Heights University Hospital

All Charges

Charge

Type

Setting

Price

PASS ZIM WIRE 1.O 19MM 5091247

Facility

$1,396.00

Hospital Charge Code	270601028
Hospital Revenue Code	272
Min. Negotiated Rate	$209.40
Max. Negotiated Rate	$209.40
Rate for Payer: Qualcare PPO/HMO/WC	$209.40

PASS ZIM WIRE 1.O 19MM 5091247

Facility

$1,396.00

Hospital Charge Code	270601028
Hospital Revenue Code	272
Min. Negotiated Rate	$181.48
Max. Negotiated Rate	$698.00
Rate for Payer: Aetna Commercial	$418.80
Rate for Payer: Aetna Medicare Advantage	$418.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.98
Rate for Payer: Cigna Commercial	$698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.48
Rate for Payer: Oxford Commercial	$698.00
Rate for Payer: Qualcare PPO/HMO/WC	$209.40
Rate for Payer: UnitedHealthcare Commercial	$698.00

PASTE BMT ORTHBLAST 3CC 200003

Facility

$2,261.65

Hospital Charge Code	270619714
Hospital Revenue Code	278
Min. Negotiated Rate	$339.25
Max. Negotiated Rate	$1,130.83
Rate for Payer: Aetna Commercial	$678.50
Rate for Payer: Aetna Medicare Advantage	$678.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.72
Rate for Payer: Cigna Commercial	$1,130.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.32
Rate for Payer: Qualcare PPO/HMO/WC	$339.25

PASTE BMT ORTHBLAST 3CC 200003

Facility

$2,261.65

Hospital Charge Code	270619714
Hospital Revenue Code	278
Min. Negotiated Rate	$339.25
Max. Negotiated Rate	$547.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.32
Rate for Payer: Qualcare PPO/HMO/WC	$339.25

PASTE OSTOMY STRIP

Facility

$4.02

Hospital Charge Code	270650471
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PASTE OSTOMY STRIP

Facility

$4.02

Hospital Charge Code	270650471
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.21
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.01

PASTE POLYTEF INJ 7ML 22-7000

Facility

$3,180.85

Hospital Charge Code	270616154
Hospital Revenue Code	272
Min. Negotiated Rate	$413.51
Max. Negotiated Rate	$1,590.42
Rate for Payer: Aetna Commercial	$954.25
Rate for Payer: Aetna Medicare Advantage	$954.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$811.12
Rate for Payer: Cigna Commercial	$1,590.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.51
Rate for Payer: Oxford Commercial	$1,590.42
Rate for Payer: Qualcare PPO/HMO/WC	$477.13
Rate for Payer: UnitedHealthcare Commercial	$1,590.42

PASTE POLYTEF INJ 7ML 22-7000

Facility

$3,180.85

Hospital Charge Code	270616154
Hospital Revenue Code	272
Min. Negotiated Rate	$477.13
Max. Negotiated Rate	$477.13
Rate for Payer: Qualcare PPO/HMO/WC	$477.13

PASTE PROTECTANT CALAZIME 4oz

Facility

$21.68

Hospital Charge Code	270650073
Hospital Revenue Code	270
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.25

PASTE PROTECTANT CALAZIME 4oz

Facility

$21.68

Hospital Charge Code	270650073
Hospital Revenue Code	270
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$10.84
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna Medicare Advantage	$6.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.53
Rate for Payer: Cigna Commercial	$10.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.82
Rate for Payer: Oxford Commercial	$10.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.25
Rate for Payer: UnitedHealthcare Commercial	$10.84

PASTE REME CALAZ 4OZ MSC094544

Facility

$21.75

Hospital Charge Code	270640977
Hospital Revenue Code	272
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$10.88
Rate for Payer: Aetna Commercial	$6.53
Rate for Payer: Aetna Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.55
Rate for Payer: Cigna Commercial	$10.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.83
Rate for Payer: Oxford Commercial	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$3.26
Rate for Payer: UnitedHealthcare Commercial	$10.88

PASTE REME CALAZ 4OZ MSC094544

Facility

$21.75

Hospital Charge Code	270640977
Hospital Revenue Code	272
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$3.26
Rate for Payer: Qualcare PPO/HMO/WC	$3.26

