Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASK FULL FACE PETITE DISP

Facility

$139.35

Hospital Charge Code	270618249
Hospital Revenue Code	272
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$69.67
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$41.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.53
Rate for Payer: Cigna Commercial	$69.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.12
Rate for Payer: Oxford Commercial	$69.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.90
Rate for Payer: UnitedHealthcare Commercial	$69.67

MASK FULL FACE SM DISP VENTED

Facility

$111.66

Hospital Charge Code	270652272
Hospital Revenue Code	270
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$16.75
Rate for Payer: Qualcare PPO/HMO/WC	$16.75

MASK FULL FACE SM DISP VENTED

Facility

$111.66

Hospital Charge Code	270652272
Hospital Revenue Code	270
Min. Negotiated Rate	$14.52
Max. Negotiated Rate	$55.83
Rate for Payer: Aetna Commercial	$33.50
Rate for Payer: Aetna Medicare Advantage	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.47
Rate for Payer: Cigna Commercial	$55.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Oxford Commercial	$55.83
Rate for Payer: Qualcare PPO/HMO/WC	$16.75
Rate for Payer: UnitedHealthcare Commercial	$55.83

MASK INFANT BLD8854

Facility

$24.85

Hospital Charge Code	270600639
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

MASK INFANT BLD8854

Facility

$24.85

Hospital Charge Code	270600639
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

MASK LAR ST SEAL SZ5 321500000

Facility

$47.50

Hospital Charge Code	270640279
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

MASK LAR ST SEAL SZ5 321500000

Facility

$47.50

Hospital Charge Code	270640279
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.17
Rate for Payer: Oxford Commercial	$23.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$23.75

MASK LARYL SFTSL SZ3 100220300

Facility

$56.65

Hospital Charge Code	270634373
Hospital Revenue Code	272
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.36
Rate for Payer: Oxford Commercial	$28.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$28.32

MASK LARYL SFTSL SZ3 100220300

Facility

$56.65

Hospital Charge Code	270634373
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

MASK LARYL SFTSL SZ4 100220400

Facility

$55.00

Hospital Charge Code	270634374
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

MASK LARYL SFTSL SZ4 100220400

Facility

$55.00

Hospital Charge Code	270634374
Hospital Revenue Code	272
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

MASK LARYN AIRWAY SZ #2 125020

Facility

$33.32

Hospital Charge Code	270642066
Hospital Revenue Code	272
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.00

MASK LARYN AIRWAY SZ #2 125020

Facility

$33.32

Hospital Charge Code	270642066
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$16.66
Rate for Payer: Aetna Commercial	$10.00
Rate for Payer: Aetna Medicare Advantage	$10.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.50
Rate for Payer: Cigna Commercial	$16.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.33
Rate for Payer: Oxford Commercial	$16.66
Rate for Payer: Qualcare PPO/HMO/WC	$5.00
Rate for Payer: UnitedHealthcare Commercial	$16.66

MASK LARYNGEAL AIRWAY #3 SILI

Facility

$34.75

Hospital Charge Code	270645379
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

MASK LARYNGEAL AIRWAY #3 SILI

Facility

$34.75

Hospital Charge Code	270645379
Hospital Revenue Code	272
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$10.43
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$17.38

MASK LARYNGEAL AIRWAY #3 SILI-

Facility

$210.00

Hospital Charge Code	2706453779
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MASK LARYNGEAL AIRWAY #3 SILI-

Facility

$210.00

Hospital Charge Code	2706453779
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$105.00

MASK LARYNGEAL AIRWAY #4 SILI

Facility

$34.75

Hospital Charge Code	270645382
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

MASK LARYNGEAL AIRWAY #4 SILI

Facility

$34.75

Hospital Charge Code	270645382
Hospital Revenue Code	272
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$10.43
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$17.38

MASK LARYNGEAL AIRWAY 5 544001

Facility

$1,092.00

Hospital Charge Code	270606111
Hospital Revenue Code	272
Min. Negotiated Rate	$141.96
Max. Negotiated Rate	$546.00
Rate for Payer: Aetna Commercial	$327.60
Rate for Payer: Aetna Medicare Advantage	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.46
Rate for Payer: Cigna Commercial	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.96
Rate for Payer: Oxford Commercial	$546.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.80
Rate for Payer: UnitedHealthcare Commercial	$546.00

MASK LARYNGEAL AIRWAY 5 544001

Facility

$1,092.00

Hospital Charge Code	270606111
Hospital Revenue Code	272
Min. Negotiated Rate	$163.80
Max. Negotiated Rate	$163.80
Rate for Payer: Qualcare PPO/HMO/WC	$163.80

MASK LARYNGEAL AIRWAY #5 SILI

Facility

$34.75

Hospital Charge Code	270645383
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

MASK LARYNGEAL AIRWAY #5 SILI

Facility

$34.75

Hospital Charge Code	270645383
Hospital Revenue Code	272
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$10.43
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$17.38

MASK LARYNGEAL SOFT SEAL #4

Facility

$47.50

Hospital Charge Code	270633314
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.17
Rate for Payer: Oxford Commercial	$23.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$23.75

MASK LARYNGEAL SOFT SEAL #4

Facility

$47.50

Hospital Charge Code	270633314
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

Know your out-of-pocket cost for care.

All Charges