Heights University Hospital

All Charges

Charge

Type

Setting

Price

POLAR CATH 5.0mmx100mmx120cm

Facility

$3,890.00

Hospital Charge Code	2709006410
Hospital Revenue Code	272
Min. Negotiated Rate	$583.50
Max. Negotiated Rate	$583.50
Rate for Payer: Qualcare PPO/HMO/WC	$583.50

POLAR CATH 5.0mmx100mmx120cm

Facility

$3,890.00

Hospital Charge Code	2709006410
Hospital Revenue Code	272
Min. Negotiated Rate	$505.70
Max. Negotiated Rate	$1,945.00
Rate for Payer: Aetna Commercial	$1,167.00
Rate for Payer: Aetna Medicare Advantage	$1,167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$991.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$991.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$991.95
Rate for Payer: Cigna Commercial	$1,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.70
Rate for Payer: Oxford Commercial	$1,945.00
Rate for Payer: Qualcare PPO/HMO/WC	$583.50
Rate for Payer: UnitedHealthcare Commercial	$1,945.00

POLAR CATH 5MMX100MMX120MM

Facility

$778.00

Hospital Charge Code	270638809
Hospital Revenue Code	272
Min. Negotiated Rate	$116.70
Max. Negotiated Rate	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$116.70

POLAR CATH 5MMX100MMX120MM

Facility

$778.00

Hospital Charge Code	270638809
Hospital Revenue Code	272
Min. Negotiated Rate	$101.14
Max. Negotiated Rate	$389.00
Rate for Payer: Aetna Commercial	$233.40
Rate for Payer: Aetna Medicare Advantage	$233.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.39
Rate for Payer: Cigna Commercial	$389.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.14
Rate for Payer: Oxford Commercial	$389.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.70
Rate for Payer: UnitedHealthcare Commercial	$389.00

POLAR CATHETER NO2 CARTRIDGE

Facility

$250.00

Hospital Charge Code	2709006112
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

POLAR CATHETER NO2 CARTRIDGE

Facility

$250.00

Hospital Charge Code	2709006112
Hospital Revenue Code	272
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$125.00

POLARCATH P54012001

Facility

$3,000.00

Hospital Charge Code	270644107C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

POLARCATH P54012001

Facility

$3,000.00

Hospital Charge Code	270644108C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

POLARCATH P54012001

Facility

$3,000.00

Hospital Charge Code	270644108C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

POLARCATH P54012001

Facility

$3,000.00

Hospital Charge Code	270644107C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

POLARCATHPERIPHERAL INFLAM UNI

Facility

$4,750.00

Hospital Charge Code	2709006111
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

POLARCATHPERIPHERAL INFLAM UNI

Facility

$4,750.00

Hospital Charge Code	2709006111
Hospital Revenue Code	272
Min. Negotiated Rate	$617.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.50
Rate for Payer: Oxford Commercial	$2,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$2,375.00

POLARCATH T3510015001

Facility

$4,232.25

Hospital Charge Code	270644103C
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

POLARCATH T3510015001

Facility

$4,232.25

Hospital Charge Code	270644103C
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,269.67
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

POLAR HEAT/8OZ/GEL

Facility

$28.00

Hospital Charge Code	60634656
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

POLAR HEAT/8OZ/GEL

Facility

$28.00

Hospital Charge Code	60634656
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

POLIBAR ACB

Facility

$44.24

Hospital Charge Code	60635825
Hospital Revenue Code	250
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$22.12
Rate for Payer: Aetna Commercial	$13.27
Rate for Payer: Aetna Medicare Advantage	$13.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.28
Rate for Payer: Cigna Commercial	$22.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.75
Rate for Payer: Oxford Commercial	$22.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.64
Rate for Payer: UnitedHealthcare Commercial	$22.12

POLIBAR ACB

Facility

$44.24

Hospital Charge Code	60635825
Hospital Revenue Code	250
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$6.64
Rate for Payer: Qualcare PPO/HMO/WC	$6.64

POLIBAR PLUS

Facility

$147.04

Hospital Charge Code	60635827
Hospital Revenue Code	250
Min. Negotiated Rate	$19.12
Max. Negotiated Rate	$73.52
Rate for Payer: Aetna Commercial	$44.11
Rate for Payer: Aetna Medicare Advantage	$44.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.50
Rate for Payer: Cigna Commercial	$73.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.12
Rate for Payer: Oxford Commercial	$73.52
Rate for Payer: Qualcare PPO/HMO/WC	$22.06
Rate for Payer: UnitedHealthcare Commercial	$73.52

POLIBAR PLUS

Facility

$147.04

Hospital Charge Code	60635827
Hospital Revenue Code	250
Min. Negotiated Rate	$22.06
Max. Negotiated Rate	$22.06
Rate for Payer: Qualcare PPO/HMO/WC	$22.06

POLIBAR PS BARIUM SULFATE 750M

Facility

$103.50

Hospital Charge Code	606390571
Hospital Revenue Code	250
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

POLIBAR PS BARIUM SULFATE 750M

Facility

$103.50

Hospital Charge Code	606390571
Hospital Revenue Code	250
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$51.75
Rate for Payer: Aetna Commercial	$31.05
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$51.75

POLIO AB

Facility

$103.25

Service Code	HCPCS 8665891
Hospital Charge Code	3000366B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

POLIO AB

Facility

$103.25

Service Code	HCPCS 8665891
Hospital Charge Code	3000366A
Hospital Revenue Code	302
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.98
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.33
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$114.00

POLIO AB

Facility

$103.25

Service Code	HCPCS 8665891
Hospital Charge Code	3000366B
Hospital Revenue Code	302
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.98
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.33
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges