERVOIR SOR300

Facility

$328.75

Hospital Charge Code	270616335
Hospital Revenue Code	272
Min. Negotiated Rate	$49.31
Max. Negotiated Rate	$49.31
Rate for Payer: Qualcare PPO/HMO/WC	$49.31

COLLECTION SYSTEM SAFETOUCH BE

Facility

$1,001.85

Hospital Charge Code	270664262
Hospital Revenue Code	270
Min. Negotiated Rate	$130.24
Max. Negotiated Rate	$500.93
Rate for Payer: Aetna Commercial	$300.56
Rate for Payer: Aetna Medicare Advantage	$300.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.47
Rate for Payer: Cigna Commercial	$500.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.24
Rate for Payer: Oxford Commercial	$500.93
Rate for Payer: Qualcare PPO/HMO/WC	$150.28
Rate for Payer: UnitedHealthcare Commercial	$500.93

COLLECTION SYSTEM SAFETOUCH BE

Facility

$1,001.85

Hospital Charge Code	270664262
Hospital Revenue Code	270
Min. Negotiated Rate	$150.28
Max. Negotiated Rate	$150.28
Rate for Payer: Qualcare PPO/HMO/WC	$150.28

Know your out-of-pocket cost for care.

All Charges