Heights University Hospital

All Charges

Charge

Type

Setting

Price

MODULE INTRAOSSEOUS BLUE

Facility

$210.00

Hospital Charge Code	270613367
Hospital Revenue Code	271
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MODULE INTRAOSSEOUS GREEN

Facility

$210.00

Hospital Charge Code	270644386
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

MODULE INTRAOSSEOUS GREEN

Facility

$210.00

Hospital Charge Code	270644386
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MODULE INTRAOSSEOUS ORANGE

Facility

$210.00

Hospital Charge Code	270644387
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MODULE INTRAOSSEOUS ORANGE

Facility

$210.00

Hospital Charge Code	270644387
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

MODULE INTRAOSSEOUS PURPLE

Facility

$210.00

Hospital Charge Code	270613364
Hospital Revenue Code	271
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MODULE INTRAOSSEOUS PURPLE

Facility

$210.00

Hospital Charge Code	270613364
Hospital Revenue Code	271
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

MODULE INTRAOSSEOUS YELLOW

Facility

$210.00

Hospital Charge Code	270613365
Hospital Revenue Code	271
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

MODULE INTRAOSSEOUS YELLOW

Facility

$210.00

Hospital Charge Code	270613365
Hospital Revenue Code	271
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

MODULE INTUBATION BLUE

Facility

$150.00

Hospital Charge Code	270613337
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION BLUE

Facility

$150.00

Hospital Charge Code	270613337
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION GREEN

Facility

$150.00

Hospital Charge Code	270613339
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION GREEN

Facility

$150.00

Hospital Charge Code	270613339
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION ORANGE

Facility

$150.00

Hospital Charge Code	270613338
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION ORANGE

Facility

$150.00

Hospital Charge Code	270613338
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION PURPLE

Facility

$150.00

Hospital Charge Code	270613334
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION PURPLE

Facility

$150.00

Hospital Charge Code	270613334
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION RED

Facility

$150.00

Hospital Charge Code	270613333
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION RED

Facility

$150.00

Hospital Charge Code	270613333
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION WHITE

Facility

$150.00

Hospital Charge Code	270613336
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION WHITE

Facility

$150.00

Hospital Charge Code	270613336
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE INTUBATION YELLOW

Facility

$150.00

Hospital Charge Code	270613335
Hospital Revenue Code	271
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

MODULE INTUBATION YELLOW

Facility

$150.00

Hospital Charge Code	270613335
Hospital Revenue Code	271
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MODULE IV DELIVERY BLUE

Facility

$167.50

Hospital Charge Code	270613360
Hospital Revenue Code	271
Min. Negotiated Rate	$21.77
Max. Negotiated Rate	$83.75
Rate for Payer: Aetna Commercial	$50.25
Rate for Payer: Aetna Medicare Advantage	$50.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.71
Rate for Payer: Cigna Commercial	$83.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.77
Rate for Payer: Oxford Commercial	$83.75
Rate for Payer: Qualcare PPO/HMO/WC	$25.12
Rate for Payer: UnitedHealthcare Commercial	$83.75

MODULE IV DELIVERY BLUE

Facility

$167.50

Hospital Charge Code	270613360
Hospital Revenue Code	271
Min. Negotiated Rate	$25.12
Max. Negotiated Rate	$25.12
Rate for Payer: Qualcare PPO/HMO/WC	$25.12

Know your out-of-pocket cost for care.

All Charges