Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRAIN ROUND SILICONE 14 19FR

Facility

$29.81

Hospital Charge Code	270649143
Hospital Revenue Code	270
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$14.90
Rate for Payer: Aetna Commercial	$8.94
Rate for Payer: Aetna Medicare Advantage	$8.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.60
Rate for Payer: Cigna Commercial	$14.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.88
Rate for Payer: Oxford Commercial	$14.90
Rate for Payer: Qualcare PPO/HMO/WC	$4.47
Rate for Payer: UnitedHealthcare Commercial	$14.90

DRAIN ROUND SILICONE 14 19FR

Facility

$29.81

Hospital Charge Code	270649143
Hospital Revenue Code	270
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$4.47

DRAIN SHIRLEY WOUND

Facility

$44.03

Hospital Charge Code	270649920
Hospital Revenue Code	270
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.02
Rate for Payer: Aetna Commercial	$13.21
Rate for Payer: Aetna Medicare Advantage	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.23
Rate for Payer: Cigna Commercial	$22.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.02

DRAIN SHIRLEY WOUND

Facility

$44.03

Hospital Charge Code	270649920
Hospital Revenue Code	270
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

DRAIN SILICONE TRIPLE

Facility

$332.00

Hospital Charge Code	270060730
Hospital Revenue Code	272
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$166.00
Rate for Payer: Aetna Commercial	$99.60
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.16
Rate for Payer: Oxford Commercial	$166.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$166.00

DRAIN SILICONE TRIPLE

Facility

$332.00

Hospital Charge Code	270060730
Hospital Revenue Code	272
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

DRAIN (TAUT) *******

Facility

$55.00

Hospital Charge Code	8000564
Hospital Revenue Code	279
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

DRAIN (TAUT) *******

Facility

$55.00

Hospital Charge Code	8000564
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

DRAIN TO PERITONEAL CAVITY

Facility

$3,005.56

Service Code	HCPCS 49062
Hospital Charge Code	1600000343
Hospital Revenue Code	360
Min. Negotiated Rate	$390.72
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$901.67
Rate for Payer: Aetna Medicare Advantage	$901.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.42
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	$766.42
Rate for Payer: Cigna Commercial	$802.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.72
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.83
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DRAIN TO PERITONEAL CAVITY

Facility

$3,005.56

Service Code	HCPCS 49062
Hospital Charge Code	1600000343
Hospital Revenue Code	360
Min. Negotiated Rate	$450.83
Max. Negotiated Rate	$450.83
Rate for Payer: Qualcare PPO/HMO/WC	$450.83

DRAIN T-TUBE CATTELL 16 FR

Facility

$37.73

Hospital Charge Code	270659384
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$18.86
Rate for Payer: Aetna Commercial	$11.32
Rate for Payer: Aetna Medicare Advantage	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.62
Rate for Payer: Cigna Commercial	$18.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.90
Rate for Payer: Oxford Commercial	$18.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.66
Rate for Payer: UnitedHealthcare Commercial	$18.86

DRAIN T-TUBE CATTELL 16 FR

Facility

$37.73

Hospital Charge Code	270659384
Hospital Revenue Code	270
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$5.66
Rate for Payer: Qualcare PPO/HMO/WC	$5.66

DRAIN URET,SYSTEM STRL

Facility

$103.00

Hospital Charge Code	270331591
Hospital Revenue Code	278
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$24.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.93
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

DRAIN URET,SYSTEM STRL

Facility

$103.00

Hospital Charge Code	270331591
Hospital Revenue Code	278
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$51.50
Rate for Payer: Aetna Commercial	$30.90
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.93
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

DRAIN WICK MEROCAL EYE 400108

Facility

$3.25

Hospital Charge Code	270614580
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.49

DRAIN WICK MEROCAL EYE 400108

Facility

$3.25

Hospital Charge Code	270614580
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.62
Rate for Payer: Aetna Commercial	$0.98
Rate for Payer: Aetna Medicare Advantage	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.83
Rate for Payer: Cigna Commercial	$1.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.49
Rate for Payer: UnitedHealthcare Commercial	$1.62

DRAIN WOUND EVAC MED 1/8

Facility

$53.35

Hospital Charge Code	270601098
Hospital Revenue Code	272
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$26.68
Rate for Payer: Aetna Commercial	$16.00
Rate for Payer: Aetna Medicare Advantage	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.60
Rate for Payer: Cigna Commercial	$26.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.94
Rate for Payer: Oxford Commercial	$26.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.00
Rate for Payer: UnitedHealthcare Commercial	$26.68

DRAIN WOUND EVAC MED 1/8

Facility

$53.35

Hospital Charge Code	270601098
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.00

DRAIN WOUND SHIRLEY AN-30

Facility

$51.45

Hospital Charge Code	270649145
Hospital Revenue Code	270
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$25.73
Rate for Payer: Aetna Commercial	$15.44
Rate for Payer: Aetna Medicare Advantage	$15.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.12
Rate for Payer: Cigna Commercial	$25.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.69
Rate for Payer: Oxford Commercial	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$25.73

DRAIN WOUND SHIRLEY AN-30

Facility

$51.45

Hospital Charge Code	270649145
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

DRAPE 3M STER *******

Facility

$15.00

Hospital Charge Code	1600857
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

DRAPE 3M STER *******

Facility

$15.00

Hospital Charge Code	1600857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

DRAPE ANGIOGRAPHY

Facility

$30.57

Hospital Charge Code	270628155
Hospital Revenue Code	270
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$15.29
Rate for Payer: Aetna Commercial	$9.17
Rate for Payer: Aetna Medicare Advantage	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.80
Rate for Payer: Cigna Commercial	$15.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.97
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.59
Rate for Payer: UnitedHealthcare Commercial	$15.29

DRAPE ANGIOGRAPHY

Facility

$30.57

Hospital Charge Code	270628155
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$4.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.59

DRAPE BAG VI ISOLATION

Facility

$93.65

Hospital Charge Code	270060795
Hospital Revenue Code	272
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

Know your out-of-pocket cost for care.

All Charges