Heights University Hospital

All Charges

Charge

Type

Setting

Price

PIGMENT STERILE 7 FLESH 200162

Facility

$129.00

Hospital Charge Code	270632782
Hospital Revenue Code	272
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

PIGMENT STERILE 7 FLESH 200162

Facility

$129.00

Hospital Charge Code	270632782
Hospital Revenue Code	272
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$64.50

PIGMENT UMBER STERILE P200292

Facility

$129.00

Hospital Charge Code	270635199
Hospital Revenue Code	272
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

PIGMENT UMBER STERILE P200292

Facility

$129.00

Hospital Charge Code	270635199
Hospital Revenue Code	272
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$64.50

PILLCAM SB 3 CAPSULE

Facility

$2,650.00

Hospital Charge Code	270690170
Hospital Revenue Code	271
Min. Negotiated Rate	$344.50
Max. Negotiated Rate	$1,325.00
Rate for Payer: Aetna Commercial	$795.00
Rate for Payer: Aetna Medicare Advantage	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.75
Rate for Payer: Cigna Commercial	$1,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.50
Rate for Payer: Oxford Commercial	$1,325.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.50
Rate for Payer: UnitedHealthcare Commercial	$1,325.00

PILLCAM SB 3 CAPSULE

Facility

$2,650.00

Hospital Charge Code	270690170
Hospital Revenue Code	271
Min. Negotiated Rate	$397.50
Max. Negotiated Rate	$397.50
Rate for Payer: Qualcare PPO/HMO/WC	$397.50

PILLCAM SENSOR BELT 2 DISP

Facility

$30.00

Hospital Charge Code	270690171
Hospital Revenue Code	270
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$9.00
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$15.00

PILLCAM SENSOR BELT 2 DISP

Facility

$30.00

Hospital Charge Code	270690171
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

PILLOW ABDUCTION

Facility

$80.93

Hospital Charge Code	270655566
Hospital Revenue Code	271
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$12.14
Rate for Payer: Qualcare PPO/HMO/WC	$12.14

PILLOW ABDUCTION

Facility

$125.00

Hospital Charge Code	1606326
Hospital Revenue Code	279
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

PILLOW ABDUCTION

Facility

$125.00

Hospital Charge Code	1606326
Hospital Revenue Code	279
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

PILLOW ABDUCTION

Facility

$80.93

Hospital Charge Code	270655566
Hospital Revenue Code	271
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$40.47
Rate for Payer: Aetna Commercial	$24.28
Rate for Payer: Aetna Medicare Advantage	$24.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.64
Rate for Payer: Cigna Commercial	$40.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.52
Rate for Payer: Oxford Commercial	$40.47
Rate for Payer: Qualcare PPO/HMO/WC	$12.14
Rate for Payer: UnitedHealthcare Commercial	$40.47

PILLOW ABDUCTION MED

Facility

$209.95

Hospital Charge Code	270600341
Hospital Revenue Code	270
Min. Negotiated Rate	$27.29
Max. Negotiated Rate	$104.97
Rate for Payer: Aetna Commercial	$62.98
Rate for Payer: Aetna Medicare Advantage	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.54
Rate for Payer: Cigna Commercial	$104.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.29
Rate for Payer: Oxford Commercial	$104.97
Rate for Payer: Qualcare PPO/HMO/WC	$31.49
Rate for Payer: UnitedHealthcare Commercial	$104.97

PILLOW ABDUCTION MED

Facility

$209.95

Hospital Charge Code	270600341
Hospital Revenue Code	270
Min. Negotiated Rate	$31.49
Max. Negotiated Rate	$31.49
Rate for Payer: Qualcare PPO/HMO/WC	$31.49

PILLOW ABDUCTION MEDIUM

Facility

$80.93

Hospital Charge Code	270650304
Hospital Revenue Code	272
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$12.14
Rate for Payer: Qualcare PPO/HMO/WC	$12.14

