Heights University Hospital

All Charges

Charge

Type

Setting

Price

BANDAGE ACE 2 - 4 *******

Facility

$4.00

Hospital Charge Code	8000036
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BANDAGE ACE 2 - 4 *******

Facility

$4.00

Hospital Charge Code	8000036
Hospital Revenue Code	279
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

BANDAGE ACE 3

Facility

$5.00

Hospital Charge Code	270300220
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

BANDAGE ACE 3

Facility

$5.00

Hospital Charge Code	270300220
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

BANDAGE ACE 4

Facility

$312.60

Hospital Charge Code	270300225
Hospital Revenue Code	272
Min. Negotiated Rate	$40.64
Max. Negotiated Rate	$156.30
Rate for Payer: Aetna Commercial	$93.78
Rate for Payer: Aetna Medicare Advantage	$93.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.71
Rate for Payer: Cigna Commercial	$156.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.64
Rate for Payer: Oxford Commercial	$156.30
Rate for Payer: Qualcare PPO/HMO/WC	$46.89
Rate for Payer: UnitedHealthcare Commercial	$156.30

BANDAGE ACE 4

Facility

$312.60

Hospital Charge Code	270300225
Hospital Revenue Code	272
Min. Negotiated Rate	$46.89
Max. Negotiated Rate	$46.89
Rate for Payer: Qualcare PPO/HMO/WC	$46.89

BANDAGE ACE 6

Facility

$11.25

Hospital Charge Code	270300230
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

BANDAGE ACE 6

Facility

$11.25

Hospital Charge Code	270300230W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

BANDAGE ACE 6

Facility

$11.25

Hospital Charge Code	270300230W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

BANDAGE ACE 6

Facility

$11.25

Hospital Charge Code	270300230
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

BANDAGE ACE 6 ********

Facility

$6.00

Hospital Charge Code	8000044
Hospital Revenue Code	279
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

BANDAGE ACE 6 ********

Facility

$6.00

Hospital Charge Code	8000044
Hospital Revenue Code	279
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

BANDAGE BUKLEY KERFLIX 3

Facility

$3.00

Hospital Charge Code	270649699
Hospital Revenue Code	270
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

BANDAGE BUKLEY KERFLIX 3

Facility

$3.00

Hospital Charge Code	270649699
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BANDAGE COBAN ********

Facility

$2.00

Hospital Charge Code	1608314
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

BANDAGE COBAN ********

Facility

$2.00

Hospital Charge Code	1608314
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

BANDAGE COBAN 2

Facility

$5.62

Hospital Charge Code	270300160
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$2.81

BANDAGE COBAN 2

Facility

$5.62

Hospital Charge Code	270300160
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

BANDAGE COBAN 3

Facility

$6.76

Hospital Charge Code	270300161
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.03
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$3.38

BANDAGE COBAN 3

Facility

$6.76

Hospital Charge Code	270300161
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.01

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.23
Rate for Payer: Aetna Commercial	$2.54
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.16
Rate for Payer: Cigna Commercial	$4.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.10
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$4.23

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.23
Rate for Payer: Aetna Commercial	$2.54
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.16
Rate for Payer: Cigna Commercial	$4.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.10
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$4.23

BANDAGE COBAN 4 *******

Facility

$14.00

Hospital Charge Code	8000267
Hospital Revenue Code	279
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

Know your out-of-pocket cost for care.

All Charges