Heights University Hospital

All Charges

Charge

Type

Setting

Price

DERMABOND

Facility

$221.00

Hospital Charge Code	5792185
Hospital Revenue Code	250
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$33.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.15

DERMABOND ADVANCE

Facility

$185.65

Hospital Charge Code	270653957
Hospital Revenue Code	272
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$92.83
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$92.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.13
Rate for Payer: Oxford Commercial	$92.83
Rate for Payer: Qualcare PPO/HMO/WC	$27.85
Rate for Payer: UnitedHealthcare Commercial	$92.83

DERMABOND ADVANCE

Facility

$185.65

Hospital Charge Code	270653957
Hospital Revenue Code	272
Min. Negotiated Rate	$27.85
Max. Negotiated Rate	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$27.85

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$25.98
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.26
Rate for Payer: Oxford Commercial	$43.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$43.30

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$45.46
Rate for Payer: Aetna Commercial	$27.28
Rate for Payer: Aetna Medicare Advantage	$27.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.82
Rate for Payer: Oxford Commercial	$45.46
Rate for Payer: Qualcare PPO/HMO/WC	$13.64
Rate for Payer: UnitedHealthcare Commercial	$45.46

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$46.27
Rate for Payer: Aetna Commercial	$27.77
Rate for Payer: Aetna Medicare Advantage	$27.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.60
Rate for Payer: Cigna Commercial	$46.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.03
Rate for Payer: Oxford Commercial	$46.27
Rate for Payer: Qualcare PPO/HMO/WC	$13.88
Rate for Payer: UnitedHealthcare Commercial	$46.27

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$13.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.88

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$25.98
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.26
Rate for Payer: Oxford Commercial	$43.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$43.30

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$13.64
Max. Negotiated Rate	$13.64
Rate for Payer: Qualcare PPO/HMO/WC	$13.64

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$27.75
Rate for Payer: Aetna Commercial	$16.65
Rate for Payer: Aetna Medicare Advantage	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.15
Rate for Payer: Cigna Commercial	$27.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$27.75

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$57.38
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$114.75
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.73
Rate for Payer: Oxford Commercial	$191.25
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Commercial	$191.25

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$383.18
Max. Negotiated Rate	$1,473.75
Rate for Payer: Aetna Commercial	$884.25
Rate for Payer: Aetna Medicare Advantage	$884.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$751.61
Rate for Payer: Cigna Commercial	$1,473.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.18
Rate for Payer: Oxford Commercial	$1,473.75
Rate for Payer: Qualcare PPO/HMO/WC	$442.12
Rate for Payer: UnitedHealthcare Commercial	$1,473.75

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$442.12
Max. Negotiated Rate	$442.12
Rate for Payer: Qualcare PPO/HMO/WC	$442.12

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$22.23
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$85.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$85.50

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$52.20
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$87.00

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$52.20
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$87.00

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$972.00
Max. Negotiated Rate	$3,240.00
Rate for Payer: Aetna Commercial	$1,944.00
Rate for Payer: Aetna Medicare Advantage	$1,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.40
Rate for Payer: Cigna Commercial	$3,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$972.00
Max. Negotiated Rate	$1,568.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00

Know your out-of-pocket cost for care.

All Charges