Heights University Hospital

All Charges

Charge

Type

Setting

Price

FILTER MICRON 0.25

Facility

$34.03

Hospital Charge Code	270654296
Hospital Revenue Code	272
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$17.02
Rate for Payer: Aetna Commercial	$10.21
Rate for Payer: Aetna Medicare Advantage	$10.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$17.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$17.02
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$17.02

FILTER MICRON 1.2

Facility

$10.66

Hospital Charge Code	270041075
Hospital Revenue Code	270
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$5.33
Rate for Payer: Aetna Commercial	$3.20
Rate for Payer: Aetna Medicare Advantage	$3.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.72
Rate for Payer: Cigna Commercial	$5.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.60
Rate for Payer: UnitedHealthcare Commercial	$5.33

FILTER MICRON 1.2

Facility

$10.66

Hospital Charge Code	270041075
Hospital Revenue Code	270
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

FILTER MONO FUME 5051-05

Facility

$766.45

Hospital Charge Code	270600352
Hospital Revenue Code	270
Min. Negotiated Rate	$99.64
Max. Negotiated Rate	$383.23
Rate for Payer: Aetna Commercial	$229.94
Rate for Payer: Aetna Medicare Advantage	$229.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.44
Rate for Payer: Cigna Commercial	$383.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.64
Rate for Payer: Oxford Commercial	$383.23
Rate for Payer: Qualcare PPO/HMO/WC	$114.97
Rate for Payer: UnitedHealthcare Commercial	$383.23

FILTER MONO FUME 5051-05

Facility

$766.45

Hospital Charge Code	270600352
Hospital Revenue Code	270
Min. Negotiated Rate	$114.97
Max. Negotiated Rate	$114.97
Rate for Payer: Qualcare PPO/HMO/WC	$114.97

FILTER NASAL O2 49125

Facility

$86.45

Hospital Charge Code	270627189
Hospital Revenue Code	272
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$43.23
Rate for Payer: Aetna Commercial	$25.93
Rate for Payer: Aetna Medicare Advantage	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.04
Rate for Payer: Cigna Commercial	$43.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.24
Rate for Payer: Oxford Commercial	$43.23
Rate for Payer: Qualcare PPO/HMO/WC	$12.97
Rate for Payer: UnitedHealthcare Commercial	$43.23

FILTER NASAL O2 49125

Facility

$86.45

Hospital Charge Code	270627189
Hospital Revenue Code	272
Min. Negotiated Rate	$12.97
Max. Negotiated Rate	$12.97
Rate for Payer: Qualcare PPO/HMO/WC	$12.97

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626S
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626N
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,387.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626S
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626N
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

FILTER PALL RCEZ1T

Facility

$2,759.25

Hospital Charge Code	270612416
Hospital Revenue Code	272
Min. Negotiated Rate	$358.70
Max. Negotiated Rate	$1,379.62
Rate for Payer: Aetna Commercial	$827.77
Rate for Payer: Aetna Medicare Advantage	$827.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.61
Rate for Payer: Cigna Commercial	$1,379.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.70
Rate for Payer: Oxford Commercial	$1,379.62
Rate for Payer: Qualcare PPO/HMO/WC	$413.89
Rate for Payer: UnitedHealthcare Commercial	$1,379.62

FILTER PALL RCEZ1T

Facility

$2,759.25

Hospital Charge Code	270612416
Hospital Revenue Code	272
Min. Negotiated Rate	$413.89
Max. Negotiated Rate	$413.89
Rate for Payer: Qualcare PPO/HMO/WC	$413.89

FILTER PFT KOKO

Facility

$26.00

Hospital Charge Code	270652199
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$7.80
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$13.00

FILTER PFT KOKO

Facility

$26.00

Hospital Charge Code	270652199
Hospital Revenue Code	270
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

FILTER PFT WHITE PRI757W

Facility

$5.50

Hospital Charge Code	270649462
Hospital Revenue Code	270
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.75
Rate for Payer: Aetna Commercial	$1.65
Rate for Payer: Aetna Medicare Advantage	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.40
Rate for Payer: Cigna Commercial	$2.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.72
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$2.75

FILTER PFT WHITE PRI757W

Facility

$5.50

Hospital Charge Code	270649462
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

FILTER (PLASMA) BLOOD BANK

Facility

$366.45

Hospital Charge Code	3100575
Hospital Revenue Code	272
Min. Negotiated Rate	$47.64
Max. Negotiated Rate	$183.22
Rate for Payer: Aetna Commercial	$109.94
Rate for Payer: Aetna Medicare Advantage	$109.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.44
Rate for Payer: Cigna Commercial	$183.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.64
Rate for Payer: Oxford Commercial	$183.22
Rate for Payer: Qualcare PPO/HMO/WC	$54.97
Rate for Payer: UnitedHealthcare Commercial	$183.22

FILTER (PLASMA) BLOOD BANK

Facility

$366.45

Hospital Charge Code	3100575
Hospital Revenue Code	272
Min. Negotiated Rate	$54.97
Max. Negotiated Rate	$54.97
Rate for Payer: Qualcare PPO/HMO/WC	$54.97

FILTER PULMAGUARD 29-7950100

Facility

$10.10

Hospital Charge Code	270636310
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

FILTER PULMAGUARD 29-7950100

Facility

$10.10

Hospital Charge Code	270636310
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$5.05
Rate for Payer: Aetna Commercial	$3.03
Rate for Payer: Aetna Medicare Advantage	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.58
Rate for Payer: Cigna Commercial	$5.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Oxford Commercial	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$5.05

FILTER PUMP BRAVO

Facility

$475.00

Hospital Charge Code	270691425
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FILTER PUMP BRAVO

Facility

$475.00

Hospital Charge Code	270691425
Hospital Revenue Code	272
Min. Negotiated Rate	$61.75
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.75
Rate for Payer: Oxford Commercial	$237.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$237.50

Know your out-of-pocket cost for care.

All Charges