Heights University Hospital

All Charges

Charge

Type

Setting

Price

PARVOVIRUS B19 DNA,QL,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900402
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 PCR

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3038096
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

PARVOVIRUS B19 PCR

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3038096
Hospital Revenue Code	306
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

PAS FUNGUS

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005391
Hospital Revenue Code	310
Min. Negotiated Rate	$42.23
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$97.45
Rate for Payer: Aetna Medicare Advantage	$97.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.84
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$62.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

PAS FUNGUS

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005391
Hospital Revenue Code	310
Min. Negotiated Rate	$48.73
Max. Negotiated Rate	$48.73
Rate for Payer: Qualcare PPO/HMO/WC	$48.73

PASSER ATK SUTURE LOOP 906976

Facility

$536.85

Hospital Charge Code	270613301
Hospital Revenue Code	272
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$80.53
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

PASSER ATK SUTURE LOOP 906976

Facility

$536.85

Hospital Charge Code	270613301
Hospital Revenue Code	272
Min. Negotiated Rate	$69.79
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$161.06
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: Oxford Commercial	$268.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Commercial	$268.43

PASSER CATHETER 60cm S/C DISP

Facility

$888.00

Service Code	HCPCS C1729
Hospital Charge Code	270612675
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

PASSER CATHETER 60cm S/C DISP

Facility

$888.00

Service Code	HCPCS C1729
Hospital Charge Code	270612675
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$266.40
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

PASSER JJ CATH 36CM 82-1515

Facility

$284.85

Hospital Charge Code	270600328
Hospital Revenue Code	272
Min. Negotiated Rate	$37.03
Max. Negotiated Rate	$142.43
Rate for Payer: Aetna Commercial	$85.45
Rate for Payer: Aetna Medicare Advantage	$85.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.64
Rate for Payer: Cigna Commercial	$142.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Oxford Commercial	$142.43
Rate for Payer: Qualcare PPO/HMO/WC	$42.73
Rate for Payer: UnitedHealthcare Commercial	$142.43

PASSER JJ CATH 36CM 82-1515

Facility

$284.85

Hospital Charge Code	270600328
Hospital Revenue Code	272
Min. Negotiated Rate	$42.73
Max. Negotiated Rate	$42.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.73

PASSER JJ CATH 55CM 82-1516

Facility

$309.65

Hospital Charge Code	270600329
Hospital Revenue Code	272
Min. Negotiated Rate	$40.25
Max. Negotiated Rate	$154.82
Rate for Payer: Aetna Commercial	$92.89
Rate for Payer: Aetna Medicare Advantage	$92.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.96
Rate for Payer: Cigna Commercial	$154.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.25
Rate for Payer: Oxford Commercial	$154.82
Rate for Payer: Qualcare PPO/HMO/WC	$46.45
Rate for Payer: UnitedHealthcare Commercial	$154.82

PASSER JJ CATH 55CM 82-1516

Facility

$309.65

Hospital Charge Code	270600329
Hospital Revenue Code	272
Min. Negotiated Rate	$46.45
Max. Negotiated Rate	$46.45
Rate for Payer: Qualcare PPO/HMO/WC	$46.45

PASSER MEDT CATH 38CM 48407

Facility

$536.85

Hospital Charge Code	270612722
Hospital Revenue Code	272
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$80.53
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

PASSER MEDT CATH 38CM 48407

Facility

$536.85

Hospital Charge Code	270612722
Hospital Revenue Code	272
Min. Negotiated Rate	$69.79
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$161.06
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: Oxford Commercial	$268.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Commercial	$268.43

PASSER SUTURE HEWSON

Facility

$822.50

Hospital Charge Code	270620933
Hospital Revenue Code	272
Min. Negotiated Rate	$106.92
Max. Negotiated Rate	$411.25
Rate for Payer: Aetna Commercial	$246.75
Rate for Payer: Aetna Medicare Advantage	$246.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.74
Rate for Payer: Cigna Commercial	$411.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.92
Rate for Payer: Oxford Commercial	$411.25
Rate for Payer: Qualcare PPO/HMO/WC	$123.38
Rate for Payer: UnitedHealthcare Commercial	$411.25

PASSER SUTURE HEWSON

Facility

$822.50

Hospital Charge Code	270620933
Hospital Revenue Code	272
Min. Negotiated Rate	$123.38
Max. Negotiated Rate	$123.38
Rate for Payer: Qualcare PPO/HMO/WC	$123.38

PASSER SUTURE STRAIGHT

Facility

$1,655.00

Hospital Charge Code	270613181
Hospital Revenue Code	272
Min. Negotiated Rate	$248.25
Max. Negotiated Rate	$248.25
Rate for Payer: Qualcare PPO/HMO/WC	$248.25

PASSER SUTURE STRAIGHT

Facility

$1,655.00

Hospital Charge Code	270613181
Hospital Revenue Code	272
Min. Negotiated Rate	$215.15
Max. Negotiated Rate	$827.50
Rate for Payer: Aetna Commercial	$496.50
Rate for Payer: Aetna Medicare Advantage	$496.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.02
Rate for Payer: Cigna Commercial	$827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.15
Rate for Payer: Oxford Commercial	$827.50
Rate for Payer: Qualcare PPO/HMO/WC	$248.25
Rate for Payer: UnitedHealthcare Commercial	$827.50

PASSPORT 8MM X 4

Facility

$160.00

Hospital Charge Code	270667982
Hospital Revenue Code	270
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

PASSPORT 8MM X 4

Facility

$160.00

Hospital Charge Code	270667982
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

PASSPORT BUTTON CANNULA

Facility

$160.00

Hospital Charge Code	270684275
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

PASSPORT BUTTON CANNULA

Facility

$160.00

Hospital Charge Code	270684275
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

PASS ZIM WIRE 1.5 19MM 5091248

Facility

$328.85

Hospital Charge Code	270601269
Hospital Revenue Code	272
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$49.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

PASS ZIM WIRE 1.5 19MM 5091248

Facility

$328.85

Hospital Charge Code	270601269
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$98.66
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: Oxford Commercial	$164.43
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Commercial	$164.43

Know your out-of-pocket cost for care.

All Charges