Heights University Hospital

All Charges

Charge

Type

Setting

Price

FILTER JUGULAR ECLIPSE EC500J

Facility

$7,475.00

Hospital Charge Code	270644010
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

FILTER JUGULAR ECLIPSE EC500J

Facility

$7,475.00

Hospital Charge Code	270644010
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

FILTER LEUKOCYTE RCEZIT

Facility

$180.00

Hospital Charge Code	270626660
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

FILTER LEUKOCYTE RCEZIT

Facility

$180.00

Hospital Charge Code	270626660
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$90.00

FILTER LINE H-SET

Facility

$325.00

Hospital Charge Code	270646167
Hospital Revenue Code	270
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

FILTER LINE H-SET

Facility

$325.00

Hospital Charge Code	270646167
Hospital Revenue Code	270
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

FILTERLINE H SET ADULT/PEDS

Facility

$66.95

Hospital Charge Code	270652784
Hospital Revenue Code	270
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$33.48
Rate for Payer: Aetna Commercial	$20.09
Rate for Payer: Aetna Medicare Advantage	$20.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.07
Rate for Payer: Cigna Commercial	$33.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.70
Rate for Payer: Oxford Commercial	$33.48
Rate for Payer: Qualcare PPO/HMO/WC	$10.04
Rate for Payer: UnitedHealthcare Commercial	$33.48

FILTERLINE H SET ADULT/PEDS

Facility

$66.95

Hospital Charge Code	270652784
Hospital Revenue Code	270
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$10.04
Rate for Payer: Qualcare PPO/HMO/WC	$10.04

FILTERLINE W/O2 CONN F/CPAP/

Facility

$63.22

Hospital Charge Code	270674939
Hospital Revenue Code	272
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$9.48
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

FILTERLINE W/O2 CONN F/CPAP/

Facility

$63.22

Hospital Charge Code	270674939
Hospital Revenue Code	272
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.61
Rate for Payer: Aetna Commercial	$18.97
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.12
Rate for Payer: Cigna Commercial	$31.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.61
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Commercial	$31.61

FILTER LIPID

Facility

$224.60

Hospital Charge Code	270674073
Hospital Revenue Code	272
Min. Negotiated Rate	$29.20
Max. Negotiated Rate	$112.30
Rate for Payer: Aetna Commercial	$67.38
Rate for Payer: Aetna Medicare Advantage	$67.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.27
Rate for Payer: Cigna Commercial	$112.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.20
Rate for Payer: Oxford Commercial	$112.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.69
Rate for Payer: UnitedHealthcare Commercial	$112.30

FILTER LIPID

Facility

$224.60

Hospital Charge Code	270674073
Hospital Revenue Code	272
Min. Negotiated Rate	$33.69
Max. Negotiated Rate	$33.69
Rate for Payer: Qualcare PPO/HMO/WC	$33.69

FILTER MEMBRANE DISP

Facility

$85.65

Hospital Charge Code	270607684
Hospital Revenue Code	279
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$25.70
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.13
Rate for Payer: Oxford Commercial	$42.83
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Commercial	$42.83

FILTER MEMBRANE DISP

Facility

$85.65

Hospital Charge Code	270607684
Hospital Revenue Code	279
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$12.85
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

FILTER MERIDIAN VENA

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FILTER MERIDIAN VENA

Facility

$7,725.00

Hospital Charge Code	270646597C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,317.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

FILTER MERIDIAN VENA

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FILTER MERIDIAN VENA

Facility

$7,725.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

FILTER MERIDIAN VENA

Facility

$7,725.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,317.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

FILTER MERIDIAN VENA

Facility

$7,725.00

Hospital Charge Code	270646597C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

FILTER MICROGUARD PFT DISP

Facility

$15.45

Hospital Charge Code	270647353
Hospital Revenue Code	270
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$7.72
Rate for Payer: Aetna Commercial	$4.63
Rate for Payer: Aetna Medicare Advantage	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.94
Rate for Payer: Cigna Commercial	$7.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.01
Rate for Payer: Oxford Commercial	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.32
Rate for Payer: UnitedHealthcare Commercial	$7.72

FILTER MICROGUARD PFT DISP

Facility

$15.45

Hospital Charge Code	270647353
Hospital Revenue Code	270
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.32

FILTER MICRON 0.22

Facility

$50.45

Hospital Charge Code	270600852
Hospital Revenue Code	270
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

FILTER MICRON 0.22

Facility

$50.45

Hospital Charge Code	270600852
Hospital Revenue Code	270
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

FILTER MICRON 0.25

Facility

$34.03

Hospital Charge Code	270654296
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

Know your out-of-pocket cost for care.

All Charges