PASTE REME CALAZ 4OZ MSC094544

Facility

$25.00

Hospital Charge Code	270640977W
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

PASTE REME CALAZ 4OZ MSC094544

Facility

$25.00

Hospital Charge Code	270640977W
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

PASTE REMEDY CALAZIME MSC09454

Facility

$21.00

Hospital Charge Code	270302490
Hospital Revenue Code	270
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

PASTE REMEDY CALAZIME MSC09454

Facility

$21.00

Hospital Charge Code	270302490
Hospital Revenue Code	270
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

PASTE STOMAHESIVE

Facility

$54.45

Hospital Charge Code	270303176
Hospital Revenue Code	272
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$27.23
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.88
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$27.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$27.23

PASTE STOMAHESIVE

Facility

$54.45

Hospital Charge Code	270303176
Hospital Revenue Code	272
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

PATCH ATK CUFF 6.5 6 920000

Facility

$14,828.85

Hospital Charge Code	270629639
Hospital Revenue Code	272
Min. Negotiated Rate	$2,224.33
Max. Negotiated Rate	$2,224.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,224.33

PATCH ATK CUFF 6.5 6 920000

Facility

$14,828.85

Hospital Charge Code	270629639
Hospital Revenue Code	272
Min. Negotiated Rate	$1,927.75
Max. Negotiated Rate	$7,414.43
Rate for Payer: Aetna Commercial	$4,448.65
Rate for Payer: Aetna Medicare Advantage	$4,448.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,781.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,781.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,781.36
Rate for Payer: Cigna Commercial	$7,414.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,927.75
Rate for Payer: Oxford Commercial	$7,414.43
Rate for Payer: Qualcare PPO/HMO/WC	$2,224.33
Rate for Payer: UnitedHealthcare Commercial	$7,414.43

PATCH BD HERNIA 11 14 0010205

Facility

$4,221.00

Hospital Charge Code	270623365
Hospital Revenue Code	278
Min. Negotiated Rate	$633.15
Max. Negotiated Rate	$2,110.50
Rate for Payer: Aetna Commercial	$1,266.30
Rate for Payer: Aetna Medicare Advantage	$1,266.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,076.36
Rate for Payer: Cigna Commercial	$2,110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,021.48
Rate for Payer: Qualcare PPO/HMO/WC	$633.15

PATCH BD HERNIA 11 14 0010205

Facility

$4,221.00

Hospital Charge Code	270623365
Hospital Revenue Code	278
Min. Negotiated Rate	$633.15
Max. Negotiated Rate	$1,021.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,021.48
Rate for Payer: Qualcare PPO/HMO/WC	$633.15

PATCH BD HERNIA 14 18 0010202

Facility

$5,351.90

Hospital Charge Code	270623366
Hospital Revenue Code	278
Min. Negotiated Rate	$802.78
Max. Negotiated Rate	$2,675.95
Rate for Payer: Aetna Commercial	$1,605.57
Rate for Payer: Aetna Medicare Advantage	$1,605.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,364.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,364.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,364.73
Rate for Payer: Cigna Commercial	$2,675.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.16
Rate for Payer: Qualcare PPO/HMO/WC	$802.78

PATCH BD HERNIA 14 18 0010202

Facility

$5,351.90

Hospital Charge Code	270623366
Hospital Revenue Code	278
Min. Negotiated Rate	$802.78
Max. Negotiated Rate	$1,295.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.16
Rate for Payer: Qualcare PPO/HMO/WC	$802.78

PATCH BD HERNIA 8 12 0010201

Facility

$2,882.50

Hospital Charge Code	270623364
Hospital Revenue Code	278
Min. Negotiated Rate	$432.38
Max. Negotiated Rate	$1,441.25
Rate for Payer: Aetna Commercial	$864.75
Rate for Payer: Aetna Medicare Advantage	$864.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$576.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.04
Rate for Payer: Cigna Commercial	$1,441.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$697.57
Rate for Payer: Qualcare PPO/HMO/WC	$432.38

Know your out-of-pocket cost for care.

All Charges