Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT COLOSTOMY/ILEOSTOMY 4

Facility

$14.28

Hospital Charge Code	270654223
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

KIT COLOSTOMY/ILEOSTOMY 4

Facility

$14.28

Hospital Charge Code	270654223
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$7.14
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$7.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$7.14

KIT CRAINOPLASTY 431050

Facility

$1,488.00

Hospital Charge Code	270607324
Hospital Revenue Code	278
Min. Negotiated Rate	$223.20
Max. Negotiated Rate	$744.00
Rate for Payer: Aetna Commercial	$446.40
Rate for Payer: Aetna Medicare Advantage	$446.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.44
Rate for Payer: Cigna Commercial	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: Qualcare PPO/HMO/WC	$223.20

KIT CRAINOPLASTY 431050

Facility

$1,488.00

Hospital Charge Code	270607324
Hospital Revenue Code	278
Min. Negotiated Rate	$223.20
Max. Negotiated Rate	$360.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.10
Rate for Payer: Qualcare PPO/HMO/WC	$223.20

KIT CRANIOPLASTIC 43-1050

Facility

$2,760.85

Hospital Charge Code	270600729
Hospital Revenue Code	272
Min. Negotiated Rate	$358.91
Max. Negotiated Rate	$1,380.42
Rate for Payer: Aetna Commercial	$828.25
Rate for Payer: Aetna Medicare Advantage	$828.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$704.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$704.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$704.02
Rate for Payer: Cigna Commercial	$1,380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.91
Rate for Payer: Oxford Commercial	$1,380.42
Rate for Payer: Qualcare PPO/HMO/WC	$414.13
Rate for Payer: UnitedHealthcare Commercial	$1,380.42

KIT CRANIOPLASTIC 43-1050

Facility

$2,760.85

Hospital Charge Code	270600729
Hospital Revenue Code	272
Min. Negotiated Rate	$414.13
Max. Negotiated Rate	$414.13
Rate for Payer: Qualcare PPO/HMO/WC	$414.13

KIT CURETTE TITANIUM PROBE

Facility

$2,225.00

Hospital Charge Code	270663201
Hospital Revenue Code	272
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

KIT CURETTE TITANIUM PROBE

Facility

$2,225.00

Hospital Charge Code	270663201
Hospital Revenue Code	272
Min. Negotiated Rate	$289.25
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$667.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.25
Rate for Payer: Oxford Commercial	$1,112.50
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Commercial	$1,112.50

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111S
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111S
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

KIT CUSTOM INFLATION IN4909

Facility

$1,830.00

Hospital Charge Code	270646784
Hospital Revenue Code	279
Min. Negotiated Rate	$237.90
Max. Negotiated Rate	$915.00
Rate for Payer: Aetna Commercial	$549.00
Rate for Payer: Aetna Medicare Advantage	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$466.65
Rate for Payer: Cigna Commercial	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.90
Rate for Payer: Oxford Commercial	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$274.50
Rate for Payer: UnitedHealthcare Commercial	$915.00

KIT CUSTOM INFLATION IN4909

Facility

$1,830.00

Hospital Charge Code	270646784
Hospital Revenue Code	279
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$274.50
Rate for Payer: Qualcare PPO/HMO/WC	$274.50

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784C
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784C
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784N
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

KIT CV CATH II****

Facility

$84.00

Hospital Charge Code	8002636
Hospital Revenue Code	279
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

KIT CV CATH II****

Facility

$84.00

Hospital Charge Code	8002636
Hospital Revenue Code	279
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

KIT DECOMPRES 1.5 W/CVD 407251

Facility

$10,280.00

Hospital Charge Code	270641738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,336.40
Max. Negotiated Rate	$5,140.00
Rate for Payer: Aetna Commercial	$3,084.00
Rate for Payer: Aetna Medicare Advantage	$3,084.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,621.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,621.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,621.40
Rate for Payer: Cigna Commercial	$5,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,336.40
Rate for Payer: Oxford Commercial	$5,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.00
Rate for Payer: UnitedHealthcare Commercial	$5,140.00

KIT DECOMPRES 1.5 W/CVD 407251

Facility

$10,280.00

Hospital Charge Code	270641738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,542.00
Max. Negotiated Rate	$1,542.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.00

KIT DELIVERY CUSTOM B575

Facility

$108.00

Hospital Charge Code	270606557
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

KIT DELIVERY CUSTOM B575

Facility

$108.00

Hospital Charge Code	270606557
Hospital Revenue Code	272
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$32.40
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.04
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$54.00

KIT DIALYSATE #2

Facility

$60.00

Hospital Charge Code	8200115
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

Know your out-of-pocket cost for care.

All Charges