Heights University Hospital

All Charges

Charge

Type

Setting

Price

HUMER DIAPH SH CEMENTLESS SZ9

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693055
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

HUMER DIAPH SH CEMENTLESS SZ9

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693055
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

HUMER DIAPHY SHORT NO CEMENT 8

Facility

$17,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270696753
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.50
Max. Negotiated Rate	$4,295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50

HUMER DIAPHY SHORT NO CEMENT 8

Facility

$17,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270696753
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.50
Max. Negotiated Rate	$8,875.00
Rate for Payer: Aetna Commercial	$5,325.00
Rate for Payer: Aetna Medicare Advantage	$5,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,526.25
Rate for Payer: Cigna Commercial	$8,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50

HUMERUS 2 VIEWS-BILAT

Facility

$250.00

Service Code	HCPCS 7306050
Hospital Charge Code	94061217
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HUMERUS 2 VIEWS-BILAT

Facility

$250.00

Service Code	HCPCS 7306050
Hospital Charge Code	94061217
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

HUMERUS 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73060LT
Hospital Charge Code	94061293
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HUMERUS 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73060LT
Hospital Charge Code	94061293
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HUMERUS 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73060RT
Hospital Charge Code	94061295
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HUMERUS 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73060RT
Hospital Charge Code	94061295
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HUM HEAD 40Mx18M SOLAR53504018

Facility

$8,220.00

Hospital Charge Code	270640741
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.00
Max. Negotiated Rate	$4,110.00
Rate for Payer: Aetna Commercial	$2,466.00
Rate for Payer: Aetna Medicare Advantage	$2,466.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,096.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,096.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,644.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,096.10
Rate for Payer: Cigna Commercial	$4,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,989.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.00

HUM HEAD 40Mx18M SOLAR53504018

Facility

$8,220.00

Hospital Charge Code	270640741
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.00
Max. Negotiated Rate	$1,989.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,989.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.00

HUMIDFIER 02***

Facility

$9.90

Hospital Charge Code	9500091
Hospital Revenue Code	279
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

HUMIDFIER 02***

Facility

$9.90

Hospital Charge Code	9500091
Hospital Revenue Code	279
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$4.95
Rate for Payer: Aetna Commercial	$2.97
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.52
Rate for Payer: Cigna Commercial	$4.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.29
Rate for Payer: Oxford Commercial	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$4.95

HUMIDIFiER BALLARD FLEX HME

Facility

$9.20

Hospital Charge Code	270643318
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$4.60
Rate for Payer: Aetna Commercial	$2.76
Rate for Payer: Aetna Medicare Advantage	$2.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.35
Rate for Payer: Cigna Commercial	$4.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.38
Rate for Payer: UnitedHealthcare Commercial	$4.60

HUMIDIFiER BALLARD FLEX HME

Facility

$9.20

Hospital Charge Code	270643318
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

HUMIDIFIER BUBBLE

Facility

$40.00

Hospital Charge Code	270639795
Hospital Revenue Code	272
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$20.00

HUMIDIFIER BUBBLE

Facility

$40.00

Hospital Charge Code	270639795
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

HUMIDIFIER HYGROSCOPIC

Facility

$84.00

Hospital Charge Code	270600875
Hospital Revenue Code	272
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

HUMIDIFIER HYGROSCOPIC

Facility

$84.00

Hospital Charge Code	270600875
Hospital Revenue Code	272
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

HUMIDIFIER OXYGEN 500 ML

Facility

$6.96

Hospital Charge Code	270625161
Hospital Revenue Code	270
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

HUMIDIFIER OXYGEN 500 ML

Facility

$6.96

Hospital Charge Code	270625161
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.09
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.77
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$3.48

HUMIDIFIER OXYGEN STERILE H20

Facility

$5.50

Hospital Charge Code	270369531
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

HUMIDIFIER OXYGEN STERILE H20

Facility

$5.50

Hospital Charge Code	270369531
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

HUMIDIFIER RM

Facility

$141.65

Hospital Charge Code	8000895
Hospital Revenue Code	270
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$42.49
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$70.83
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$70.83

Know your out-of-pocket cost for care.

All Charges