Heights University Hospital

All Charges

Charge

Type

Setting

Price

NASAL ENDO,W CONCHA BULLA RES

Facility

$22,334.60

Service Code	HCPCS 31240
Hospital Charge Code	1600000708
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,700.38
Rate for Payer: Aetna Commercial	$6,700.38
Rate for Payer: Aetna Medicare Advantage	$6,700.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,695.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,695.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,695.32
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,903.50
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

NASAL ENDOW ETHMOIDEC BL

Facility

$36,247.00

Service Code	HCPCS 31255
Hospital Charge Code	1600000478
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$16,806.60
Rate for Payer: Aetna Commercial	$10,874.10
Rate for Payer: Aetna Medicare Advantage	$10,874.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,242.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,242.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,242.99
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,712.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.05
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

NASAL ENDOW ETHMOIDEC BL

Facility

$36,247.00

Service Code	HCPCS 31255
Hospital Charge Code	1600000478
Hospital Revenue Code	360
Min. Negotiated Rate	$5,437.05
Max. Negotiated Rate	$5,437.05
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.05

NASAL ENDO W MAXILL ANTROSTMY

Facility

$43,275.35

Service Code	HCPCS 31256
Hospital Charge Code	1600000312
Hospital Revenue Code	360
Min. Negotiated Rate	$855.69
Max. Negotiated Rate	$12,982.60
Rate for Payer: Aetna Better Health Medicaid	$855.69
Rate for Payer: Aetna Commercial	$12,982.60
Rate for Payer: Aetna Medicare Advantage	$12,982.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,035.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,035.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,035.21
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,625.80
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30
Rate for Payer: UnitedHealthcare Commercial	$5,529.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$872.80
Rate for Payer: Wellpoint Medicaid Managed Care	$855.69

NASAL ENDO W MAXILL ANTROSTMY

Facility

$43,275.35

Service Code	HCPCS 31256
Hospital Charge Code	1600000312
Hospital Revenue Code	360
Min. Negotiated Rate	$6,491.30
Max. Negotiated Rate	$6,491.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30

NASAL END W MA,W RM TISS MS RT

Facility

$28,850.55

Service Code	HCPCS 31267
Hospital Charge Code	1600000492
Hospital Revenue Code	360
Min. Negotiated Rate	$4,327.58
Max. Negotiated Rate	$4,327.58
Rate for Payer: Qualcare PPO/HMO/WC	$4,327.58

NASAL END W MA,W RM TISS MS RT

Facility

$28,850.55

Service Code	HCPCS 31267
Hospital Charge Code	1600000492
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$16,806.60
Rate for Payer: Aetna Better Health Medicaid	$14,074.35
Rate for Payer: Aetna Commercial	$8,655.17
Rate for Payer: Aetna Medicare Advantage	$8,655.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,356.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,356.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,356.89
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.57
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,327.58
Rate for Payer: UnitedHealthcare Commercial	$5,529.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,355.84
Rate for Payer: Wellpoint Medicaid Managed Care	$14,074.35

NASALIDE 0.025% NASAL/25M

Facility

$135.00

Hospital Charge Code	60633504
Hospital Revenue Code	250
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

NASALIDE 0.025% NASAL/25M

Facility

$135.00

Hospital Charge Code	60633504
Hospital Revenue Code	250
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$40.50
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Oxford Commercial	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$67.50

NASAL PILLOW SWIFT FX

Facility

$550.00

Hospital Charge Code	270648553
Hospital Revenue Code	271
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$275.00

NASAL PILLOW SWIFT FX

Facility

$550.00

Hospital Charge Code	270648553
Hospital Revenue Code	271
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

NASAL/S ENDO W FRNTAL SINUS B

Facility

$43,275.35

Service Code	HCPCS 31276
Hospital Charge Code	1600000484
Hospital Revenue Code	360
Min. Negotiated Rate	$6,491.30
Max. Negotiated Rate	$6,491.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30

NASAL/S ENDO W FRNTAL SINUS B

Facility

$43,275.35

Service Code	HCPCS 31276
Hospital Charge Code	1600000484
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$16,806.60
Rate for Payer: Aetna Commercial	$12,982.60
Rate for Payer: Aetna Medicare Advantage	$12,982.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,035.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,035.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,035.21
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,625.80
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

NASAL SEPTAL BUTTON 3.2CM

Facility

$204.00

Hospital Charge Code	270335719
Hospital Revenue Code	272
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$102.00
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$102.00

NASAL SEPTAL BUTTON 3.2CM

Facility

$204.00

Hospital Charge Code	270335719
Hospital Revenue Code	272
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

NASAL SEPTAL BUTTON 5.0CM

Facility

$255.00

Hospital Charge Code	270335718
Hospital Revenue Code	272
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.15
Rate for Payer: Oxford Commercial	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$127.50

NASAL SEPTAL BUTTON 5.0CM

Facility

$255.00

Hospital Charge Code	270335718
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

NASAL/SINUS ENDOSCOPY SURG

Facility

$40,761.60

Service Code	HCPCS 31287
Hospital Charge Code	1600000722
Hospital Revenue Code	360
Min. Negotiated Rate	$6,114.24
Max. Negotiated Rate	$6,114.24
Rate for Payer: Qualcare PPO/HMO/WC	$6,114.24

NASAL/SINUS ENDOSCOPY SURG

Facility

$13,338.00

Service Code	HCPCS 31291
Hospital Charge Code	1600000662
Hospital Revenue Code	360
Min. Negotiated Rate	$2,000.70
Max. Negotiated Rate	$2,000.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,000.70

NASAL/SINUS ENDOSCOPY SURG

Facility

$40,761.60

Service Code	HCPCS 31287
Hospital Charge Code	1600000722
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$16,806.60
Rate for Payer: Aetna Commercial	$12,228.48
Rate for Payer: Aetna Medicare Advantage	$12,228.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,394.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,394.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,394.21
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,299.01
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,114.24
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

NASAL/SINUS ENDOSCOPY SURG

Facility

$13,338.00

Service Code	HCPCS 31291
Hospital Charge Code	1600000662
Hospital Revenue Code	360
Min. Negotiated Rate	$1,176.08
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,001.40
Rate for Payer: Aetna Medicare Advantage	$4,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,401.19
Rate for Payer: Cigna Commercial	$1,176.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,733.94
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,000.70
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

NASAL SPLINT BLANK 3X3 BLUSH

Facility

$33.00

Hospital Charge Code	270332219
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.50

NASAL SPLINT BLANK 3X3 BLUSH

Facility

$33.00

Hospital Charge Code	270332219
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

NASAL SPRAY/15ML

Facility

$2.00

Hospital Charge Code	60634603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

NASAL SPRAY/15ML

Facility

$2.00

Hospital Charge Code	60634603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

Know your out-of-pocket cost for care.

All Charges