Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASK SURG W/O SPLASHGUARD DISP

Facility

$38.94

Hospital Charge Code	270649455
Hospital Revenue Code	270
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$19.47
Rate for Payer: Aetna Commercial	$11.68
Rate for Payer: Aetna Medicare Advantage	$11.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.93
Rate for Payer: Cigna Commercial	$19.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.06
Rate for Payer: Oxford Commercial	$19.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.84
Rate for Payer: UnitedHealthcare Commercial	$19.47

MASK SURG W/O SPLASHGUARD DISP

Facility

$38.94

Hospital Charge Code	270649455
Hospital Revenue Code	270
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.84

MASK TRACH ADULT

Facility

$5.28

Hospital Charge Code	270651423
Hospital Revenue Code	272
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$2.64
Rate for Payer: Aetna Commercial	$1.58
Rate for Payer: Aetna Medicare Advantage	$1.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.69
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$2.64

MASK TRACH ADULT

Facility

$22.45

Hospital Charge Code	9500075
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

MASK TRACH ADULT

Facility

$22.45

Hospital Charge Code	9500075
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

MASK TRACH ADULT

Facility

$5.28

Hospital Charge Code	270651423
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

MASK TRACHEOSTOMY ADULT

Facility

$11.25

Hospital Charge Code	270606305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

MASK TRACHEOSTOMY ADULT

Facility

$11.25

Hospital Charge Code	270606305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

MASK VENTURI***

Facility

$32.40

Hospital Charge Code	9500281
Hospital Revenue Code	272
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna Commercial	$9.72
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.26
Rate for Payer: Cigna Commercial	$16.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.21
Rate for Payer: Oxford Commercial	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.86
Rate for Payer: UnitedHealthcare Commercial	$16.20

MASK VENTURI***

Facility

$32.40

Hospital Charge Code	9500281
Hospital Revenue Code	272
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$4.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.86

MASK VINYL NASAL MED

Facility

$130.45

Hospital Charge Code	270600642
Hospital Revenue Code	272
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$65.22
Rate for Payer: Aetna Commercial	$39.13
Rate for Payer: Aetna Medicare Advantage	$39.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.26
Rate for Payer: Cigna Commercial	$65.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.96
Rate for Payer: Oxford Commercial	$65.22
Rate for Payer: Qualcare PPO/HMO/WC	$19.57
Rate for Payer: UnitedHealthcare Commercial	$65.22

MASK VINYL NASAL MED

Facility

$130.45

Hospital Charge Code	270600642
Hospital Revenue Code	272
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$19.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.57

MASK VINYL NASAL MED/SM

Facility

$130.45

Hospital Charge Code	270600643
Hospital Revenue Code	272
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$65.22
Rate for Payer: Aetna Commercial	$39.13
Rate for Payer: Aetna Medicare Advantage	$39.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.26
Rate for Payer: Cigna Commercial	$65.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.96
Rate for Payer: Oxford Commercial	$65.22
Rate for Payer: Qualcare PPO/HMO/WC	$19.57
Rate for Payer: UnitedHealthcare Commercial	$65.22

MASK VINYL NASAL MED/SM

Facility

$130.45

Hospital Charge Code	270600643
Hospital Revenue Code	272
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$19.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.57

MASK VINYL NASAL SM

Facility

$130.45

Hospital Charge Code	270600641
Hospital Revenue Code	272
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$65.22
Rate for Payer: Aetna Commercial	$39.13
Rate for Payer: Aetna Medicare Advantage	$39.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.26
Rate for Payer: Cigna Commercial	$65.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.96
Rate for Payer: Oxford Commercial	$65.22
Rate for Payer: Qualcare PPO/HMO/WC	$19.57
Rate for Payer: UnitedHealthcare Commercial	$65.22

MASK VINYL NASAL SM

Facility

$130.45

Hospital Charge Code	270600641
Hospital Revenue Code	272
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$19.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.57

MASK W/HEADGEAR CIRCUIT FILTER

Facility

$227.70

Hospital Charge Code	270648511
Hospital Revenue Code	272
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$34.16
Rate for Payer: Qualcare PPO/HMO/WC	$34.16

MASK W/HEADGEAR CIRCUIT FILTER

Facility

$227.70

Hospital Charge Code	270648511
Hospital Revenue Code	272
Min. Negotiated Rate	$29.60
Max. Negotiated Rate	$113.85
Rate for Payer: Aetna Commercial	$68.31
Rate for Payer: Aetna Medicare Advantage	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.06
Rate for Payer: Cigna Commercial	$113.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.60
Rate for Payer: Oxford Commercial	$113.85
Rate for Payer: Qualcare PPO/HMO/WC	$34.16
Rate for Payer: UnitedHealthcare Commercial	$113.85

MAS PLIF FIXATION ROD, 40MM

Facility

$2,980.00

Hospital Charge Code	270667571
Hospital Revenue Code	278
Min. Negotiated Rate	$447.00
Max. Negotiated Rate	$721.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00

MAS PLIF FIXATION ROD, 40MM

Facility

$2,980.00

Hospital Charge Code	270667571
Hospital Revenue Code	278
Min. Negotiated Rate	$447.00
Max. Negotiated Rate	$1,490.00
Rate for Payer: Aetna Commercial	$894.00
Rate for Payer: Aetna Medicare Advantage	$894.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.90
Rate for Payer: Cigna Commercial	$1,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$2,324.25
Max. Negotiated Rate	$3,749.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$2,324.25
Max. Negotiated Rate	$7,747.50
Rate for Payer: Aetna Commercial	$4,648.50
Rate for Payer: Aetna Medicare Advantage	$4,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,951.22
Rate for Payer: Cigna Commercial	$7,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25

MASSAGE 10 MIN

Facility

$328.00

Service Code	HCPCS 97124
Hospital Charge Code	409297124
Hospital Revenue Code	420
Min. Negotiated Rate	$33.32
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$98.40
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.64
Rate for Payer: Cigna Commercial	$33.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.64
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$686.00

MASSAGE 10 MIN

Facility

$328.00

Service Code	HCPCS 97124
Hospital Charge Code	409297124
Hospital Revenue Code	420
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$35.05
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.19
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges