Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT URINARY COLLECTION******

Facility

$194.00

Hospital Charge Code	8001034
Hospital Revenue Code	279
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$97.00
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Oxford Commercial	$97.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$97.00

KIT UROSTOMY 2-3/4 70MM POST

Facility

$14.62

Hospital Charge Code	270654222
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$7.31
Rate for Payer: Aetna Commercial	$4.39
Rate for Payer: Aetna Medicare Advantage	$4.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.73
Rate for Payer: Cigna Commercial	$7.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.90
Rate for Payer: Oxford Commercial	$7.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.19
Rate for Payer: UnitedHealthcare Commercial	$7.31

KIT UROSTOMY 2-3/4 70MM POST

Facility

$14.62

Hospital Charge Code	270654222
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.19

KIT VASCEL MICRO-PORT 45-318

Facility

$2,681.15

Hospital Charge Code	270629788V
Hospital Revenue Code	270
Min. Negotiated Rate	$402.17
Max. Negotiated Rate	$402.17
Rate for Payer: Qualcare PPO/HMO/WC	$402.17

KIT VASCEL MICRO-PORT 45-318

Facility

$1,649.65

Hospital Charge Code	270629788
Hospital Revenue Code	270
Min. Negotiated Rate	$247.45
Max. Negotiated Rate	$247.45
Rate for Payer: Qualcare PPO/HMO/WC	$247.45

KIT VASCEL MICRO-PORT 45-318

Facility

$1,649.65

Hospital Charge Code	270629788
Hospital Revenue Code	270
Min. Negotiated Rate	$214.45
Max. Negotiated Rate	$824.83
Rate for Payer: Aetna Commercial	$494.89
Rate for Payer: Aetna Medicare Advantage	$494.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.66
Rate for Payer: Cigna Commercial	$824.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.45
Rate for Payer: Oxford Commercial	$824.83
Rate for Payer: Qualcare PPO/HMO/WC	$247.45
Rate for Payer: UnitedHealthcare Commercial	$824.83

KIT VASCEL MICRO-PORT 45-318

Facility

$2,681.15

Hospital Charge Code	270629788V
Hospital Revenue Code	270
Min. Negotiated Rate	$348.55
Max. Negotiated Rate	$1,340.58
Rate for Payer: Aetna Commercial	$804.35
Rate for Payer: Aetna Medicare Advantage	$804.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.69
Rate for Payer: Cigna Commercial	$1,340.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.55
Rate for Payer: Oxford Commercial	$1,340.58
Rate for Payer: Qualcare PPO/HMO/WC	$402.17
Rate for Payer: UnitedHealthcare Commercial	$1,340.58

KIT VENTRICULOSTOMY

Facility

$1,530.00

Hospital Charge Code	270600327
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$459.00
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY

Facility

$1,530.00

Service Code	HCPCS C1729
Hospital Charge Code	270600327S
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY

Facility

$1,530.00

Hospital Charge Code	270600327
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY

Facility

$1,530.00

Service Code	HCPCS C1729
Hospital Charge Code	270600327S
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$459.00
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY *******

Facility

$280.00

Hospital Charge Code	1608066
Hospital Revenue Code	251
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$84.00
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$140.00

KIT VENTRICULOSTOMY *******

Facility

$280.00

Hospital Charge Code	1608066
Hospital Revenue Code	251
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

KIT VERTIFLEX SUPERION VIP

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698878
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT VERTIFLEX SUPERION VIP

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698878
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$750.00
Rate for Payer: UnitedHealthcare Commercial	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT VIZADISC HIP

Facility

$1,150.00

Hospital Charge Code	270668614
Hospital Revenue Code	272
Min. Negotiated Rate	$149.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$575.00

KIT VIZADISC HIP

Facility

$1,150.00

Hospital Charge Code	270668614
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

KIT WAVE WRITER ALPHA THAL

Facility

$500.00

Hospital Charge Code	270701897
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KIT WAVE WRITER ALPHA THAL

Facility

$500.00

Hospital Charge Code	270701897
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KIT WOUND DRAIN 3/16

Facility

$218.45

Hospital Charge Code	270605807
Hospital Revenue Code	272
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$32.77
Rate for Payer: Qualcare PPO/HMO/WC	$32.77

KIT WOUND DRAIN 3/16

Facility

$218.45

Hospital Charge Code	270605807
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$109.22
Rate for Payer: Aetna Commercial	$65.53
Rate for Payer: Aetna Medicare Advantage	$65.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.70
Rate for Payer: Cigna Commercial	$109.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.40
Rate for Payer: Oxford Commercial	$109.22
Rate for Payer: Qualcare PPO/HMO/WC	$32.77
Rate for Payer: UnitedHealthcare Commercial	$109.22

KIT WOUNDEVAC 400ml SU1304040

Facility

$41.05

Hospital Charge Code	270627962
Hospital Revenue Code	272
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.16

KIT WOUNDEVAC 400ml SU1304040

Facility

$41.05

Hospital Charge Code	270627962
Hospital Revenue Code	272
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$20.52
Rate for Payer: Aetna Commercial	$12.31
Rate for Payer: Aetna Medicare Advantage	$12.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.47
Rate for Payer: Cigna Commercial	$20.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.34
Rate for Payer: Oxford Commercial	$20.52
Rate for Payer: Qualcare PPO/HMO/WC	$6.16
Rate for Payer: UnitedHealthcare Commercial	$20.52

KIT WOUND SUCTION SURGIVAC ***

Facility

$109.00

Hospital Charge Code	1606086
Hospital Revenue Code	272
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$54.50
Rate for Payer: Aetna Commercial	$32.70
Rate for Payer: Aetna Medicare Advantage	$32.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.80
Rate for Payer: Cigna Commercial	$54.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.17
Rate for Payer: Oxford Commercial	$54.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.35
Rate for Payer: UnitedHealthcare Commercial	$54.50

KIT WOUND SUCTION SURGIVAC ***

Facility

$109.00

Hospital Charge Code	1606086
Hospital Revenue Code	272
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

Know your out-of-pocket cost for care.

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