Heights University Hospital

All Charges

Charge

Type

Setting

Price

SET MINI-INFUSOR BARD

Facility

$8.00

Hospital Charge Code	1801117
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

SET NEEDLE 25x6 SPINAL 181031

Facility

$60.60

Hospital Charge Code	270636102
Hospital Revenue Code	272
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$30.30
Rate for Payer: Aetna Commercial	$18.18
Rate for Payer: Aetna Medicare Advantage	$18.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.45
Rate for Payer: Cigna Commercial	$30.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$30.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.09
Rate for Payer: UnitedHealthcare Commercial	$30.30

SET NEEDLE 25x6 SPINAL 181031

Facility

$60.60

Hospital Charge Code	270636102
Hospital Revenue Code	272
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$9.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.09

SET NEPHROSTOMY PIGTAIL 080008

Facility

$674.65

Hospital Charge Code	270632772
Hospital Revenue Code	272
Min. Negotiated Rate	$101.20
Max. Negotiated Rate	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$101.20

SET NEPHROSTOMY PIGTAIL 080008

Facility

$674.65

Hospital Charge Code	270632772
Hospital Revenue Code	272
Min. Negotiated Rate	$87.70
Max. Negotiated Rate	$337.32
Rate for Payer: Aetna Commercial	$202.40
Rate for Payer: Aetna Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.04
Rate for Payer: Cigna Commercial	$337.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.70
Rate for Payer: Oxford Commercial	$337.32
Rate for Payer: Qualcare PPO/HMO/WC	$101.20
Rate for Payer: UnitedHealthcare Commercial	$337.32

SET NIGHT DRAINAGE

Facility

$1,685.65

Hospital Charge Code	270303175
Hospital Revenue Code	272
Min. Negotiated Rate	$219.13
Max. Negotiated Rate	$842.83
Rate for Payer: Aetna Commercial	$505.69
Rate for Payer: Aetna Medicare Advantage	$505.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.84
Rate for Payer: Cigna Commercial	$842.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.13
Rate for Payer: Oxford Commercial	$842.83
Rate for Payer: Qualcare PPO/HMO/WC	$252.85
Rate for Payer: UnitedHealthcare Commercial	$842.83

SET NIGHT DRAINAGE

Facility

$1,685.65

Hospital Charge Code	270303175
Hospital Revenue Code	272
Min. Negotiated Rate	$252.85
Max. Negotiated Rate	$252.85
Rate for Payer: Qualcare PPO/HMO/WC	$252.85

SET PECUTANEOUS PIGTAIL NEPHRO

Facility

$707.20

Hospital Charge Code	270666870
Hospital Revenue Code	272
Min. Negotiated Rate	$106.08
Max. Negotiated Rate	$106.08
Rate for Payer: Qualcare PPO/HMO/WC	$106.08

SET PECUTANEOUS PIGTAIL NEPHRO

Facility

$707.20

Hospital Charge Code	270666870
Hospital Revenue Code	272
Min. Negotiated Rate	$91.94
Max. Negotiated Rate	$353.60
Rate for Payer: Aetna Commercial	$212.16
Rate for Payer: Aetna Medicare Advantage	$212.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.34
Rate for Payer: Cigna Commercial	$353.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.94
Rate for Payer: Oxford Commercial	$353.60
Rate for Payer: Qualcare PPO/HMO/WC	$106.08
Rate for Payer: UnitedHealthcare Commercial	$353.60

SET PERCUTANEOUS MALECOT

Facility

$715.00

Hospital Charge Code	270331380
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$214.50
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

SET PERCUTANEOUS MALECOT

Facility

$715.00

Hospital Charge Code	270331380
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$173.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

SET PICK CHONDRO

Facility

$10,735.00

Hospital Charge Code	270688808
Hospital Revenue Code	272
Min. Negotiated Rate	$1,610.25
Max. Negotiated Rate	$1,610.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.25

