Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING AQUACEL 2x2

Facility

$26.24

Hospital Charge Code	270677555
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

DRESSING AQUACEL 2x2

Facility

$26.24

Hospital Charge Code	270677555
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$7.87
Rate for Payer: Aetna Medicare Advantage	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.41
Rate for Payer: Oxford Commercial	$13.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$13.12

DRESSING AQUACEL 4x4 177902

Facility

$18.69

Hospital Charge Code	270350285
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

DRESSING AQUACEL 4x4 177902

Facility

$18.69

Hospital Charge Code	270350285
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$9.35
Rate for Payer: Aetna Commercial	$5.61
Rate for Payer: Aetna Medicare Advantage	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.77
Rate for Payer: Cigna Commercial	$9.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$9.35
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$9.35

DRESSING AQUACEL 4X4.7

Facility

$50.54

Hospital Charge Code	270649157
Hospital Revenue Code	272
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$25.27
Rate for Payer: Aetna Commercial	$15.16
Rate for Payer: Aetna Medicare Advantage	$15.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.89
Rate for Payer: Cigna Commercial	$25.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.57
Rate for Payer: Oxford Commercial	$25.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.58
Rate for Payer: UnitedHealthcare Commercial	$25.27

DRESSING AQUACEL 4X4.7

Facility

$50.54

Hospital Charge Code	270649157
Hospital Revenue Code	272
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.58

DRESSING AQUACEL AG 1/2x18IN

Facility

$57.73

Hospital Charge Code	270649155
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$28.86
Rate for Payer: Aetna Commercial	$17.32
Rate for Payer: Aetna Medicare Advantage	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.72
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$28.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$28.86

DRESSING AQUACEL AG 1/2x18IN

Facility

$57.73

Hospital Charge Code	270649155
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

DRESSING AQUACEL AG 3/4x18

Facility

$57.73

Hospital Charge Code	270638207
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$28.86
Rate for Payer: Aetna Commercial	$17.32
Rate for Payer: Aetna Medicare Advantage	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.72
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$28.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$28.86

DRESSING AQUACEL AG 3/4x18

Facility

$57.73

Hospital Charge Code	270638207
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

DRESSING AQUACEL AG 3.5x12IN

Facility

$171.99

Hospital Charge Code	270654311
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

DRESSING AQUACEL AG 3.5x12IN

Facility

$171.99

Hospital Charge Code	270654311
Hospital Revenue Code	272
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

DRESSING AQUACEL AG 3.5x13.75

Facility

$171.99

Hospital Charge Code	270677592
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

DRESSING AQUACEL AG 3.5x13.75

Facility

$171.99

Hospital Charge Code	270677592
Hospital Revenue Code	272
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

DRESSING AQUACEL AG 3.5x9.75

Facility

$167.65

Hospital Charge Code	270653001
Hospital Revenue Code	272
Min. Negotiated Rate	$25.15
Max. Negotiated Rate	$25.15
Rate for Payer: Qualcare PPO/HMO/WC	$25.15

DRESSING AQUACEL AG 3.5x9.75

Facility

$154.36

Hospital Charge Code	270660553
Hospital Revenue Code	272
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$77.18
Rate for Payer: Aetna Commercial	$46.31
Rate for Payer: Aetna Medicare Advantage	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.36
Rate for Payer: Cigna Commercial	$77.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.07
Rate for Payer: Oxford Commercial	$77.18
Rate for Payer: Qualcare PPO/HMO/WC	$23.15
Rate for Payer: UnitedHealthcare Commercial	$77.18

DRESSING AQUACEL AG 3.5x9.75

Facility

$167.65

Hospital Charge Code	270653001
Hospital Revenue Code	272
Min. Negotiated Rate	$21.79
Max. Negotiated Rate	$83.83
Rate for Payer: Aetna Commercial	$50.30
Rate for Payer: Aetna Medicare Advantage	$50.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.75
Rate for Payer: Cigna Commercial	$83.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.79
Rate for Payer: Oxford Commercial	$83.83
Rate for Payer: Qualcare PPO/HMO/WC	$25.15
Rate for Payer: UnitedHealthcare Commercial	$83.83

DRESSING AQUACEL AG 3.5x9.75

Facility

$154.36

Hospital Charge Code	270660553
Hospital Revenue Code	272
Min. Negotiated Rate	$23.15
Max. Negotiated Rate	$23.15
Rate for Payer: Qualcare PPO/HMO/WC	$23.15

DRESSING AQUACEL AG 6x6

Facility

$113.70

Hospital Charge Code	270649722
Hospital Revenue Code	272
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$56.85
Rate for Payer: Aetna Commercial	$34.11
Rate for Payer: Aetna Medicare Advantage	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.99
Rate for Payer: Cigna Commercial	$56.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.78
Rate for Payer: Oxford Commercial	$56.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$56.85

DRESSING AQUACEL AG 6x6

Facility

$113.70

Hospital Charge Code	270649722
Hospital Revenue Code	272
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

DRESSING AQUACEL AG 6X6 403710

Facility

$168.10

Hospital Charge Code	270632870
Hospital Revenue Code	272
Min. Negotiated Rate	$25.21
Max. Negotiated Rate	$25.21
Rate for Payer: Qualcare PPO/HMO/WC	$25.21

DRESSING AQUACEL AG 6X6 403710

Facility

$168.10

Hospital Charge Code	270632870
Hospital Revenue Code	272
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$84.05
Rate for Payer: Aetna Commercial	$50.43
Rate for Payer: Aetna Medicare Advantage	$50.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.87
Rate for Payer: Cigna Commercial	$84.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.85
Rate for Payer: Oxford Commercial	$84.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.21
Rate for Payer: UnitedHealthcare Commercial	$84.05

DRESSING AQUACEL AG 8x12 HYDR

Facility

$149.61

Hospital Charge Code	270643952
Hospital Revenue Code	272
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$74.81
Rate for Payer: Aetna Commercial	$44.88
Rate for Payer: Aetna Medicare Advantage	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.15
Rate for Payer: Cigna Commercial	$74.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.45
Rate for Payer: Oxford Commercial	$74.81
Rate for Payer: Qualcare PPO/HMO/WC	$22.44
Rate for Payer: UnitedHealthcare Commercial	$74.81

DRESSING AQUACEL AG 8x12 HYDR

Facility

$149.61

Hospital Charge Code	270643952
Hospital Revenue Code	272
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$22.44
Rate for Payer: Qualcare PPO/HMO/WC	$22.44

DRESSING AQUACEL AG 9x15cm

Facility

$123.48

Hospital Charge Code	270666440
Hospital Revenue Code	272
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$61.74
Rate for Payer: Aetna Commercial	$37.04
Rate for Payer: Aetna Medicare Advantage	$37.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.49
Rate for Payer: Cigna Commercial	$61.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.05
Rate for Payer: Oxford Commercial	$61.74
Rate for Payer: Qualcare PPO/HMO/WC	$18.52
Rate for Payer: UnitedHealthcare Commercial	$61.74

Know your out-of-pocket cost for care.

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