Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

MASK BIPAP SM DISP HG 1012526

Facility

$275.00

Hospital Charge Code	270637976
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 SM DISP HG 1012526

Facility

$275.00

Hospital Charge Code	270637976
Hospital Revenue Code	272
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Aetna Commercial	$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 SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
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 SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
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 COMFORT FLAP SMALL

Facility

$5.00

Hospital Charge Code	270657829
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

MASK COMFORT FLAP SMALL

Facility

$5.00

Hospital Charge Code	270657829
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

MASK COMFORT FULL LARGE

Facility

$75.00

Hospital Charge Code	270657875
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

MASK COMFORT FULL LARGE

Facility

$75.00

Hospital Charge Code	270657875
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT FULL MEDIUM

Facility

$75.00

Hospital Charge Code	270657874
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT FULL MEDIUM

Facility

$75.00

Hospital Charge Code	270657874
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

MASK COMFORT FULL SMALL

Facility

$75.00

Hospital Charge Code	270657873
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

MASK COMFORT FULL SMALL

Facility

$75.00

Hospital Charge Code	270657873
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT GEL LARGE

Facility

$45.00

Hospital Charge Code	270657814
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL LARGE

Facility

$45.00

Hospital Charge Code	270657814
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL MED

Facility

$45.00

Hospital Charge Code	270657813
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL MED

Facility

$45.00

Hospital Charge Code	270657813
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$22.50

MASK COMFORT GEL PETITE

Facility

$45.00

Hospital Charge Code	270657871
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$22.50

MASK COMFORT GEL PETITE

Facility

$45.00

Hospital Charge Code	270657871
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORTLITE 2 COMBO WITH

Facility

$1,196.85

Hospital Charge Code	270643158
Hospital Revenue Code	272
Min. Negotiated Rate	$155.59
Max. Negotiated Rate	$598.42
Rate for Payer: Aetna Commercial	$359.06
Rate for Payer: Aetna Medicare Advantage	$359.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.20
Rate for Payer: Cigna Commercial	$598.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.59
Rate for Payer: Oxford Commercial	$598.42
Rate for Payer: Qualcare PPO/HMO/WC	$179.53
Rate for Payer: UnitedHealthcare Commercial	$598.42

MASK COMFORTLITE 2 COMBO WITH

Facility

$1,196.85

Hospital Charge Code	270643158
Hospital Revenue Code	272
Min. Negotiated Rate	$179.53
Max. Negotiated Rate	$179.53
Rate for Payer: Qualcare PPO/HMO/WC	$179.53

MASK CUSHION INFANT 20 EA

Facility

$30.43

Hospital Charge Code	270684076
Hospital Revenue Code	272
Min. Negotiated Rate	$4.56
Max. Negotiated Rate	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$4.56

MASK CUSHION INFANT 20 EA

Facility

$30.43

Hospital Charge Code	270684076
Hospital Revenue Code	272
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$15.21
Rate for Payer: Aetna Commercial	$9.13
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$15.21
Rate for Payer: Qualcare PPO/HMO/WC	$4.56
Rate for Payer: UnitedHealthcare Commercial	$15.21

MASK FACE FILTER DUCK BILL

Facility

$19.25

Hospital Charge Code	270061035C
Hospital Revenue Code	270
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

MASK FACE FILTER DUCK BILL

Facility

$19.25

Hospital Charge Code	270061035C
Hospital Revenue Code	270
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

Know your out-of-pocket cost for care.

All Charges