Heights University Hospital

All Charges

Charge

Type

Setting

Price

PUMP BREAST *********

Facility

$40.00

Hospital Charge Code	1801133
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

PUMP BREAST****

Facility

$55.00

Hospital Charge Code	270130180
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

PUMP BREAST****

Facility

$55.00

Hospital Charge Code	270130180
Hospital Revenue Code	272
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

PUMP BREAST 107900

Facility

$40.85

Hospital Charge Code	270622863
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

PUMP BREAST 107900

Facility

$40.85

Hospital Charge Code	270622863
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$12.26
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.31
Rate for Payer: Oxford Commercial	$20.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$20.43

PUMP CASSETTE

Facility

$35.00

Service Code	HCPCS 99999
Hospital Charge Code	3400280
Hospital Revenue Code	272
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$17.50

PUMP CASSETTE

Facility

$35.00

Service Code	HCPCS 99999
Hospital Charge Code	3400280
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

PUMP CONTROL W INHIBZ 72404127

Facility

$17,990.00

Hospital Charge Code	270641448
Hospital Revenue Code	278
Min. Negotiated Rate	$2,698.50
Max. Negotiated Rate	$8,995.00
Rate for Payer: Aetna Commercial	$5,397.00
Rate for Payer: Aetna Medicare Advantage	$5,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,587.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,587.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,587.45
Rate for Payer: Cigna Commercial	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,353.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,698.50

PUMP CONTROL W INHIBZ 72404127

Facility

$17,990.00

Hospital Charge Code	270641448
Hospital Revenue Code	278
Min. Negotiated Rate	$2,698.50
Max. Negotiated Rate	$4,353.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,353.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,698.50

PUMP DRAIN MATE

Facility

$2,591.25

Hospital Charge Code	270612103
Hospital Revenue Code	272
Min. Negotiated Rate	$388.69
Max. Negotiated Rate	$388.69
Rate for Payer: Qualcare PPO/HMO/WC	$388.69

PUMP DRAIN MATE

Facility

$2,591.25

Hospital Charge Code	270612103
Hospital Revenue Code	272
Min. Negotiated Rate	$336.86
Max. Negotiated Rate	$1,295.62
Rate for Payer: Aetna Commercial	$777.38
Rate for Payer: Aetna Medicare Advantage	$777.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.77
Rate for Payer: Cigna Commercial	$1,295.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.86
Rate for Payer: Oxford Commercial	$1,295.62
Rate for Payer: Qualcare PPO/HMO/WC	$388.69
Rate for Payer: UnitedHealthcare Commercial	$1,295.62

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$40.81
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$94.19
Rate for Payer: Aetna Medicare Advantage	$94.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.06
Rate for Payer: Cigna Commercial	$156.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.81
Rate for Payer: Oxford Commercial	$156.97
Rate for Payer: Qualcare PPO/HMO/WC	$47.09
Rate for Payer: UnitedHealthcare Commercial	$156.97

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$47.09
Rate for Payer: Qualcare PPO/HMO/WC	$47.09

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$7,569.75
Max. Negotiated Rate	$25,232.50
Rate for Payer: Aetna Commercial	$15,139.50
Rate for Payer: Aetna Medicare Advantage	$15,139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,868.58
Rate for Payer: Cigna Commercial	$25,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$7,569.75
Max. Negotiated Rate	$12,212.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75

PUMP INFUSOR LV5

Facility

$231.34

Hospital Charge Code	270638219
Hospital Revenue Code	272
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$34.70
Rate for Payer: Qualcare PPO/HMO/WC	$34.70

PUMP INFUSOR LV5

Facility

$231.34

Hospital Charge Code	270638219
Hospital Revenue Code	272
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$115.67
Rate for Payer: Aetna Commercial	$69.40
Rate for Payer: Aetna Medicare Advantage	$69.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.99
Rate for Payer: Cigna Commercial	$115.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.07
Rate for Payer: Oxford Commercial	$115.67
Rate for Payer: Qualcare PPO/HMO/WC	$34.70
Rate for Payer: UnitedHealthcare Commercial	$115.67

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$47.85
Max. Negotiated Rate	$184.06
Rate for Payer: Aetna Commercial	$110.43
Rate for Payer: Aetna Medicare Advantage	$110.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.87
Rate for Payer: Cigna Commercial	$184.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.85
Rate for Payer: Oxford Commercial	$184.06
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$184.06

PUMPING SYST SGL ACTION*****

Facility

$190.00

Hospital Charge Code	1604727
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

PUMPING SYST SGL ACTION*****

Facility

$190.00

Hospital Charge Code	1604727
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

PUMP INTRATHECAL AP03000H

Facility

$69,750.00

Service Code	HCPCS C1772
Hospital Charge Code	270699219
Hospital Revenue Code	278
Min. Negotiated Rate	$10,462.50
Max. Negotiated Rate	$16,879.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,879.50
Rate for Payer: Qualcare PPO/HMO/WC	$10,462.50

PUMP INTRATHECAL AP03000H

Facility

$69,750.00

Service Code	HCPCS C1772
Hospital Charge Code	270699219
Hospital Revenue Code	278
Min. Negotiated Rate	$10,462.50
Max. Negotiated Rate	$34,875.00
Rate for Payer: Aetna Commercial	$20,925.00
Rate for Payer: Aetna Medicare Advantage	$20,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,786.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,786.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,786.25
Rate for Payer: Cigna Commercial	$34,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,879.50
Rate for Payer: Qualcare PPO/HMO/WC	$10,462.50

PUMP IZ 700CX

Facility

$51,525.00

Service Code	HCPCS C1813
Hospital Charge Code	270688017
Hospital Revenue Code	278
Min. Negotiated Rate	$7,728.75
Max. Negotiated Rate	$12,469.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,469.05
Rate for Payer: Qualcare PPO/HMO/WC	$7,728.75

PUMP IZ 700CX

Facility

$51,525.00

Service Code	HCPCS C1813
Hospital Charge Code	270688017
Hospital Revenue Code	278
Min. Negotiated Rate	$7,728.75
Max. Negotiated Rate	$25,762.50
Rate for Payer: Aetna Commercial	$15,457.50
Rate for Payer: Aetna Medicare Advantage	$15,457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,138.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,138.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,138.88
Rate for Payer: Cigna Commercial	$25,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,469.05
Rate for Payer: Qualcare PPO/HMO/WC	$7,728.75

Know your out-of-pocket cost for care.

All Charges