Heights University Hospital

All Charges

Charge

Type

Setting

Price

QUICKSET KIT

Facility

$7,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270681350
Hospital Revenue Code	278
Min. Negotiated Rate	$1,155.00
Max. Negotiated Rate	$1,863.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00

QUICKSET KIT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270675562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

QUICKSET KIT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270675562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

QUICKSET KIT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270681322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

QUICKTRACH

Facility

$712.45

Hospital Charge Code	270680585
Hospital Revenue Code	272
Min. Negotiated Rate	$92.62
Max. Negotiated Rate	$356.23
Rate for Payer: Aetna Commercial	$213.74
Rate for Payer: Aetna Medicare Advantage	$213.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.67
Rate for Payer: Cigna Commercial	$356.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.62
Rate for Payer: Oxford Commercial	$356.23
Rate for Payer: Qualcare PPO/HMO/WC	$106.87
Rate for Payer: UnitedHealthcare Commercial	$356.23

QUICKTRACH

Facility

$712.45

Hospital Charge Code	270680585
Hospital Revenue Code	272
Min. Negotiated Rate	$106.87
Max. Negotiated Rate	$106.87
Rate for Payer: Qualcare PPO/HMO/WC	$106.87

QUICKTRACH KIT 2.0MM

Facility

$930.05

Hospital Charge Code	270692860
Hospital Revenue Code	272
Min. Negotiated Rate	$120.91
Max. Negotiated Rate	$465.02
Rate for Payer: Aetna Commercial	$279.01
Rate for Payer: Aetna Medicare Advantage	$279.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.16
Rate for Payer: Cigna Commercial	$465.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.91
Rate for Payer: Oxford Commercial	$465.02
Rate for Payer: Qualcare PPO/HMO/WC	$139.51
Rate for Payer: UnitedHealthcare Commercial	$465.02

QUICKTRACH KIT 2.0MM

Facility

$930.05

Hospital Charge Code	270692860
Hospital Revenue Code	272
Min. Negotiated Rate	$139.51
Max. Negotiated Rate	$139.51
Rate for Payer: Qualcare PPO/HMO/WC	$139.51

QUICK-VAC MIXING BOWL SINGLE

Facility

$11,630.00

Hospital Charge Code	270657073
Hospital Revenue Code	270
Min. Negotiated Rate	$1,511.90
Max. Negotiated Rate	$5,815.00
Rate for Payer: Aetna Commercial	$3,489.00
Rate for Payer: Aetna Medicare Advantage	$3,489.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,965.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,965.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,965.65
Rate for Payer: Cigna Commercial	$5,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.90
Rate for Payer: Oxford Commercial	$5,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,744.50
Rate for Payer: UnitedHealthcare Commercial	$5,815.00

QUICK-VAC MIXING BOWL SINGLE

Facility

$11,630.00

Hospital Charge Code	270657073
Hospital Revenue Code	270
Min. Negotiated Rate	$1,744.50
Max. Negotiated Rate	$1,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,744.50

QUICKWHIP SUTURE

Facility

$405.00

Hospital Charge Code	270678190
Hospital Revenue Code	272
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$121.50
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.65
Rate for Payer: Oxford Commercial	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$202.50

QUICKWHIP SUTURE

Facility

$405.00

Hospital Charge Code	270678190
Hospital Revenue Code	272
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

QUIDEWIRE STRY 3 800 0080S

Facility

$544.85

Hospital Charge Code	270627181
Hospital Revenue Code	272
Min. Negotiated Rate	$70.83
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$163.46
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.83
Rate for Payer: Oxford Commercial	$272.43
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Commercial	$272.43

QUIDEWIRE STRY 3 800 0080S

Facility

$544.85

Hospital Charge Code	270627181
Hospital Revenue Code	272
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$81.73
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

QUIET BIG FOOT FLUID MANAGEMEN

Facility

$55.00

Hospital Charge Code	270679630
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

QUIET BIG FOOT FLUID MANAGEMEN

Facility

$55.00

Hospital Charge Code	270679630
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

QUIK-CATH CATHETER W/LUER

Facility

$11.00

Hospital Charge Code	270331738
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

QUIK-CATH CATHETER W/LUER

Facility

$11.00

Hospital Charge Code	270331738
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

QUINAGLUTE/324MG/TAB

Facility

$3.00

Hospital Charge Code	60633798
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

QUINAGLUTE/324MG/TAB

Facility

$3.00

Hospital Charge Code	60633797
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

QUINAGLUTE/324MG/TAB

Facility

$3.00

Hospital Charge Code	60633798
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

QUINAGLUTE/324MG/TAB

Facility

$3.00

Hospital Charge Code	60633797
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

QUINAMM/260MG/TAB

Facility

$3.00

Hospital Charge Code	60633799
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

QUINAMM/260MG/TAB

Facility

$3.00

Hospital Charge Code	60633799
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

QUINAPRIL 10MCG/5ML

Facility

$21.15

Hospital Charge Code	6017065
Hospital Revenue Code	252
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

Know your out-of-pocket cost for care.

All Charges