Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRESSG 3X3 BOX ******

Facility

$9.00

Hospital Charge Code	8000507
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

DRESSG 4x4 STER BOX

Facility

$5.00

Hospital Charge Code	270350100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

DRESSG 4x4 STER BOX

Facility

$5.00

Hospital Charge Code	270350100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

DRESSG 4X4 STER BOX *****

Facility

$9.00

Hospital Charge Code	8000515
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

DRESSG 4X4 STER BOX *****

Facility

$9.00

Hospital Charge Code	8000515
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

DRESSG ABD BOX ******

Facility

$23.00

Hospital Charge Code	8000523
Hospital Revenue Code	279
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

DRESSG ABD BOX ******

Facility

$23.00

Hospital Charge Code	8000523
Hospital Revenue Code	279
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

DRESSG ACTICOAT 4X5 SN20141

Facility

$95.83

Hospital Charge Code	270627497
Hospital Revenue Code	272
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$14.37
Rate for Payer: Qualcare PPO/HMO/WC	$14.37

DRESSG ACTICOAT 4X5 SN20141

Facility

$95.83

Hospital Charge Code	270627497
Hospital Revenue Code	272
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$47.91
Rate for Payer: Aetna Commercial	$28.75
Rate for Payer: Aetna Medicare Advantage	$28.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.44
Rate for Payer: Cigna Commercial	$47.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.46
Rate for Payer: Oxford Commercial	$47.91
Rate for Payer: Qualcare PPO/HMO/WC	$14.37
Rate for Payer: UnitedHealthcare Commercial	$47.91

DRESSG ADAPTIC ST 3X8

Facility

$6.70

Hospital Charge Code	270350190
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$3.35
Rate for Payer: Aetna Commercial	$2.01
Rate for Payer: Aetna Medicare Advantage	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.71
Rate for Payer: Cigna Commercial	$3.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.87
Rate for Payer: Oxford Commercial	$3.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$3.35

DRESSG ADAPTIC ST 3X8

Facility

$6.70

Hospital Charge Code	270350190
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

DRESSG ADAPTIC STER 3X8******

Facility

$21.00

Hospital Charge Code	8000093
Hospital Revenue Code	279
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

DRESSG ADAPTIC STER 3X8******

Facility

$21.00

Hospital Charge Code	8000093
Hospital Revenue Code	279
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

DRESSG AQUACEL ROPE 177904

Facility

$137.15

Hospital Charge Code	270350286
Hospital Revenue Code	272
Min. Negotiated Rate	$17.83
Max. Negotiated Rate	$68.58
Rate for Payer: Aetna Commercial	$41.15
Rate for Payer: Aetna Medicare Advantage	$41.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.97
Rate for Payer: Cigna Commercial	$68.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.83
Rate for Payer: Oxford Commercial	$68.58
Rate for Payer: Qualcare PPO/HMO/WC	$20.57
Rate for Payer: UnitedHealthcare Commercial	$68.58

DRESSG AQUACEL ROPE 177904

Facility

$137.15

Hospital Charge Code	270350286
Hospital Revenue Code	272
Min. Negotiated Rate	$20.57
Max. Negotiated Rate	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$20.57

DRESSG BANDAID 8X6

Facility

$11.25

Hospital Charge Code	270350155
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRESSG BANDAID 8X6

Facility

$11.25

Hospital Charge Code	270350155
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

DRESSG BANDAID 8X6******

Facility

$21.00

Hospital Charge Code	8000085
Hospital Revenue Code	279
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

DRESSG BANDAID 8X6******

Facility

$21.00

Hospital Charge Code	8000085
Hospital Revenue Code	279
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

DRESSG BIOCCLUSIVE 2X3****

Facility

$9.00

Hospital Charge Code	8002735
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

DRESSG BIOCCLUSIVE 2X3****

Facility

$9.00

Hospital Charge Code	8002735
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

DRESSG BIOCCLUSIVE 4X10******

Facility

$21.00

Hospital Charge Code	8002750
Hospital Revenue Code	279
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

DRESSG BIOCCLUSIVE 4X10******

Facility

$21.00

Hospital Charge Code	8002750
Hospital Revenue Code	279
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

DRESSG BIOCCLUSIVE 4X5******

Facility

$9.00

Hospital Charge Code	8002743
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

DRESSG BIOCCLUSIVE 4X5******

Facility

$9.00

Hospital Charge Code	8002743
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

Know your out-of-pocket cost for care.

All Charges