Heights University Hospital

All Charges

Charge

Type

Setting

Price

IRRIGATION TUBE SET SINGLE PK

Facility

$231.00

Hospital Charge Code	270674704
Hospital Revenue Code	272
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$34.65

IRRIGATOR ARTHRO FLO

Facility

$120.00

Hospital Charge Code	270654349
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

IRRIGATOR ARTHRO FLO

Facility

$120.00

Hospital Charge Code	270654349
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

IRRIGATOR IGLOO WOUND

Facility

$5.34

Hospital Charge Code	270644301
Hospital Revenue Code	270
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$1.60
Rate for Payer: Aetna Medicare Advantage	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.36
Rate for Payer: Cigna Commercial	$2.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.69
Rate for Payer: Oxford Commercial	$2.67
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$2.67

IRRIGATOR IGLOO WOUND

Facility

$5.34

Hospital Charge Code	270644301
Hospital Revenue Code	270
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

IRRIGATOR SHOWEHEAD SET TIP

Facility

$628.45

Hospital Charge Code	270657856
Hospital Revenue Code	270
Min. Negotiated Rate	$81.70
Max. Negotiated Rate	$314.23
Rate for Payer: Aetna Commercial	$188.53
Rate for Payer: Aetna Medicare Advantage	$188.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.25
Rate for Payer: Cigna Commercial	$314.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.70
Rate for Payer: Oxford Commercial	$314.23
Rate for Payer: Qualcare PPO/HMO/WC	$94.27
Rate for Payer: UnitedHealthcare Commercial	$314.23

IRRIGATOR SHOWEHEAD SET TIP

Facility

$628.45

Hospital Charge Code	270657856
Hospital Revenue Code	270
Min. Negotiated Rate	$94.27
Max. Negotiated Rate	$94.27
Rate for Payer: Qualcare PPO/HMO/WC	$94.27

IRRIGATOR SIMPULSE

Facility

$475.00

Hospital Charge Code	270335141
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

IRRIGATOR SIMPULSE

Facility

$475.00

Hospital Charge Code	270335141
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

IRRIGATOR SUCTION

Facility

$453.65

Hospital Charge Code	270600334
Hospital Revenue Code	270
Min. Negotiated Rate	$68.05
Max. Negotiated Rate	$68.05
Rate for Payer: Qualcare PPO/HMO/WC	$68.05

IRRIGATOR SUCTION

Facility

$453.65

Hospital Charge Code	270600334
Hospital Revenue Code	270
Min. Negotiated Rate	$58.97
Max. Negotiated Rate	$226.82
Rate for Payer: Aetna Commercial	$136.09
Rate for Payer: Aetna Medicare Advantage	$136.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.68
Rate for Payer: Cigna Commercial	$226.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.97
Rate for Payer: Oxford Commercial	$226.82
Rate for Payer: Qualcare PPO/HMO/WC	$68.05
Rate for Payer: UnitedHealthcare Commercial	$226.82

IRRIG CORPOR CAVERN F PRIAPISM

Facility

$833.00

Service Code	HCPCS 54220
Hospital Charge Code	5770001
Hospital Revenue Code	450
Min. Negotiated Rate	$99.12
Max. Negotiated Rate	$594.98
Rate for Payer: Aetna Commercial	$249.90
Rate for Payer: Aetna Medicare Advantage	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.41
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.29
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IRRIG CORPOR CAVERN F PRIAPISM

Facility

$833.00

Service Code	HCPCS 54220
Hospital Charge Code	5770001
Hospital Revenue Code	450
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IRRIG. CYSTOTOME 25G FORMED

Facility

$36.00

Hospital Charge Code	270331571
Hospital Revenue Code	272
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

IRRIG. CYSTOTOME 25G FORMED

Facility

$36.00

Hospital Charge Code	270331571
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

IRRIG G.U. 3000 ML *****

Facility

$20.00

Hospital Charge Code	7000888
Hospital Revenue Code	279
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

IRRIG G.U. 3000 ML *****

Facility

$20.00

Hospital Charge Code	7000888
Hospital Revenue Code	279
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

IRRIG OF DRUG DELIVERY SYSTEM

Facility

$323.35

Service Code	HCPCS 96523
Hospital Charge Code	3401160
Hospital Revenue Code	335
Min. Negotiated Rate	$48.50
Max. Negotiated Rate	$48.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.50

IRRIG OF DRUG DELIVERY SYSTEM

Facility

$323.35

Service Code	HCPCS 96523
Hospital Charge Code	3401160
Hospital Revenue Code	335
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$97.00
Rate for Payer: Aetna Medicare Advantage	$97.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.45
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.04
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

IRRIG STERILE WATER 1000ML****

Facility

$10.00

Hospital Charge Code	7000110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

IRRIG STERILE WATER 1000ML****

Facility

$10.00

Hospital Charge Code	7000110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

IRRISEPT CLEANSNG & DEBRID SYS

Facility

$316.50

Hospital Charge Code	270680866
Hospital Revenue Code	272
Min. Negotiated Rate	$47.48
Max. Negotiated Rate	$47.48
Rate for Payer: Qualcare PPO/HMO/WC	$47.48

IRRISEPT CLEANSNG & DEBRID SYS

Facility

$316.50

Hospital Charge Code	270680866
Hospital Revenue Code	272
Min. Negotiated Rate	$41.15
Max. Negotiated Rate	$158.25
Rate for Payer: Aetna Commercial	$94.95
Rate for Payer: Aetna Medicare Advantage	$94.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.71
Rate for Payer: Cigna Commercial	$158.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.15
Rate for Payer: Oxford Commercial	$158.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.48
Rate for Payer: UnitedHealthcare Commercial	$158.25

IR RNAL CYST STDY TRNSLMBR LFT

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2600110
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$199.46
Rate for Payer: Aetna Medicare Advantage	$199.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.54
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.43
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR RNAL CYST STDY TRNSLMBR LFT

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2600110
Hospital Revenue Code	320
Min. Negotiated Rate	$99.73
Max. Negotiated Rate	$99.73
Rate for Payer: Qualcare PPO/HMO/WC	$99.73

Know your out-of-pocket cost for care.

All Charges