PILLOW ABDUCTION MEDIUM

Facility

$80.93

Hospital Charge Code	270650304
Hospital Revenue Code	272
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$40.47
Rate for Payer: Aetna Commercial	$24.28
Rate for Payer: Aetna Medicare Advantage	$24.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.64
Rate for Payer: Cigna Commercial	$40.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.52
Rate for Payer: Oxford Commercial	$40.47
Rate for Payer: Qualcare PPO/HMO/WC	$12.14
Rate for Payer: UnitedHealthcare Commercial	$40.47

PILLOW ABDUCTION SM

Facility

$147.64

Hospital Charge Code	270600340
Hospital Revenue Code	270
Min. Negotiated Rate	$19.19
Max. Negotiated Rate	$73.82
Rate for Payer: Aetna Commercial	$44.29
Rate for Payer: Aetna Medicare Advantage	$44.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.65
Rate for Payer: Cigna Commercial	$73.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.19
Rate for Payer: Oxford Commercial	$73.82
Rate for Payer: Qualcare PPO/HMO/WC	$22.15
Rate for Payer: UnitedHealthcare Commercial	$73.82

PILLOW ABDUCTION SM

Facility

$147.64

Hospital Charge Code	270600340
Hospital Revenue Code	270
Min. Negotiated Rate	$22.15
Max. Negotiated Rate	$22.15
Rate for Payer: Qualcare PPO/HMO/WC	$22.15

PILLOW ABDUCTION SMALL

Facility

$92.29

Hospital Charge Code	270651036
Hospital Revenue Code	272
Min. Negotiated Rate	$13.84
Max. Negotiated Rate	$13.84
Rate for Payer: Qualcare PPO/HMO/WC	$13.84

PILLOW ABDUCTION SMALL

Facility

$92.29

Hospital Charge Code	270651036
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$46.15
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$27.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.53
Rate for Payer: Cigna Commercial	$46.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$46.15
Rate for Payer: Qualcare PPO/HMO/WC	$13.84
Rate for Payer: UnitedHealthcare Commercial	$46.15

PILLOW FOOT

Facility

$72.45

Hospital Charge Code	270302940
Hospital Revenue Code	271
Min. Negotiated Rate	$10.87
Max. Negotiated Rate	$10.87
Rate for Payer: Qualcare PPO/HMO/WC	$10.87

PILLOW FOOT

Facility

$72.45

Hospital Charge Code	270302940
Hospital Revenue Code	271
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$36.23
Rate for Payer: Aetna Commercial	$21.73
Rate for Payer: Aetna Medicare Advantage	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.47
Rate for Payer: Cigna Commercial	$36.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.42
Rate for Payer: Oxford Commercial	$36.23
Rate for Payer: Qualcare PPO/HMO/WC	$10.87
Rate for Payer: UnitedHealthcare Commercial	$36.23

PILLOW SHOULDER ABDUCTN LG

Facility

$158.70

Hospital Charge Code	270652248
Hospital Revenue Code	272
Min. Negotiated Rate	$23.80
Max. Negotiated Rate	$23.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.80

PILLOW SHOULDER ABDUCTN LG

Facility

$158.70

Hospital Charge Code	270652248
Hospital Revenue Code	272
Min. Negotiated Rate	$20.63
Max. Negotiated Rate	$79.35
Rate for Payer: Aetna Commercial	$47.61
Rate for Payer: Aetna Medicare Advantage	$47.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.47
Rate for Payer: Cigna Commercial	$79.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.63
Rate for Payer: Oxford Commercial	$79.35
Rate for Payer: Qualcare PPO/HMO/WC	$23.80
Rate for Payer: UnitedHealthcare Commercial	$79.35

PILLOW SHOULDER ABDUCTN MED

Facility

$156.95

Hospital Charge Code	270652246
Hospital Revenue Code	272
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$78.47
Rate for Payer: Aetna Commercial	$47.09
Rate for Payer: Aetna Medicare Advantage	$47.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.02
Rate for Payer: Cigna Commercial	$78.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.40
Rate for Payer: Oxford Commercial	$78.47
Rate for Payer: Qualcare PPO/HMO/WC	$23.54
Rate for Payer: UnitedHealthcare Commercial	$78.47

Know your out-of-pocket cost for care.

All Charges