Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPECULUM VAG DISPOS W/BUILT IN

Facility

$21.27

Hospital Charge Code	270654043
Hospital Revenue Code	272
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

SPECULUM VAGINAL DISP

Facility

$4.85

Hospital Charge Code	270301895
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

SPECULUM VAGINAL DISP

Facility

$4.85

Hospital Charge Code	270301895
Hospital Revenue Code	270
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.63
Rate for Payer: Oxford Commercial	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$2.42

SPECULUM VAGINAL DISP ********

Facility

$11.00

Hospital Charge Code	8003386
Hospital Revenue Code	279
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

SPECULUM VAGINAL DISP ********

Facility

$11.00

Hospital Charge Code	8003386
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

SPECULUM VAGINAL DISP LARGE 10

Facility

$17.25

Hospital Charge Code	2709006405
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$8.62
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna Medicare Advantage	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.40
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.24
Rate for Payer: Oxford Commercial	$8.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.59
Rate for Payer: UnitedHealthcare Commercial	$8.62

SPECULUM VAGINAL DISP LARGE 10

Facility

$17.25

Hospital Charge Code	2709006405
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.59

SPECULUM VAGINAL ER-SPEC L

Facility

$1,248.00

Hospital Charge Code	270665605
Hospital Revenue Code	270
Min. Negotiated Rate	$162.24
Max. Negotiated Rate	$624.00
Rate for Payer: Aetna Commercial	$374.40
Rate for Payer: Aetna Medicare Advantage	$374.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.24
Rate for Payer: Cigna Commercial	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.24
Rate for Payer: Oxford Commercial	$624.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.20
Rate for Payer: UnitedHealthcare Commercial	$624.00

SPECULUM VAGINAL ER-SPEC L

Facility

$1,248.00

Hospital Charge Code	270665605
Hospital Revenue Code	270
Min. Negotiated Rate	$187.20
Max. Negotiated Rate	$187.20
Rate for Payer: Qualcare PPO/HMO/WC	$187.20

SPECULUM VAGINAL ER-SPEC M

Facility

$1,404.00

Hospital Charge Code	270665604
Hospital Revenue Code	270
Min. Negotiated Rate	$182.52
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$421.20
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.52
Rate for Payer: Oxford Commercial	$702.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Commercial	$702.00

SPECULUM VAGINAL ER-SPEC M

Facility

$1,404.00

Hospital Charge Code	270665604
Hospital Revenue Code	270
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$210.60
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SPECULUM VAGINAL ER-SPEC S

Facility

$1,404.00

Hospital Charge Code	270665603
Hospital Revenue Code	270
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$210.60
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SPECULUM VAGINAL ER-SPEC S

Facility

$1,404.00

Hospital Charge Code	270665603
Hospital Revenue Code	270
Min. Negotiated Rate	$182.52
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$421.20
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.52
Rate for Payer: Oxford Commercial	$702.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Commercial	$702.00

SPECULUM VAGINAL LARGE DISP.

Facility

$8.64

Hospital Charge Code	270658820
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$4.32
Rate for Payer: Aetna Commercial	$2.59
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$4.32

SPECULUM VAGINAL LARGE DISP.

Facility

$8.64

Hospital Charge Code	270658820
Hospital Revenue Code	270
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.45
Rate for Payer: Aetna Commercial	$2.07
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$3.45

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

SPECULUM VAGINAL SMALL DISP.

Facility

$6.51

Hospital Charge Code	270658819
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

SPECULUM VAGINAL SMALL DISP.

Facility

$6.51

Hospital Charge Code	270658819
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$1.95
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.85
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$3.25

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$321.01
Max. Negotiated Rate	$1,234.65
Rate for Payer: Aetna Commercial	$740.79
Rate for Payer: Aetna Medicare Advantage	$740.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.67
Rate for Payer: Cigna Commercial	$1,234.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.01
Rate for Payer: Oxford Commercial	$1,234.65
Rate for Payer: Qualcare PPO/HMO/WC	$370.39
Rate for Payer: UnitedHealthcare Commercial	$1,234.65

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$370.39
Max. Negotiated Rate	$370.39
Rate for Payer: Qualcare PPO/HMO/WC	$370.39

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges