Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASK ANESTHESIA ADLT DISP SZ 5

Facility

$7.44

Hospital Charge Code	270649449
Hospital Revenue Code	270
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$3.72
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare Advantage	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.90
Rate for Payer: Cigna Commercial	$3.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Oxford Commercial	$3.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$3.72

MASK ANESTHESIA ADLT DISP SZ 5

Facility

$7.44

Hospital Charge Code	270649449
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

MASK ANESTHESIA ADULT SIZE 5

Facility

$145.35

Hospital Charge Code	270645629
Hospital Revenue Code	272
Min. Negotiated Rate	$21.80
Max. Negotiated Rate	$21.80
Rate for Payer: Qualcare PPO/HMO/WC	$21.80

MASK ANESTHESIA ADULT SIZE 5

Facility

$145.35

Hospital Charge Code	270645629
Hospital Revenue Code	272
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$72.67
Rate for Payer: Aetna Commercial	$43.60
Rate for Payer: Aetna Medicare Advantage	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.06
Rate for Payer: Cigna Commercial	$72.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$72.67
Rate for Payer: Qualcare PPO/HMO/WC	$21.80
Rate for Payer: UnitedHealthcare Commercial	$72.67

MASK ANESTHESIA CHILD SIZE 4

Facility

$659.20

Hospital Charge Code	270655723
Hospital Revenue Code	272
Min. Negotiated Rate	$85.70
Max. Negotiated Rate	$329.60
Rate for Payer: Aetna Commercial	$197.76
Rate for Payer: Aetna Medicare Advantage	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.10
Rate for Payer: Cigna Commercial	$329.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.70
Rate for Payer: Oxford Commercial	$329.60
Rate for Payer: Qualcare PPO/HMO/WC	$98.88
Rate for Payer: UnitedHealthcare Commercial	$329.60

MASK ANESTHESIA CHILD SIZE 4

Facility

$659.20

Hospital Charge Code	270655723
Hospital Revenue Code	272
Min. Negotiated Rate	$98.88
Max. Negotiated Rate	$98.88
Rate for Payer: Qualcare PPO/HMO/WC	$98.88

MASK ANESTHESIA CIRCUT LG 5045

Facility

$7.85

Hospital Charge Code	270070061
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$2.35
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.00
Rate for Payer: Cigna Commercial	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.02
Rate for Payer: Oxford Commercial	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$3.92

MASK ANESTHESIA CIRCUT LG 5045

Facility

$7.85

Hospital Charge Code	270070061
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

MASK ANESTHESIA PED 1274

Facility

$9.25

Hospital Charge Code	270605258
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.36
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.39
Rate for Payer: UnitedHealthcare Commercial	$4.62

MASK ANESTHESIA PED 1274

Facility

$9.25

Hospital Charge Code	270605258
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.39

MASK ANESTHES INFANT DISP 5220

Facility

$7.62

Hospital Charge Code	270649451
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

MASK ANESTHES INFANT DISP 5220

Facility

$7.62

Hospital Charge Code	270649451
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 ANES TODDLER FACE 5230

Facility

$7.26

Hospital Charge Code	270649453
Hospital Revenue Code	270
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.63
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	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.63

MASK ANES TODDLER FACE 5230

Facility

$7.26

Hospital Charge Code	270649453
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

MASK ANETHESIA TODDLER SIZE 3

Facility

$113.63

Hospital Charge Code	270655715
Hospital Revenue Code	272
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$56.81
Rate for Payer: Aetna Commercial	$34.09
Rate for Payer: Aetna Medicare Advantage	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.98
Rate for Payer: Cigna Commercial	$56.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Oxford Commercial	$56.81
Rate for Payer: Qualcare PPO/HMO/WC	$17.04
Rate for Payer: UnitedHealthcare Commercial	$56.81

MASK ANETHESIA TODDLER SIZE 3

Facility

$113.63

Hospital Charge Code	270655715
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$17.04
Rate for Payer: Qualcare PPO/HMO/WC	$17.04

MASK BIPAP LG DISP HG 1012529

Facility

$275.00

Hospital Charge Code	270637978
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

MASK BIPAP LG DISP HG 1012529

Facility

$275.00

Hospital Charge Code	270637978
Hospital Revenue Code	272
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$137.50

MASK BIPAP LG NON-VENTED

Facility

$120.45

Hospital Charge Code	270655468
Hospital Revenue Code	270
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$60.23
Rate for Payer: Aetna Commercial	$36.13
Rate for Payer: Aetna Medicare Advantage	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.71
Rate for Payer: Cigna Commercial	$60.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.66
Rate for Payer: Oxford Commercial	$60.23
Rate for Payer: Qualcare PPO/HMO/WC	$18.07
Rate for Payer: UnitedHealthcare Commercial	$60.23

MASK BIPAP LG NON-VENTED

Facility

$120.45

Hospital Charge Code	270655468
Hospital Revenue Code	270
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.07

MASK BIPAP MED DISP HG 1012528

Facility

$275.00

Hospital Charge Code	270637977
Hospital Revenue Code	272
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$137.50

MASK BIPAP MED DISP HG 1012528

Facility

$275.00

Hospital Charge Code	270637977
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$32.44
Rate for Payer: Aetna Medicare Advantage	$32.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.06
Rate for Payer: Oxford Commercial	$54.07
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$54.07

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK BIPAP ME WIDE DISP

Facility

$153.65

Hospital Charge Code	270606855
Hospital Revenue Code	272
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

Know your out-of-pocket cost for care.

All Charges