Heights University Hospital

All Charges

Charge

Type

Setting

Price

NEBULIZER HEATED***

Facility

$27.00

Service Code	HCPCS 94664
Hospital Charge Code	9500224
Hospital Revenue Code	419
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

NEBULIZER HEATED***

Facility

$27.00

Service Code	HCPCS 94664
Hospital Charge Code	9500224
Hospital Revenue Code	419
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

NEBULIZER INHALATION TX***

Facility

$39.60

Service Code	HCPCS 94640
Hospital Charge Code	9500515
Hospital Revenue Code	410
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.94

NEBULIZER INHALATION TX***

Facility

$39.60

Service Code	HCPCS 94640
Hospital Charge Code	9500515
Hospital Revenue Code	410
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$11.88
Rate for Payer: Aetna Medicare Advantage	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.10
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.15
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.94
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

NEBULIZER MISTY MAX 10 DISP

Facility

$4.13

Hospital Charge Code	270651481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$2.06
Rate for Payer: Aetna Commercial	$1.24
Rate for Payer: Aetna Medicare Advantage	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.05
Rate for Payer: Cigna Commercial	$2.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.54
Rate for Payer: Oxford Commercial	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.62
Rate for Payer: UnitedHealthcare Commercial	$2.06

NEBULIZER MISTY MAX 10 DISP

Facility

$4.13

Hospital Charge Code	270651481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.62

NEBULIZER PRN

Facility

$46.00

Service Code	HCPCS 94664
Hospital Charge Code	9400505
Hospital Revenue Code	419
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$13.80
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

NEBULIZER PRN

Facility

$46.00

Service Code	HCPCS 94664
Hospital Charge Code	9400505
Hospital Revenue Code	419
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

NEBULIZER PRN***

Facility

$50.00

Service Code	HCPCS 94664
Hospital Charge Code	9500505
Hospital Revenue Code	419
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

NEBULIZER PRN***

Facility

$50.00

Service Code	HCPCS 94664
Hospital Charge Code	9500505
Hospital Revenue Code	419
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

NEBULIZER RESPURGARD II

Facility

$25.65

Hospital Charge Code	270688898
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.82
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$7.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.54
Rate for Payer: Cigna Commercial	$12.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.85
Rate for Payer: UnitedHealthcare Commercial	$12.82

NEBULIZER RESPURGARD II

Facility

$25.65

Hospital Charge Code	270688898
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$3.85

NEBULIZER SET-UP***

Facility

$32.40

Service Code	HCPCS 94664
Hospital Charge Code	9500513
Hospital Revenue Code	419
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$4.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.86

NEBULIZER SET-UP***

Facility

$32.40

Service Code	HCPCS 94664
Hospital Charge Code	9500513
Hospital Revenue Code	419
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$1,004.00
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) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.26
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.21
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.86
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

NEBULIZER STERILE WATER 1070ml

Facility

$15.91

Hospital Charge Code	270622941
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$7.96
Rate for Payer: Aetna Commercial	$4.77
Rate for Payer: Aetna Medicare Advantage	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.06
Rate for Payer: Cigna Commercial	$7.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$7.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.39
Rate for Payer: UnitedHealthcare Commercial	$7.96

NEBULIZER STERILE WATER 1070ml

Facility

$15.91

Hospital Charge Code	270622941
Hospital Revenue Code	272
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$2.39
Rate for Payer: Qualcare PPO/HMO/WC	$2.39

NEBULIZER STERILE WATER 440ml

Facility

$12.67

Hospital Charge Code	270626230
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

NEBULIZER STERILE WATER 440ml

Facility

$12.67

Hospital Charge Code	270626230
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.65
Rate for Payer: Oxford Commercial	$6.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$6.33

NEBULIZER STERILE WATER 760ml

Facility

$13.40

Hospital Charge Code	270626229
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$6.70
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.42
Rate for Payer: Cigna Commercial	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.74
Rate for Payer: Oxford Commercial	$6.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$6.70

NEBULIZER STERILE WATER 760ml

Facility

$13.40

Hospital Charge Code	270626229
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

NEBU-MASK SYSTEM ADULT

Facility

$160.00

Hospital Charge Code	270648119
Hospital Revenue Code	272
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

NEBU-MASK SYSTEM ADULT

Facility

$160.00

Hospital Charge Code	270648119
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

NEBUPENT INHAL/300MG/EACH

Facility

$588.00

Hospital Charge Code	60633514
Hospital Revenue Code	250
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$88.20
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

NEBUPENT INHAL/300MG/EACH

Facility

$588.00

Hospital Charge Code	60633514
Hospital Revenue Code	250
Min. Negotiated Rate	$76.44
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$176.40
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.44
Rate for Payer: Oxford Commercial	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Commercial	$294.00

NECK ADJUSTMENT SLEEVE STD V40

Facility

$1,089.00

Hospital Charge Code	270669748
Hospital Revenue Code	272
Min. Negotiated Rate	$141.57
Max. Negotiated Rate	$544.50
Rate for Payer: Aetna Commercial	$326.70
Rate for Payer: Aetna Medicare Advantage	$326.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$277.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$277.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$277.69
Rate for Payer: Cigna Commercial	$544.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Oxford Commercial	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$163.35
Rate for Payer: UnitedHealthcare Commercial	$544.50

Know your out-of-pocket cost for care.

All Charges