Heights University Hospital

All Charges

Charge

Type

Setting

Price

FILM CURIX ORTHO HTG 24X24

Facility

$116.75

Hospital Charge Code	270654382
Hospital Revenue Code	272
Min. Negotiated Rate	$17.51
Max. Negotiated Rate	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$17.51

FILM ENDO PICTURE UPC5010A

Facility

$1,189.17

Hospital Charge Code	270607072
Hospital Revenue Code	270
Min. Negotiated Rate	$154.59
Max. Negotiated Rate	$594.59
Rate for Payer: Aetna Commercial	$356.75
Rate for Payer: Aetna Medicare Advantage	$356.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.24
Rate for Payer: Cigna Commercial	$594.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.59
Rate for Payer: Oxford Commercial	$594.59
Rate for Payer: Qualcare PPO/HMO/WC	$178.38
Rate for Payer: UnitedHealthcare Commercial	$594.59

FILM ENDO PICTURE UPC5010A

Facility

$1,189.17

Hospital Charge Code	270607072
Hospital Revenue Code	270
Min. Negotiated Rate	$178.38
Max. Negotiated Rate	$178.38
Rate for Payer: Qualcare PPO/HMO/WC	$178.38

FILM MEDT EPI 2.5X2.5 1417000

Facility

$768.85

Hospital Charge Code	270622520
Hospital Revenue Code	272
Min. Negotiated Rate	$115.33
Max. Negotiated Rate	$115.33
Rate for Payer: Qualcare PPO/HMO/WC	$115.33

FILM MEDT EPI 2.5X2.5 1417000

Facility

$768.85

Hospital Charge Code	270622520
Hospital Revenue Code	272
Min. Negotiated Rate	$99.95
Max. Negotiated Rate	$384.43
Rate for Payer: Aetna Commercial	$230.66
Rate for Payer: Aetna Medicare Advantage	$230.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.06
Rate for Payer: Cigna Commercial	$384.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.95
Rate for Payer: Oxford Commercial	$384.43
Rate for Payer: Qualcare PPO/HMO/WC	$115.33
Rate for Payer: UnitedHealthcare Commercial	$384.43

FILM NO-STING BARRIER 3344****

Facility

$2.00

Hospital Charge Code	270611000
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

FILM NO-STING BARRIER 3344****

Facility

$2.00

Hospital Charge Code	270611000
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

FILTER

Facility

$2,190.40

Hospital Charge Code	270657245
Hospital Revenue Code	278
Min. Negotiated Rate	$328.56
Max. Negotiated Rate	$1,095.20
Rate for Payer: Aetna Commercial	$657.12
Rate for Payer: Aetna Medicare Advantage	$657.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.55
Rate for Payer: Cigna Commercial	$1,095.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$530.08
Rate for Payer: Qualcare PPO/HMO/WC	$328.56

FILTER

Facility

$2,190.40

Hospital Charge Code	270657245
Hospital Revenue Code	278
Min. Negotiated Rate	$328.56
Max. Negotiated Rate	$530.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$530.08
Rate for Payer: Qualcare PPO/HMO/WC	$328.56

FILTER 40 MICRON

Facility

$131.25

Hospital Charge Code	270605804
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

FILTER 40 MICRON

Facility

$131.25

Hospital Charge Code	270605804
Hospital Revenue Code	272
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$39.38
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$65.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$65.62

FILTER 5-MICRON WSHNG MACHINE

Facility

$208.33

Hospital Charge Code	270606087
Hospital Revenue Code	271
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$31.25
Rate for Payer: Qualcare PPO/HMO/WC	$31.25

FILTER 5-MICRON WSHNG MACHINE

Facility

$208.33

Hospital Charge Code	270606087
Hospital Revenue Code	271
Min. Negotiated Rate	$27.08
Max. Negotiated Rate	$104.17
Rate for Payer: Aetna Commercial	$62.50
Rate for Payer: Aetna Medicare Advantage	$62.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.12
Rate for Payer: Cigna Commercial	$104.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.08
Rate for Payer: Oxford Commercial	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$31.25
Rate for Payer: UnitedHealthcare Commercial	$104.17

FILTER ANA CUBE FOR BX41 MICRO

Facility

$5,063.50

Hospital Charge Code	270665724
Hospital Revenue Code	270
Min. Negotiated Rate	$759.52
Max. Negotiated Rate	$759.52
Rate for Payer: Qualcare PPO/HMO/WC	$759.52

FILTER ANA CUBE FOR BX41 MICRO

Facility

$5,063.50

Hospital Charge Code	270665724
Hospital Revenue Code	270
Min. Negotiated Rate	$658.25
Max. Negotiated Rate	$2,531.75
Rate for Payer: Aetna Commercial	$1,519.05
Rate for Payer: Aetna Medicare Advantage	$1,519.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,291.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,291.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,291.19
Rate for Payer: Cigna Commercial	$2,531.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.25
Rate for Payer: Oxford Commercial	$2,531.75
Rate for Payer: Qualcare PPO/HMO/WC	$759.52
Rate for Payer: UnitedHealthcare Commercial	$2,531.75

FILTER ARTHROSC SPEC COLLECT**

Facility

$36.00

Hospital Charge Code	1603034
Hospital Revenue Code	279
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

FILTER ARTHROSC SPEC COLLECT**

Facility

$36.00

Hospital Charge Code	1603034
Hospital Revenue Code	279
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$18.00

FILTER ASSY PRECISION FLOW 02

Facility

$875.00

Hospital Charge Code	270680237
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

FILTER ASSY PRECISION FLOW 02

Facility

$875.00

Hospital Charge Code	270680237
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

FILTER BAC EXHALATION 40107930

Facility

$46.90

Hospital Charge Code	270633107
Hospital Revenue Code	272
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$23.45
Rate for Payer: Aetna Commercial	$14.07
Rate for Payer: Aetna Medicare Advantage	$14.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.96
Rate for Payer: Cigna Commercial	$23.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.10
Rate for Payer: Oxford Commercial	$23.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.04
Rate for Payer: UnitedHealthcare Commercial	$23.45

FILTER BAC EXHALATION 40107930

Facility

$46.90

Hospital Charge Code	270633107
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.04

FILTER BACTERIA DISP

Facility

$11.25

Hospital Charge Code	270600629
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

FILTER BACTERIA DISP

Facility

$11.25

Hospital Charge Code	270600629
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

FILTER BACTERIA DISP***

Facility

$18.00

Hospital Charge Code	9501073
Hospital Revenue Code	279
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FILTER BACTERIA DISP***

Facility

$18.00

Hospital Charge Code	9501073
Hospital Revenue Code	279
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

Know your out-of-pocket cost for care.

All Charges