Heights University Hospital

All Charges

Charge

Type

Setting

Price

FNA W/O IMAGE

Facility

$1,838.13

Service Code	HCPCS 10021
Hospital Charge Code	1600000560
Hospital Revenue Code	360
Min. Negotiated Rate	$275.72
Max. Negotiated Rate	$275.72
Rate for Payer: Qualcare PPO/HMO/WC	$275.72

FNA W/O IMAGE

Facility

$1,838.13

Service Code	HCPCS 10021
Hospital Charge Code	1600000560
Hospital Revenue Code	360
Min. Negotiated Rate	$238.96
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$551.44
Rate for Payer: Aetna Medicare Advantage	$551.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.72
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.96
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.72
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FOAM DBM LG STRIP 100x25x5MM

Facility

$7,875.00

Hospital Charge Code	270671260
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

FOAM DBM LG STRIP 100x25x5MM

Facility

$7,875.00

Hospital Charge Code	270671260
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,362.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

FOAM DBM MED STRIP 50x25x5MM

Facility

$5,065.00

Hospital Charge Code	270671261
Hospital Revenue Code	278
Min. Negotiated Rate	$759.75
Max. Negotiated Rate	$2,532.50
Rate for Payer: Aetna Commercial	$1,519.50
Rate for Payer: Aetna Medicare Advantage	$1,519.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,291.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,291.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,291.58
Rate for Payer: Cigna Commercial	$2,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,225.73
Rate for Payer: Qualcare PPO/HMO/WC	$759.75

FOAM DBM MED STRIP 50x25x5MM

Facility

$5,065.00

Hospital Charge Code	270671261
Hospital Revenue Code	278
Min. Negotiated Rate	$759.75
Max. Negotiated Rate	$1,225.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,013.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,225.73
Rate for Payer: Qualcare PPO/HMO/WC	$759.75

FOAM DBM SKINNY STP 100x10x8MM

Facility

$8,550.00

Hospital Charge Code	270671259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,282.50
Max. Negotiated Rate	$4,275.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,180.25
Rate for Payer: Cigna Commercial	$4,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,069.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50

FOAM DBM SKINNY STP 100x10x8MM

Facility

$8,550.00

Hospital Charge Code	270671259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,282.50
Max. Negotiated Rate	$2,069.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,069.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.50

FOAM DBM SM STRIP 15x15x8MM

Facility

$1,575.00

Hospital Charge Code	270671262
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

FOAM DBM SM STRIP 15x15x8MM

Facility

$1,575.00

Hospital Charge Code	270671262
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$472.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

FOAM DRESSING DISC 4 IN

Facility

$7.74

Hospital Charge Code	270689724
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

FOAM DRESSING DISC 4 IN

Facility

$7.74

Hospital Charge Code	270689724
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$3.87
Rate for Payer: Aetna Commercial	$2.32
Rate for Payer: Aetna Medicare Advantage	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.01
Rate for Payer: Oxford Commercial	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.87

FOAM FINGER SPLINT 1 X 18

Facility

$33.00

Hospital Charge Code	270331640
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

FOAM FINGER SPLINT 1 X 18

Facility

$33.00

Hospital Charge Code	270331640
Hospital Revenue Code	270
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.50

FOAM GRAY SHEET 1/2 3'X6

Facility

$84.40

Hospital Charge Code	270636435
Hospital Revenue Code	271
Min. Negotiated Rate	$12.66
Max. Negotiated Rate	$12.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.66

FOAM GRAY SHEET 1/2 3'X6

Facility

$84.40

Hospital Charge Code	270636435
Hospital Revenue Code	271
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$42.20
Rate for Payer: Aetna Commercial	$25.32
Rate for Payer: Aetna Medicare Advantage	$25.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.52
Rate for Payer: Cigna Commercial	$42.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.97
Rate for Payer: Oxford Commercial	$42.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.66
Rate for Payer: UnitedHealthcare Commercial	$42.20

FOAM GRAY SHEET 1/4 3'X6

Facility

$44.70

Hospital Charge Code	270636434
Hospital Revenue Code	271
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna Commercial	$13.41
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.81
Rate for Payer: Oxford Commercial	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Commercial	$22.35

FOAM GRAY SHEET 1/4 3'X6

Facility

$44.70

Hospital Charge Code	270636434
Hospital Revenue Code	271
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

FOAM SELF AD 3/16 4x196 M1563L

Facility

$42.08

Hospital Charge Code	270640897W
Hospital Revenue Code	272
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

FOAM SELF AD 3/16 4x196 M1563L

Facility

$42.08

Hospital Charge Code	270640897W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$21.04
Rate for Payer: Aetna Commercial	$12.62
Rate for Payer: Aetna Medicare Advantage	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.73
Rate for Payer: Cigna Commercial	$21.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.47
Rate for Payer: Oxford Commercial	$21.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$21.04

FOAM SOFT, COLLAR CERVICAL

Facility

$18.05

Hospital Charge Code	270658928
Hospital Revenue Code	270
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$9.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$9.03

FOAM SOFT, COLLAR CERVICAL

Facility

$18.05

Hospital Charge Code	270658928
Hospital Revenue Code	270
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

FOAM VITOSS BA2X 5CC

Facility

$10,674.30

Service Code	HCPCS C1713
Hospital Charge Code	270667773
Hospital Revenue Code	278
Min. Negotiated Rate	$1,601.14
Max. Negotiated Rate	$5,337.15
Rate for Payer: Aetna Commercial	$3,202.29
Rate for Payer: Aetna Medicare Advantage	$3,202.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,721.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,721.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,134.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,721.95
Rate for Payer: Cigna Commercial	$5,337.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.14

FOAM VITOSS BA2X 5CC

Facility

$10,674.30

Service Code	HCPCS C1713
Hospital Charge Code	270667773
Hospital Revenue Code	278
Min. Negotiated Rate	$1,601.14
Max. Negotiated Rate	$2,583.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,134.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.14

FOGARTY ART EMBO CATH 3FR 80CM

Facility

$308.00

Hospital Charge Code	270330913
Hospital Revenue Code	278
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$74.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.54
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

Know your out-of-pocket cost for care.

All Charges