SET PICK CHONDRO

Facility

$10,735.00

Hospital Charge Code	270688808
Hospital Revenue Code	272
Min. Negotiated Rate	$1,395.55
Max. Negotiated Rate	$5,367.50
Rate for Payer: Aetna Commercial	$3,220.50
Rate for Payer: Aetna Medicare Advantage	$3,220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,737.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,737.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,737.43
Rate for Payer: Cigna Commercial	$5,367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,395.55
Rate for Payer: Oxford Commercial	$5,367.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.25
Rate for Payer: UnitedHealthcare Commercial	$5,367.50

SET PLEUX DRAINAGE LINE 507225

Facility

$79.45

Hospital Charge Code	270635259
Hospital Revenue Code	272
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$39.73
Rate for Payer: Aetna Commercial	$23.84
Rate for Payer: Aetna Medicare Advantage	$23.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.26
Rate for Payer: Cigna Commercial	$39.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.33
Rate for Payer: Oxford Commercial	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$11.92
Rate for Payer: UnitedHealthcare Commercial	$39.73

SET PLEUX DRAINAGE LINE 507225

Facility

$79.45

Hospital Charge Code	270635259
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$11.92
Rate for Payer: Qualcare PPO/HMO/WC	$11.92

SET PROCESNG ANGEL ANGELKIT110

Facility

$1,170.00

Hospital Charge Code	270639730
Hospital Revenue Code	272
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

SET PROCESNG ANGEL ANGELKIT110

Facility

$1,170.00

Hospital Charge Code	270639730
Hospital Revenue Code	272
Min. Negotiated Rate	$152.10
Max. Negotiated Rate	$585.00
Rate for Payer: Aetna Commercial	$351.00
Rate for Payer: Aetna Medicare Advantage	$351.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.35
Rate for Payer: Cigna Commercial	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.10
Rate for Payer: Oxford Commercial	$585.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.50
Rate for Payer: UnitedHealthcare Commercial	$585.00

SET PT ADMIN CARDIOGEN-82 42

Facility

$80.85

Hospital Charge Code	270649330
Hospital Revenue Code	271
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

SET PT ADMIN CARDIOGEN-82 42

Facility

$80.85

Hospital Charge Code	270649330
Hospital Revenue Code	271
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$40.42
Rate for Payer: Aetna Commercial	$24.25
Rate for Payer: Aetna Medicare Advantage	$24.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.62
Rate for Payer: Cigna Commercial	$40.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.51
Rate for Payer: Oxford Commercial	$40.42
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$40.42

SET PUMP KANGAROO N/STER

Facility

$10.88

Hospital Charge Code	270649489
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$5.44
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.77
Rate for Payer: Cigna Commercial	$5.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.41
Rate for Payer: Oxford Commercial	$5.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.63
Rate for Payer: UnitedHealthcare Commercial	$5.44

SET PUMP KANGAROO N/STER

Facility

$10.88

Hospital Charge Code	270649489
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.63

SET QUICK 8 CC

Facility

$9,975.00

Hospital Charge Code	270684009
Hospital Revenue Code	272
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$1,496.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SET QUICK 8 CC

Facility

$9,975.00

Hospital Charge Code	270684009
Hospital Revenue Code	272
Min. Negotiated Rate	$1,296.75
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) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,296.75
Rate for Payer: Oxford Commercial	$4,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Commercial	$4,987.50

SET RADIATION TX FIELD

Facility

$1,884.55

Service Code	HCPCS 77290
Hospital Charge Code	321077290
Hospital Revenue Code	333
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Better Health Medicaid	$105.20
Rate for Payer: Aetna Commercial	$565.37
Rate for Payer: Aetna Medicare Advantage	$565.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.56
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.99
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.68
Rate for Payer: UnitedHealthcare Commercial	$4,435.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$107.30

SET RADIATION TX FIELD

Facility

$1,884.55

Service Code	HCPCS 77290
Hospital Charge Code	404677290
Hospital Revenue Code	333
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Better Health Medicaid	$105.20
Rate for Payer: Aetna Commercial	$565.37
Rate for Payer: Aetna Medicare Advantage	$565.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.56
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.99
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.68
Rate for Payer: UnitedHealthcare Commercial	$4,435.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$107.30

Know your out-of-pocket cost for care.

All Charges