Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASK 1032 TODDLER SZ 3

Facility

$15.00

Hospital Charge Code	270667185
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

MASK 1145 CHILD SZ4 BUBBLE

Facility

$15.80

Hospital Charge Code	270667184
Hospital Revenue Code	270
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.37

MASK 1145 CHILD SZ4 BUBBLE

Facility

$15.80

Hospital Charge Code	270667184
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$7.90
Rate for Payer: Aetna Commercial	$4.74
Rate for Payer: Aetna Medicare Advantage	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.03
Rate for Payer: Cigna Commercial	$7.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.05
Rate for Payer: Oxford Commercial	$7.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.37
Rate for Payer: UnitedHealthcare Commercial	$7.90

MASK 5-PT HYBRID HEAD/NECK/SHO

Facility

$450.00

Hospital Charge Code	270676902
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

MASK 5-PT HYBRID HEAD/NECK/SHO

Facility

$450.00

Hospital Charge Code	270676902
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MASK 5 PTS HYBRID HEAD

Facility

$450.00

Hospital Charge Code	270675791
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

MASK 5 PTS HYBRID HEAD

Facility

$450.00

Hospital Charge Code	270675791
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MASK ADULT HIOX O2 WADP 508001

Facility

$85.60

Hospital Charge Code	270637487
Hospital Revenue Code	272
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$12.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.84

MASK ADULT HIOX O2 WADP 508001

Facility

$85.60

Hospital Charge Code	270637487
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$42.80
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.83
Rate for Payer: Cigna Commercial	$42.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.13
Rate for Payer: Oxford Commercial	$42.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.84
Rate for Payer: UnitedHealthcare Commercial	$42.80

MASK ADULT HIOX OXYGEN 50-8001

Facility

$88.35

Hospital Charge Code	270643016
Hospital Revenue Code	272
Min. Negotiated Rate	$13.25
Max. Negotiated Rate	$13.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.25

MASK ADULT HIOX OXYGEN 50-8001

Facility

$88.35

Hospital Charge Code	270643016
Hospital Revenue Code	272
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$44.17
Rate for Payer: Aetna Commercial	$26.50
Rate for Payer: Aetna Medicare Advantage	$26.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.53
Rate for Payer: Cigna Commercial	$44.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Oxford Commercial	$44.17
Rate for Payer: Qualcare PPO/HMO/WC	$13.25
Rate for Payer: UnitedHealthcare Commercial	$44.17

MASK ADULT TAVISH FILTER

Facility

$14.75

Hospital Charge Code	270643040
Hospital Revenue Code	270
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$7.38
Rate for Payer: Aetna Commercial	$4.42
Rate for Payer: Aetna Medicare Advantage	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.76
Rate for Payer: Cigna Commercial	$7.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$7.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.21
Rate for Payer: UnitedHealthcare Commercial	$7.38

MASK ADULT TAVISH FILTER

Facility

$14.75

Hospital Charge Code	270643040
Hospital Revenue Code	270
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.21

MASK AEROSOL ADULT 00126

Facility

$5.65

Hospital Charge Code	270200105
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

MASK AEROSOL ADULT 00126

Facility

$5.65

Hospital Charge Code	270200105
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

MASK AEROSOL INFANT 2D4820

Facility

$13.65

Hospital Charge Code	270606453
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

MASK AEROSOL INFANT 2D4820

Facility

$13.65

Hospital Charge Code	270606453
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

MASK AEROSOL PEDIATRIC 001263

Facility

$9.65

Hospital Charge Code	270600638
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

MASK AEROSOL PEDIATRIC 001263

Facility

$9.65

Hospital Charge Code	270600638
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

MASK AEROSOL PEDS W/O TUBE

Facility

$2.06

Hospital Charge Code	270650004
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$1.03
Rate for Payer: Aetna Commercial	$0.62
Rate for Payer: Aetna Medicare Advantage	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.53
Rate for Payer: Cigna Commercial	$1.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.27
Rate for Payer: Oxford Commercial	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.31
Rate for Payer: UnitedHealthcare Commercial	$1.03

MASK AEROSOL PEDS W/O TUBE

Facility

$2.06

Hospital Charge Code	270650004
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.31

MASK ANESTHE ADLT SM DISP 5240

Facility

$7.28

Hospital Charge Code	270649452
Hospital Revenue Code	270
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$3.64
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna Medicare Advantage	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.95
Rate for Payer: Oxford Commercial	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.64

MASK ANESTHE ADLT SM DISP 5240

Facility

$7.28

Hospital Charge Code	270649452
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

MASK ANESTHE NEONATE DISP 5210

Facility

$7.62

Hospital Charge Code	270649450
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$3.81
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.94
Rate for Payer: Cigna Commercial	$3.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$3.81

MASK ANESTHE NEONATE DISP 5210

Facility

$7.62

Hospital Charge Code	270649450
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

Know your out-of-pocket cost for care.

All Charges