Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING POLYMEM AG 4x4 FE1044

Facility

$30.25

Hospital Charge Code	270639101
Hospital Revenue Code	272
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

DRESSING POLYMEM AG 4x4 FE1044

Facility

$30.25

Hospital Charge Code	270639101
Hospital Revenue Code	272
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$9.07
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$15.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$15.12

DRESSING PREVENA 13 CM

Facility

$2,475.00

Hospital Charge Code	270682222
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

DRESSING PREVENA 13 CM

Facility

$2,475.00

Hospital Charge Code	270682222
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

DRESSING RELEASE

Facility

$5.00

Hospital Charge Code	270350005
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

DRESSING RELEASE

Facility

$5.00

Hospital Charge Code	270350005
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

DRESSING RELEASE****

Facility

$0.60

Hospital Charge Code	27035005
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Qualcare PPO/HMO/WC	$0.09

DRESSING RELEASE****

Facility

$0.60

Hospital Charge Code	27035005
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.30
Rate for Payer: Aetna Commercial	$0.18
Rate for Payer: Aetna Medicare Advantage	$0.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.15
Rate for Payer: Cigna Commercial	$0.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.08
Rate for Payer: Oxford Commercial	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.09
Rate for Payer: UnitedHealthcare Commercial	$0.30

DRESSING RENASYS-F/P LARGE

Facility

$265.69

Hospital Charge Code	270649164
Hospital Revenue Code	271
Min. Negotiated Rate	$39.85
Max. Negotiated Rate	$39.85
Rate for Payer: Qualcare PPO/HMO/WC	$39.85

DRESSING RENASYS-F/P LARGE

Facility

$265.69

Hospital Charge Code	270649164
Hospital Revenue Code	271
Min. Negotiated Rate	$34.54
Max. Negotiated Rate	$132.84
Rate for Payer: Aetna Commercial	$79.71
Rate for Payer: Aetna Medicare Advantage	$79.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.75
Rate for Payer: Cigna Commercial	$132.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.54
Rate for Payer: Oxford Commercial	$132.84
Rate for Payer: Qualcare PPO/HMO/WC	$39.85
Rate for Payer: UnitedHealthcare Commercial	$132.84

DRESSING RENASYS-F/P SMALL

Facility

$274.95

Hospital Charge Code	270649166
Hospital Revenue Code	271
Min. Negotiated Rate	$35.74
Max. Negotiated Rate	$137.47
Rate for Payer: Aetna Commercial	$82.48
Rate for Payer: Aetna Medicare Advantage	$82.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.11
Rate for Payer: Cigna Commercial	$137.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.74
Rate for Payer: Oxford Commercial	$137.47
Rate for Payer: Qualcare PPO/HMO/WC	$41.24
Rate for Payer: UnitedHealthcare Commercial	$137.47

DRESSING RENASYS-F/P SMALL

Facility

$274.95

Hospital Charge Code	270649166
Hospital Revenue Code	271
Min. Negotiated Rate	$41.24
Max. Negotiated Rate	$41.24
Rate for Payer: Qualcare PPO/HMO/WC	$41.24

DRESSING SACRUM 18X18CM

Facility

$32.53

Hospital Charge Code	270685350
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

DRESSING SACRUM 18X18CM

Facility

$32.53

Hospital Charge Code	270685350
Hospital Revenue Code	272
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$16.27
Rate for Payer: Aetna Commercial	$9.76
Rate for Payer: Aetna Medicare Advantage	$9.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.30
Rate for Payer: Cigna Commercial	$16.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.23
Rate for Payer: Oxford Commercial	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$16.27

DRESSING SACRUM 22X25CM

Facility

$51.34

Hospital Charge Code	270685379
Hospital Revenue Code	272
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$25.67
Rate for Payer: Aetna Commercial	$15.40
Rate for Payer: Aetna Medicare Advantage	$15.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.09
Rate for Payer: Cigna Commercial	$25.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.67
Rate for Payer: Oxford Commercial	$25.67
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Commercial	$25.67

DRESSING SACRUM 22X25CM

Facility

$51.34

Hospital Charge Code	270685379
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

DRESSING SENSATRAC WHTFOAM LG

Facility

$282.16

Hospital Charge Code	270655357
Hospital Revenue Code	271
Min. Negotiated Rate	$36.68
Max. Negotiated Rate	$141.08
Rate for Payer: Aetna Commercial	$84.65
Rate for Payer: Aetna Medicare Advantage	$84.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.95
Rate for Payer: Cigna Commercial	$141.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.68
Rate for Payer: Oxford Commercial	$141.08
Rate for Payer: Qualcare PPO/HMO/WC	$42.32
Rate for Payer: UnitedHealthcare Commercial	$141.08

DRESSING SENSATRAC WHTFOAM LG

Facility

$282.16

Hospital Charge Code	270655357
Hospital Revenue Code	271
Min. Negotiated Rate	$42.32
Max. Negotiated Rate	$42.32
Rate for Payer: Qualcare PPO/HMO/WC	$42.32

DRESSING SILVERCEL 2 2 800202

Facility

$52.29

Hospital Charge Code	270646638
Hospital Revenue Code	272
Min. Negotiated Rate	$7.84
Max. Negotiated Rate	$7.84
Rate for Payer: Qualcare PPO/HMO/WC	$7.84

DRESSING SILVERCEL 2 2 800202

Facility

$52.29

Hospital Charge Code	270646638
Hospital Revenue Code	272
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$26.14
Rate for Payer: Aetna Commercial	$15.69
Rate for Payer: Aetna Medicare Advantage	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.33
Rate for Payer: Cigna Commercial	$26.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.80
Rate for Payer: Oxford Commercial	$26.14
Rate for Payer: Qualcare PPO/HMO/WC	$7.84
Rate for Payer: UnitedHealthcare Commercial	$26.14

DRESSING SILVERCEL 2x2 800202

Facility

$52.29

Hospital Charge Code	270646638W
Hospital Revenue Code	272
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$26.14
Rate for Payer: Aetna Commercial	$15.69
Rate for Payer: Aetna Medicare Advantage	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.33
Rate for Payer: Cigna Commercial	$26.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.80
Rate for Payer: Oxford Commercial	$26.14
Rate for Payer: Qualcare PPO/HMO/WC	$7.84
Rate for Payer: UnitedHealthcare Commercial	$26.14

DRESSING SILVERCEL 2x2 800202

Facility

$52.29

Hospital Charge Code	270646638W
Hospital Revenue Code	272
Min. Negotiated Rate	$7.84
Max. Negotiated Rate	$7.84
Rate for Payer: Qualcare PPO/HMO/WC	$7.84

DRESSING SILVERCELL 4.25x4.25

Facility

$31.02

Hospital Charge Code	270646630W
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

DRESSING SILVERCELL 4.25x4.25

Facility

$31.02

Hospital Charge Code	270646630W
Hospital Revenue Code	272
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$15.51
Rate for Payer: Aetna Commercial	$9.31
Rate for Payer: Aetna Medicare Advantage	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.03
Rate for Payer: Oxford Commercial	$15.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$15.51

DRESSING SILVERCEL NON-AD 2x2

Facility

$16.18

Hospital Charge Code	270646631W
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$8.09
Rate for Payer: Aetna Commercial	$4.85
Rate for Payer: Aetna Medicare Advantage	$4.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.13
Rate for Payer: Cigna Commercial	$8.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$8.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.43
Rate for Payer: UnitedHealthcare Commercial	$8.09

Know your out-of-pocket cost for care.

All Charges