Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRAPE UNDER BUTTOCK W/POUCH

Facility

$20.26

Hospital Charge Code	270649150
Hospital Revenue Code	272
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$10.13
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.17
Rate for Payer: Cigna Commercial	$10.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Oxford Commercial	$10.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$10.13

DRAPE UNI VIDEO CAM/LAS ARM

Facility

$24.57

Hospital Charge Code	270654584
Hospital Revenue Code	272
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$12.29
Rate for Payer: Aetna Commercial	$7.37
Rate for Payer: Aetna Medicare Advantage	$7.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.27
Rate for Payer: Cigna Commercial	$12.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.19
Rate for Payer: Oxford Commercial	$12.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.69
Rate for Payer: UnitedHealthcare Commercial	$12.29

DRAPE UNI VIDEO CAM/LAS ARM

Facility

$24.57

Hospital Charge Code	270654584
Hospital Revenue Code	272
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$3.69

DRAPE UROLOG STER ******

Facility

$28.00

Hospital Charge Code	1600626
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

DRAPE UROLOG STER ******

Facility

$28.00

Hospital Charge Code	1600626
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

DRAPE UTILITY 89731

Facility

$6.68

Hospital Charge Code	270649152
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$3.34
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.70
Rate for Payer: Cigna Commercial	$3.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.87
Rate for Payer: Oxford Commercial	$3.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$3.34

DRAPE UTILITY 89731

Facility

$6.68

Hospital Charge Code	270649152
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

DRAPE VIDEO CAMERA

Facility

$64.20

Hospital Charge Code	270664199
Hospital Revenue Code	270
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$9.63
Rate for Payer: Qualcare PPO/HMO/WC	$9.63

DRAPE VIDEO CAMERA

Facility

$64.20

Hospital Charge Code	270664199
Hospital Revenue Code	270
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$32.10
Rate for Payer: Aetna Commercial	$19.26
Rate for Payer: Aetna Medicare Advantage	$19.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.37
Rate for Payer: Cigna Commercial	$32.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.35
Rate for Payer: Oxford Commercial	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$9.63
Rate for Payer: UnitedHealthcare Commercial	$32.10

DRAPE VIDEO CAMERA 4604

Facility

$77.65

Hospital Charge Code	270614584
Hospital Revenue Code	272
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$23.30
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$38.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$38.83

DRAPE VIDEO CAMERA 4604

Facility

$77.65

Hospital Charge Code	270614584
Hospital Revenue Code	272
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

DRAPE WARMER 44x66 ORS-300

Facility

$196.88

Hospital Charge Code	270648307
Hospital Revenue Code	272
Min. Negotiated Rate	$25.59
Max. Negotiated Rate	$98.44
Rate for Payer: Aetna Commercial	$59.06
Rate for Payer: Aetna Medicare Advantage	$59.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.20
Rate for Payer: Cigna Commercial	$98.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.59
Rate for Payer: Oxford Commercial	$98.44
Rate for Payer: Qualcare PPO/HMO/WC	$29.53
Rate for Payer: UnitedHealthcare Commercial	$98.44

DRAPE WARMER 44x66 ORS-300

Facility

$196.88

Hospital Charge Code	270648307
Hospital Revenue Code	272
Min. Negotiated Rate	$29.53
Max. Negotiated Rate	$29.53
Rate for Payer: Qualcare PPO/HMO/WC	$29.53

DRAPE XRAY CASSETTE *******

Facility

$17.00

Hospital Charge Code	1603042
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

DRAPE XRAY CASSETTE *******

Facility

$17.00

Hospital Charge Code	1603042
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

DRAPE XRAY CASSETTE Z-DRAPE

Facility

$47.25

Hospital Charge Code	270060845
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

DRAPE XRAY CASSETTE Z-DRAPE

Facility

$47.25

Hospital Charge Code	270060845
Hospital Revenue Code	272
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$14.18
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$23.62

DRAPE X-RAY CASSETT LARGE

Facility

$35.83

Hospital Charge Code	270650754
Hospital Revenue Code	270
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.37

DRAPE X-RAY CASSETT LARGE

Facility

$35.83

Hospital Charge Code	270650754
Hospital Revenue Code	270
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$17.91
Rate for Payer: Aetna Commercial	$10.75
Rate for Payer: Aetna Medicare Advantage	$10.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.14
Rate for Payer: Cigna Commercial	$17.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.66
Rate for Payer: Oxford Commercial	$17.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$17.91

DRAPE X-RAY MINI C-ARM/MOBILE

Facility

$172.75

Hospital Charge Code	270656039
Hospital Revenue Code	271
Min. Negotiated Rate	$22.46
Max. Negotiated Rate	$86.38
Rate for Payer: Aetna Commercial	$51.83
Rate for Payer: Aetna Medicare Advantage	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.05
Rate for Payer: Cigna Commercial	$86.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.46
Rate for Payer: Oxford Commercial	$86.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.91
Rate for Payer: UnitedHealthcare Commercial	$86.38

DRAPE X-RAY MINI C-ARM/MOBILE

Facility

$172.75

Hospital Charge Code	270656039
Hospital Revenue Code	271
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$25.91
Rate for Payer: Qualcare PPO/HMO/WC	$25.91

DRAW BLOOD ESTABLISHED LINE

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	3401165
Hospital Revenue Code	361
Min. Negotiated Rate	$93.53
Max. Negotiated Rate	$93.53
Rate for Payer: Qualcare PPO/HMO/WC	$93.53

DRAW BLOOD ESTABLISHED LINE

Facility

$623.55

Service Code	HCPCS 36592
Hospital Charge Code	3401165
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

DREAMTOME 450CM

Facility

$2,029.75

Service Code	HCPCS C1769
Hospital Charge Code	270696134
Hospital Revenue Code	272
Min. Negotiated Rate	$304.46
Max. Negotiated Rate	$304.46
Rate for Payer: Qualcare PPO/HMO/WC	$304.46

DREAMTOME 450CM

Facility

$2,029.75

Service Code	HCPCS C1769
Hospital Charge Code	270696134
Hospital Revenue Code	272
Min. Negotiated Rate	$263.87
Max. Negotiated Rate	$1,014.88
Rate for Payer: Aetna Commercial	$608.92
Rate for Payer: Aetna Medicare Advantage	$608.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.59
Rate for Payer: Cigna Commercial	$1,014.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.87
Rate for Payer: Oxford Commercial	$1,014.88
Rate for Payer: Qualcare PPO/HMO/WC	$304.46
Rate for Payer: UnitedHealthcare Commercial	$1,014.88

Know your out-of-pocket cost for care.

All Charges