Heights University Hospital

All Charges

Charge

Type

Setting

Price

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$49.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$49.62

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$607.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$579.00
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$3.42
Rate for Payer: Qualcare PPO/HMO/WC	$3.42

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$11.40
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$6.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.81
Rate for Payer: Cigna Commercial	$11.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.96
Rate for Payer: Oxford Commercial	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.42
Rate for Payer: UnitedHealthcare Commercial	$11.40

SET KANGAROO ENTERAL PUMP****

Facility

$33.00

Hospital Charge Code	8000796
Hospital Revenue Code	279
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SET KANGAROO ENTERAL PUMP****

Facility

$33.00

Hospital Charge Code	8000796
Hospital Revenue Code	279
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.50

SET LIPID INFUSION LPS-3017

Facility

$29.65

Hospital Charge Code	270622023
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SET LIPID INFUSION LPS-3017

Facility

$29.65

Hospital Charge Code	270622023
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$8.89
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$14.82

SET LIVER TRANSJUGULAR ROSCH

Facility

$2,262.00

Hospital Charge Code	270686621
Hospital Revenue Code	272
Min. Negotiated Rate	$294.06
Max. Negotiated Rate	$1,131.00
Rate for Payer: Aetna Commercial	$678.60
Rate for Payer: Aetna Medicare Advantage	$678.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.81
Rate for Payer: Cigna Commercial	$1,131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.06
Rate for Payer: Oxford Commercial	$1,131.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.30
Rate for Payer: UnitedHealthcare Commercial	$1,131.00

SET LIVER TRANSJUGULAR ROSCH

Facility

$2,262.00

Hospital Charge Code	270686621
Hospital Revenue Code	272
Min. Negotiated Rate	$339.30
Max. Negotiated Rate	$339.30
Rate for Payer: Qualcare PPO/HMO/WC	$339.30

SET MARX-COPE GASTROJEJUNOSTMY

Facility

$1,778.65

Hospital Charge Code	270642026
Hospital Revenue Code	278
Min. Negotiated Rate	$266.80
Max. Negotiated Rate	$889.33
Rate for Payer: Aetna Commercial	$533.60
Rate for Payer: Aetna Medicare Advantage	$533.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.56
Rate for Payer: Cigna Commercial	$889.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.43
Rate for Payer: Qualcare PPO/HMO/WC	$266.80

SET MARX-COPE GASTROJEJUNOSTMY

Facility

$1,778.65

Hospital Charge Code	270642026
Hospital Revenue Code	278
Min. Negotiated Rate	$266.80
Max. Negotiated Rate	$430.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.43
Rate for Payer: Qualcare PPO/HMO/WC	$266.80

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$6.25

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$6.25

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$6.25

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MINI-INFUSER BARD OB

Facility

$13.65

Hospital Charge Code	270600490
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

SET MINI-INFUSER BARD OB

Facility

$13.65

Hospital Charge Code	270600490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

SET MINI-INFUSOR BARD

Facility

$8.00

Hospital Charge Code	1801117
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

Know your out-of-pocket cost for care.

All Charges