Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH W/HYDROPHILIC COAT 12FR

Facility

$1,300.00

Hospital Charge Code	270663540
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$9.82
Rate for Payer: Aetna Medicare Advantage	$9.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.26
Rate for Payer: Oxford Commercial	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$16.38

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SHEET ANGIOGRAPHIC FEMORAL

Facility

$35.08

Hospital Charge Code	270649504N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$5.26
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

SHEET ANGIOGRAPHIC FEMORAL

Facility

$35.08

Hospital Charge Code	270649504N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.56
Max. Negotiated Rate	$17.54
Rate for Payer: Aetna Commercial	$10.52
Rate for Payer: Aetna Medicare Advantage	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.95
Rate for Payer: Cigna Commercial	$17.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.56
Rate for Payer: Oxford Commercial	$17.54
Rate for Payer: Qualcare PPO/HMO/WC	$5.26
Rate for Payer: UnitedHealthcare Commercial	$17.54

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$9.82
Rate for Payer: Aetna Medicare Advantage	$9.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.26
Rate for Payer: Oxford Commercial	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$16.38

SHEET BILATERAL LIMB ********

Facility

$45.00

Hospital Charge Code	1608421
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$22.50

SHEET BILATERAL LIMB ********

Facility

$45.00

Hospital Charge Code	1608421
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

SHEET BIL LIMB 89291

Facility

$46.45

Hospital Charge Code	270608981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$13.94
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.04
Rate for Payer: Oxford Commercial	$23.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$23.23

SHEET BIL LIMB 89291

Facility

$46.45

Hospital Charge Code	270608981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

SHEET CONFORM QPACK 45x20x7mm

Facility

$11,550.00

Hospital Charge Code	270665698
Hospital Revenue Code	272
Min. Negotiated Rate	$1,501.50
Max. Negotiated Rate	$5,775.00
Rate for Payer: Aetna Commercial	$3,465.00
Rate for Payer: Aetna Medicare Advantage	$3,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,945.25
Rate for Payer: Cigna Commercial	$5,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,501.50
Rate for Payer: Oxford Commercial	$5,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50
Rate for Payer: UnitedHealthcare Commercial	$5,775.00

SHEET CONFORM QPACK 45x20x7mm

Facility

$11,550.00

Hospital Charge Code	270665698
Hospital Revenue Code	272
Min. Negotiated Rate	$1,732.50
Max. Negotiated Rate	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50

SHEET CRANIAL/INCISE ********

Facility

$27.00

Hospital Charge Code	1608033
Hospital Revenue Code	251
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

SHEET CRANIAL/INCISE ********

Facility

$27.00

Hospital Charge Code	1608033
Hospital Revenue Code	251
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

SHEET C/S 3M *******

Facility

$282.00

Hospital Charge Code	1800101
Hospital Revenue Code	279
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$141.00
Rate for Payer: Aetna Commercial	$84.60
Rate for Payer: Aetna Medicare Advantage	$84.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.91
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.66
Rate for Payer: Oxford Commercial	$141.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$141.00

SHEET C/S 3M *******

Facility

$282.00

Hospital Charge Code	1800101
Hospital Revenue Code	279
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

SHEET DRAPE LG

Facility

$12.13

Hospital Charge Code	270649505
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$6.07
Rate for Payer: Aetna Commercial	$3.64
Rate for Payer: Aetna Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.09
Rate for Payer: Cigna Commercial	$6.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$6.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.82
Rate for Payer: UnitedHealthcare Commercial	$6.07

SHEET DRAPE LG

Facility

$12.13

Hospital Charge Code	270649505
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.82

SHEET DRAPE STER DISP OR

Facility

$24.85

Hospital Charge Code	270061500
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

SHEET DRAPE STER DISP OR

Facility

$24.85

Hospital Charge Code	270061500
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

SHEET EXTREMITY W/ISO BAC

Facility

$27.73

Hospital Charge Code	270654100
Hospital Revenue Code	270
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$13.87
Rate for Payer: Aetna Commercial	$8.32
Rate for Payer: Aetna Medicare Advantage	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.07
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$13.87
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Commercial	$13.87

SHEET EXTREMITY W/ISO BAC

Facility

$27.73

Hospital Charge Code	270654100
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

SHEET FLAT LG LONG SP66115

Facility

$60.85

Hospital Charge Code	270603091
Hospital Revenue Code	272
Min. Negotiated Rate	$7.91
Max. Negotiated Rate	$30.43
Rate for Payer: Aetna Commercial	$18.25
Rate for Payer: Aetna Medicare Advantage	$18.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.52
Rate for Payer: Cigna Commercial	$30.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$30.43
Rate for Payer: Qualcare PPO/HMO/WC	$9.13
Rate for Payer: UnitedHealthcare Commercial	$30.43

SHEET FLAT LG LONG SP66115

Facility

$60.85

Hospital Charge Code	270603091
Hospital Revenue Code	272
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$9.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.13

Know your out-of-pocket cost for care.

All Charges