Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE SAFEOP EMG KIT

Facility

$6,600.00

Hospital Charge Code	270698069
Hospital Revenue Code	272
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ELECTRODE SAFEOP EMG KIT

Facility

$6,600.00

Hospital Charge Code	270698069
Hospital Revenue Code	272
Min. Negotiated Rate	$858.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$1,980.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.00
Rate for Payer: Oxford Commercial	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Commercial	$3,300.00

ELECTRODE SELF ADHES 406650205

Facility

$125.00

Hospital Charge Code	270641685
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

ELECTRODE SELF ADHES 406650205

Facility

$125.00

Hospital Charge Code	270641685
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

ELECTRODE SMALL LOOP ******

Facility

$58.00

Hospital Charge Code	1608157
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

ELECTRODE SMALL LOOP ******

Facility

$58.00

Hospital Charge Code	1608157
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

ELECTRODE SOLID GEL DI

Facility

$4.00

Hospital Charge Code	270600754
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ELECTRODE SOLID GEL DI

Facility

$4.00

Hospital Charge Code	270600754
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

ELECTRODE SPLIT ADULT RETURN

Facility

$34.75

Hospital Charge Code	270636745
Hospital Revenue Code	272
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$10.43
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$17.38

ELECTRODE SPLIT ADULT RETURN

Facility

$34.75

Hospital Charge Code	270636745
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

ELECTRODE SS BALL 5MM DIA

Facility

$68.78

Hospital Charge Code	270676242
Hospital Revenue Code	272
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$10.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.32

ELECTRODE SS BALL 5MM DIA

Facility

$68.78

Hospital Charge Code	270676242
Hospital Revenue Code	272
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$34.39
Rate for Payer: Aetna Commercial	$20.63
Rate for Payer: Aetna Medicare Advantage	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.54
Rate for Payer: Cigna Commercial	$34.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.94
Rate for Payer: Oxford Commercial	$34.39
Rate for Payer: Qualcare PPO/HMO/WC	$10.32
Rate for Payer: UnitedHealthcare Commercial	$34.39

ELECTRODE STRESS TEST 20X50***

Facility

$21.00

Hospital Charge Code	270090035
Hospital Revenue Code	272
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

ELECTRODE STRESS TEST 20X50***

Facility

$21.00

Hospital Charge Code	270090035
Hospital Revenue Code	272
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

ELECTRODES TSN EKG****

Facility

$94.00

Hospital Charge Code	1800218
Hospital Revenue Code	739
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

ELECTRODES TSN EKG****

Facility

$94.00

Hospital Charge Code	1800218
Hospital Revenue Code	739
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$28.20
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$603.00

ELECTRODE STZ COAG 24F 27050L

Facility

$477.66

Hospital Charge Code	270627179
Hospital Revenue Code	272
Min. Negotiated Rate	$71.65
Max. Negotiated Rate	$71.65
Rate for Payer: Qualcare PPO/HMO/WC	$71.65

ELECTRODE STZ COAG 24F 27050L

Facility

$477.66

Hospital Charge Code	270627179
Hospital Revenue Code	272
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$238.83
Rate for Payer: Aetna Commercial	$143.30
Rate for Payer: Aetna Medicare Advantage	$143.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.80
Rate for Payer: Cigna Commercial	$238.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.10
Rate for Payer: Oxford Commercial	$238.83
Rate for Payer: Qualcare PPO/HMO/WC	$71.65
Rate for Payer: UnitedHealthcare Commercial	$238.83

ELECTRODES VITALSTIM SDULT

Facility

$87.08

Hospital Charge Code	270663475
Hospital Revenue Code	272
Min. Negotiated Rate	$11.32
Max. Negotiated Rate	$43.54
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$26.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.21
Rate for Payer: Cigna Commercial	$43.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Oxford Commercial	$43.54
Rate for Payer: Qualcare PPO/HMO/WC	$13.06
Rate for Payer: UnitedHealthcare Commercial	$43.54

ELECTRODES VITALSTIM SDULT

Facility

$87.08

Hospital Charge Code	270663475
Hospital Revenue Code	272
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$13.06
Rate for Payer: Qualcare PPO/HMO/WC	$13.06

ELECTRODES XMD SUBDERM 8227410

Facility

$362.45

Hospital Charge Code	270621428
Hospital Revenue Code	270
Min. Negotiated Rate	$47.12
Max. Negotiated Rate	$181.22
Rate for Payer: Aetna Commercial	$108.73
Rate for Payer: Aetna Medicare Advantage	$108.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.42
Rate for Payer: Cigna Commercial	$181.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.12
Rate for Payer: Oxford Commercial	$181.22
Rate for Payer: Qualcare PPO/HMO/WC	$54.37
Rate for Payer: UnitedHealthcare Commercial	$181.22

ELECTRODES XMD SUBDERM 8227410

Facility

$362.45

Hospital Charge Code	270621428
Hospital Revenue Code	270
Min. Negotiated Rate	$54.37
Max. Negotiated Rate	$54.37
Rate for Payer: Qualcare PPO/HMO/WC	$54.37

ELECTRODES ZOLL8900-4003 TIER3

Facility

$93.27

Hospital Charge Code	270102159
Hospital Revenue Code	272
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$46.63
Rate for Payer: Aetna Commercial	$27.98
Rate for Payer: Aetna Medicare Advantage	$27.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.78
Rate for Payer: Cigna Commercial	$46.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.13
Rate for Payer: Oxford Commercial	$46.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.99
Rate for Payer: UnitedHealthcare Commercial	$46.63

ELECTRODES ZOLL8900-4003 TIER3

Facility

$93.27

Hospital Charge Code	270102159
Hospital Revenue Code	272
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$13.99
Rate for Payer: Qualcare PPO/HMO/WC	$13.99

ELECTRODE TP PAC 5F 647308556P

Facility

$668.00

Hospital Charge Code	270634587
Hospital Revenue Code	272
Min. Negotiated Rate	$86.84
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$200.40
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.84
Rate for Payer: Oxford Commercial	$334.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.20
Rate for Payer: UnitedHealthcare Commercial	$334.00

Know your out-of-pocket cost for care.

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