Heights University Hospital

All Charges

Charge

Type

Setting

Price

BAG BONGORT PEDS****

Facility

$165.00

Hospital Charge Code	8001307
Hospital Revenue Code	279
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$49.50
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Oxford Commercial	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Commercial	$82.50

BAG BONGORT REG

Facility

$104.00

Hospital Charge Code	8001299
Hospital Revenue Code	279
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$52.00

BAG BONGORT REG

Facility

$104.00

Hospital Charge Code	8001299
Hospital Revenue Code	279
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

BAG BONGORT XLG***

Facility

$69.00

Hospital Charge Code	8001315
Hospital Revenue Code	279
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

BAG BONGORT XLG***

Facility

$69.00

Hospital Charge Code	8001315
Hospital Revenue Code	279
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$20.70
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$34.50

BAG BREATHING 3L L.F MODIFIED

Facility

$26.25

Hospital Charge Code	270645650
Hospital Revenue Code	270
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

BAG BREATHING 3L L.F MODIFIED

Facility

$26.25

Hospital Charge Code	270645650
Hospital Revenue Code	270
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$7.88
Rate for Payer: Aetna Medicare Advantage	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.41
Rate for Payer: Oxford Commercial	$13.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$13.12

BAG COLLECTION

Facility

$224.00

Hospital Charge Code	270600319
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

BAG COLLECTION

Facility

$224.00

Hospital Charge Code	270600319
Hospital Revenue Code	272
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$67.20
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$112.00

BAG COLLECTION 1500ML 16100602

Facility

$297.65

Hospital Charge Code	270630300
Hospital Revenue Code	272
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

BAG COLLECTION 1500ML 16100602

Facility

$297.65

Hospital Charge Code	270630300
Hospital Revenue Code	272
Min. Negotiated Rate	$38.69
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.69
Rate for Payer: Oxford Commercial	$148.82
Rate for Payer: Qualcare PPO/HMO/WC	$44.65
Rate for Payer: UnitedHealthcare Commercial	$148.82

BAG COLLECTION (NEURO) ****

Facility

$43.00

Hospital Charge Code	1608074
Hospital Revenue Code	251
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

BAG COLLECTION (NEURO) ****

Facility

$43.00

Hospital Charge Code	1608074
Hospital Revenue Code	251
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

BAG COLOST DANSEC 10MM 324-1

Facility

$47.25

Hospital Charge Code	270623677
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

BAG COLOST DANSEC 10MM 324-1

Facility

$47.25

Hospital Charge Code	270623677
Hospital Revenue Code	272
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$14.18
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$23.62

BAG DECANTER

Facility

$546.25

Hospital Charge Code	270654842
Hospital Revenue Code	272
Min. Negotiated Rate	$71.01
Max. Negotiated Rate	$273.12
Rate for Payer: Aetna Commercial	$163.88
Rate for Payer: Aetna Medicare Advantage	$163.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.29
Rate for Payer: Cigna Commercial	$273.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.01
Rate for Payer: Oxford Commercial	$273.12
Rate for Payer: Qualcare PPO/HMO/WC	$81.94
Rate for Payer: UnitedHealthcare Commercial	$273.12

BAG DECANTER

Facility

$546.25

Hospital Charge Code	270654842
Hospital Revenue Code	272
Min. Negotiated Rate	$81.94
Max. Negotiated Rate	$81.94
Rate for Payer: Qualcare PPO/HMO/WC	$81.94

BAG-DECANTER

Facility

$502.70

Hospital Charge Code	270653941
Hospital Revenue Code	272
Min. Negotiated Rate	$65.35
Max. Negotiated Rate	$251.35
Rate for Payer: Aetna Commercial	$150.81
Rate for Payer: Aetna Medicare Advantage	$150.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.19
Rate for Payer: Cigna Commercial	$251.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.35
Rate for Payer: Oxford Commercial	$251.35
Rate for Payer: Qualcare PPO/HMO/WC	$75.41
Rate for Payer: UnitedHealthcare Commercial	$251.35

BAG-DECANTER

Facility

$502.70

Hospital Charge Code	270653941
Hospital Revenue Code	272
Min. Negotiated Rate	$75.41
Max. Negotiated Rate	$75.41
Rate for Payer: Qualcare PPO/HMO/WC	$75.41

BAG DRAINAGE ANTIFLUX 4000ml

Facility

$16.53

Service Code	HCPCS A4357
Hospital Charge Code	270649662
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$13.11
Rate for Payer: Aetna Commercial	$4.96
Rate for Payer: Aetna Medicare Advantage	$4.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.22
Rate for Payer: Cigna Commercial	$13.11
Rate for Payer: Cigna Medicare Advantage	$7.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$8.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.48
Rate for Payer: UnitedHealthcare Commercial	$8.27

BAG DRAINAGE ANTIFLUX 4000ml

Facility

$16.53

Service Code	HCPCS A4357
Hospital Charge Code	270649662
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$2.48
Rate for Payer: Qualcare PPO/HMO/WC	$2.48

BAG DRAINAGE ANTIREFLUX 2000ml

Facility

$11.26

Service Code	HCPCS A4357
Hospital Charge Code	270649660
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$13.11
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	$13.11
Rate for Payer: Cigna Medicare Advantage	$7.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.63

BAG DRAINAGE ANTIREFLUX 2000ml

Facility

$11.26

Service Code	HCPCS A4357
Hospital Charge Code	270649660
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

BAG DRAINAGE DEPORT 600ml

Facility

$46.50

Hospital Charge Code	270651482S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

BAG DRAINAGE DEPORT 600ml

Facility

$46.50

Hospital Charge Code	270651482
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$23.25
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.86
Rate for Payer: Cigna Commercial	$23.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.04
Rate for Payer: Oxford Commercial	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$23.25

Know your out-of-pocket cost for care.

All Charges