Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING MINI ISLAND TELFA 2X3

Facility

$2.00

Hospital Charge Code	270649163
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

DRESSING NASAL 8 CM

Facility

$1,475.00

Hospital Charge Code	270660192
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

DRESSING NASAL 8 CM

Facility

$1,475.00

Hospital Charge Code	270660192
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

DRESSING NASAL GOODMAN

Facility

$137.50

Hospital Charge Code	270628903
Hospital Revenue Code	271
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

DRESSING NASAL GOODMAN

Facility

$109.50

Hospital Charge Code	270638903
Hospital Revenue Code	272
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.75
Rate for Payer: Aetna Commercial	$32.85
Rate for Payer: Aetna Medicare Advantage	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.92
Rate for Payer: Cigna Commercial	$54.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$16.43
Rate for Payer: UnitedHealthcare Commercial	$54.75

DRESSING NASAL GOODMAN

Facility

$109.50

Hospital Charge Code	270638903
Hospital Revenue Code	272
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.43

DRESSING NASAL GOODMAN

Facility

$137.50

Hospital Charge Code	270628903
Hospital Revenue Code	271
Min. Negotiated Rate	$17.88
Max. Negotiated Rate	$68.75
Rate for Payer: Aetna Commercial	$41.25
Rate for Payer: Aetna Medicare Advantage	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.06
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.88
Rate for Payer: Oxford Commercial	$68.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$68.75

DRESSING NASAL RIEMANN

Facility

$157.50

Hospital Charge Code	270628901
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$47.25
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.48
Rate for Payer: Oxford Commercial	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Commercial	$78.75

DRESSING NASAL RIEMANN

Facility

$157.50

Hospital Charge Code	270628901
Hospital Revenue Code	272
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

DRESSING NON-ADHERING 3x8 KNE

Facility

$64.38

Hospital Charge Code	270649980
Hospital Revenue Code	272
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$9.66
Rate for Payer: Qualcare PPO/HMO/WC	$9.66

DRESSING NON-ADHERING 3x8 KNE

Facility

$64.38

Hospital Charge Code	270649980
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$32.19
Rate for Payer: Aetna Commercial	$19.31
Rate for Payer: Aetna Medicare Advantage	$19.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.42
Rate for Payer: Cigna Commercial	$32.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$32.19
Rate for Payer: Qualcare PPO/HMO/WC	$9.66
Rate for Payer: UnitedHealthcare Commercial	$32.19

DRESSING OPTIFOAM GENTLE 4x4

Facility

$14.01

Hospital Charge Code	270646071
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$7.00

DRESSING OPTIFOAM GENTLE 4x4

Facility

$14.01

Hospital Charge Code	270646071
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

DRESSING OPTIFOAM GENTLE 6x6

Facility

$23.02

Hospital Charge Code	270646072
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

DRESSING OPTIFOAM GENTLE 6x6

Facility

$23.02

Hospital Charge Code	270646072
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.51
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$6.91
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	$11.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.51
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.51

DRESSING OPTIFOAM SACRUM 7x7

Facility

$29.60

Hospital Charge Code	270350281
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.44

DRESSING OPTIFOAM SACRUM 7x7

Facility

$29.60

Hospital Charge Code	270350281
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$14.80
Rate for Payer: Aetna Commercial	$8.88
Rate for Payer: Aetna Medicare Advantage	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.55
Rate for Payer: Cigna Commercial	$14.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$14.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.44
Rate for Payer: UnitedHealthcare Commercial	$14.80

DRESSING OPTILOCK 5x5.5

Facility

$10.57

Hospital Charge Code	270646073
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$3.17
Rate for Payer: Aetna Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.37
Rate for Payer: Oxford Commercial	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$5.29

DRESSING OPTILOCK 5x5.5

Facility

$10.57

Hospital Charge Code	270646073
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

DRESSING OPTILOCK 6.5x10

Facility

$33.25

Hospital Charge Code	270646074
Hospital Revenue Code	272
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$16.62
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.48
Rate for Payer: Cigna Commercial	$16.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.32
Rate for Payer: Oxford Commercial	$16.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$16.62

DRESSING OPTILOCK 6.5x10

Facility

$33.25

Hospital Charge Code	270646074
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

DRESSING PAD ABD 5x9 STERILE

Facility

$17.49

Hospital Charge Code	270350055
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

DRESSING PAD ABD 5x9 STERILE

Facility

$17.49

Hospital Charge Code	270350055
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$8.74
Rate for Payer: Aetna Commercial	$5.25
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$8.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$8.74

DRESSING POLYMEM 4x4 FE5044

Facility

$14.94

Hospital Charge Code	270639037
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$7.47
Rate for Payer: Aetna Commercial	$4.48
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.81
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.24
Rate for Payer: UnitedHealthcare Commercial	$7.47

DRESSING POLYMEM 4x4 FE5044

Facility

$14.94

Hospital Charge Code	270639037
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

Know your out-of-pocket cost for care.

All Charges