Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT TOOTHETTE W/CHLORHEXIDINE

Facility

$111.56

Hospital Charge Code	270649817
Hospital Revenue Code	272
Min. Negotiated Rate	$16.73
Max. Negotiated Rate	$16.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.73

KIT TOOTHETTE W/CHLORHEXIDINE

Facility

$111.56

Hospital Charge Code	270649817
Hospital Revenue Code	272
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$55.78
Rate for Payer: Aetna Commercial	$33.47
Rate for Payer: Aetna Medicare Advantage	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.45
Rate for Payer: Cigna Commercial	$55.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.50
Rate for Payer: Oxford Commercial	$55.78
Rate for Payer: Qualcare PPO/HMO/WC	$16.73
Rate for Payer: UnitedHealthcare Commercial	$55.78

KIT TRACH CARE 14F EB TIP 2219

Facility

$96.85

Hospital Charge Code	270611888
Hospital Revenue Code	272
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$14.53

KIT TRACH CARE 14F EB TIP 2219

Facility

$96.85

Hospital Charge Code	270611888
Hospital Revenue Code	272
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$48.42
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$29.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.70
Rate for Payer: Cigna Commercial	$48.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.59
Rate for Payer: Oxford Commercial	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$14.53
Rate for Payer: UnitedHealthcare Commercial	$48.42

KIT TRACH CARE 14FR W/WET PACK

Facility

$124.85

Hospital Charge Code	270606991
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

KIT TRACH CARE 14FR W/WET PACK

Facility

$124.85

Hospital Charge Code	270606991
Hospital Revenue Code	272
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.23
Rate for Payer: Oxford Commercial	$62.42
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$62.42

KIT TRACH CARE W/NACL BULLETS

Facility

$43.89

Hospital Charge Code	270608338
Hospital Revenue Code	272
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$21.95
Rate for Payer: Aetna Commercial	$13.17
Rate for Payer: Aetna Medicare Advantage	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.19
Rate for Payer: Cigna Commercial	$21.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$21.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.58
Rate for Payer: UnitedHealthcare Commercial	$21.95

KIT TRACH CARE W/NACL BULLETS

Facility

$43.89

Hospital Charge Code	270608338
Hospital Revenue Code	272
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$6.58
Rate for Payer: Qualcare PPO/HMO/WC	$6.58

KIT TRANSPAC II MONITORING****

Facility

$204.00

Hospital Charge Code	8003139
Hospital Revenue Code	279
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$102.00
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$102.00

KIT TRANSPAC II MONITORING****

Facility

$204.00

Hospital Charge Code	8003139
Hospital Revenue Code	279
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

KIT TRANSPAC MONITORING

Facility

$54.90

Hospital Charge Code	270110096
Hospital Revenue Code	270
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$27.45
Rate for Payer: Aetna Commercial	$16.47
Rate for Payer: Aetna Medicare Advantage	$16.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.00
Rate for Payer: Cigna Commercial	$27.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.14
Rate for Payer: Oxford Commercial	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$8.23
Rate for Payer: UnitedHealthcare Commercial	$27.45

KIT TRANSPAC MONITORING

Facility

$54.90

Hospital Charge Code	270110096
Hospital Revenue Code	270
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$8.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.23

KIT TRANSPAC MONITORING******

Facility

$166.00

Hospital Charge Code	1603182
Hospital Revenue Code	279
Min. Negotiated Rate	$21.58
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$49.80
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Oxford Commercial	$83.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Commercial	$83.00

KIT TRANSPAC MONITORING******

Facility

$166.00

Hospital Charge Code	1603182
Hospital Revenue Code	279
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$24.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

KIT TRANSVENOUS PACING

Facility

$686.20

Hospital Charge Code	270616215
Hospital Revenue Code	272
Min. Negotiated Rate	$102.93
Max. Negotiated Rate	$102.93
Rate for Payer: Qualcare PPO/HMO/WC	$102.93

KIT TRANSVENOUS PACING

Facility

$686.20

Hospital Charge Code	270616215
Hospital Revenue Code	272
Min. Negotiated Rate	$89.21
Max. Negotiated Rate	$343.10
Rate for Payer: Aetna Commercial	$205.86
Rate for Payer: Aetna Medicare Advantage	$205.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.98
Rate for Payer: Cigna Commercial	$343.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.21
Rate for Payer: Oxford Commercial	$343.10
Rate for Payer: Qualcare PPO/HMO/WC	$102.93
Rate for Payer: UnitedHealthcare Commercial	$343.10

KIT TROCAR CATH ********

Facility

$225.00

Hospital Charge Code	1603190
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

KIT TROCAR CATH ********

Facility

$225.00

Hospital Charge Code	1603190
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

KIT TUMOR ABLATION STAR

Facility

$19,475.00

Hospital Charge Code	270670691
Hospital Revenue Code	272
Min. Negotiated Rate	$2,531.75
Max. Negotiated Rate	$9,737.50
Rate for Payer: Aetna Commercial	$5,842.50
Rate for Payer: Aetna Medicare Advantage	$5,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,966.12
Rate for Payer: Cigna Commercial	$9,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,531.75
Rate for Payer: Oxford Commercial	$9,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25
Rate for Payer: UnitedHealthcare Commercial	$9,737.50

KIT TUMOR ABLATION STAR

Facility

$19,475.00

Hospital Charge Code	270670691
Hospital Revenue Code	272
Min. Negotiated Rate	$2,921.25
Max. Negotiated Rate	$2,921.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25

KIT ULTRA DRIVE IMPLANTATION

Facility

$8,450.00

Hospital Charge Code	270695353
Hospital Revenue Code	272
Min. Negotiated Rate	$1,267.50
Max. Negotiated Rate	$1,267.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50

KIT ULTRA DRIVE IMPLANTATION

Facility

$8,450.00

Hospital Charge Code	270695353
Hospital Revenue Code	272
Min. Negotiated Rate	$1,098.50
Max. Negotiated Rate	$4,225.00
Rate for Payer: Aetna Commercial	$2,535.00
Rate for Payer: Aetna Medicare Advantage	$2,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,154.75
Rate for Payer: Cigna Commercial	$4,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,098.50
Rate for Payer: Oxford Commercial	$4,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50
Rate for Payer: UnitedHealthcare Commercial	$4,225.00

KIT ULTRA PRO II DSPSABLE REPL

Facility

$80.21

Hospital Charge Code	270663445
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$40.10
Rate for Payer: Aetna Commercial	$24.06
Rate for Payer: Aetna Medicare Advantage	$24.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.45
Rate for Payer: Cigna Commercial	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.43
Rate for Payer: Oxford Commercial	$40.10
Rate for Payer: Qualcare PPO/HMO/WC	$12.03
Rate for Payer: UnitedHealthcare Commercial	$40.10

KIT ULTRA PRO II DSPSABLE REPL

Facility

$80.21

Hospital Charge Code	270663445
Hospital Revenue Code	272
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$12.03
Rate for Payer: Qualcare PPO/HMO/WC	$12.03

KIT URINARY COLLECTION******

Facility

$194.00

Hospital Charge Code	8001034
Hospital Revenue Code	279
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

Know your out-of-pocket cost for care.

All Charges