Heights University Hospital

All Charges

Charge

Type

Setting

Price

STYLET INTUBATION 6FR SATIN

Facility

$11.47

Hospital Charge Code	270650995
Hospital Revenue Code	270
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$5.74
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna Medicare Advantage	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.92
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.49
Rate for Payer: Oxford Commercial	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.72
Rate for Payer: UnitedHealthcare Commercial	$5.74

STYLET INTUBATION 6FR SATIN

Facility

$11.47

Hospital Charge Code	270650995
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.72

STYLET INTUBATION FLEX-SLIP

Facility

$8.55

Hospital Charge Code	270666882
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$4.28
Rate for Payer: Aetna Commercial	$2.56
Rate for Payer: Aetna Medicare Advantage	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.18
Rate for Payer: Cigna Commercial	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.11
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.28
Rate for Payer: UnitedHealthcare Commercial	$4.28

STYLET INTUBATION FLEX-SLIP

Facility

$8.55

Hospital Charge Code	270666882
Hospital Revenue Code	272
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.28

STYLET KIT 6093-52

Facility

$198.45

Hospital Charge Code	270627552
Hospital Revenue Code	272
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$29.77

STYLET KIT 6093-52

Facility

$198.45

Hospital Charge Code	270627552
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$99.22
Rate for Payer: Aetna Commercial	$59.53
Rate for Payer: Aetna Medicare Advantage	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.60
Rate for Payer: Cigna Commercial	$99.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.80
Rate for Payer: Oxford Commercial	$99.22
Rate for Payer: Qualcare PPO/HMO/WC	$29.77
Rate for Payer: UnitedHealthcare Commercial	$99.22

STYLET KIT W STYLET CAP 70cm

Facility

$925.00

Hospital Charge Code	270679698
Hospital Revenue Code	272
Min. Negotiated Rate	$120.25
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.25
Rate for Payer: Oxford Commercial	$462.50
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$462.50

STYLET KIT W STYLET CAP 70cm

Facility

$925.00

Hospital Charge Code	270679698
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

STYLET SPINAL INVICTUS 40MM

Facility

$1,625.00

Hospital Charge Code	270698064
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

STYLET SPINAL INVICTUS 40MM

Facility

$1,625.00

Hospital Charge Code	270698064
Hospital Revenue Code	272
Min. Negotiated Rate	$211.25
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.25
Rate for Payer: Oxford Commercial	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$812.50

STYLET SPINAL INVICTUS 45MM

Facility

$1,625.00

Hospital Charge Code	270698065
Hospital Revenue Code	272
Min. Negotiated Rate	$211.25
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.25
Rate for Payer: Oxford Commercial	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$812.50

STYLET SPINAL INVICTUS 45MM

Facility

$1,625.00

Hospital Charge Code	270698065
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

STYLOS BA PUTTY 10

Facility

$16,125.00

Hospital Charge Code	270702356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

STYLOS BA PUTTY 10

Facility

$16,125.00

Hospital Charge Code	270702356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$4,837.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

STYYLET 45 CM CM

Facility

$200.00

Hospital Charge Code	270688562
Hospital Revenue Code	270
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

STYYLET 45 CM CM

Facility

$200.00

Hospital Charge Code	270688562
Hospital Revenue Code	270
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$100.00

SUBARACHNOID INJ (NEUORLYTIC)

Facility

$3,107.20

Service Code	HCPCS 62280
Hospital Charge Code	84506015
Hospital Revenue Code	361
Min. Negotiated Rate	$403.94
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$932.16
Rate for Payer: Aetna Medicare Advantage	$932.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$792.34
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.94
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$466.08
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

SUBARACHNOID INJ (NEUORLYTIC)

Facility

$3,107.20

Service Code	HCPCS 62280
Hospital Charge Code	84506015
Hospital Revenue Code	361
Min. Negotiated Rate	$466.08
Max. Negotiated Rate	$466.08
Rate for Payer: Qualcare PPO/HMO/WC	$466.08

SUBC/IM INF ADDNL PUMP-NEW SIT

Facility

$206.86

Service Code	HCPCS 96371
Hospital Charge Code	3408030
Hospital Revenue Code	260
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$62.06
Rate for Payer: Aetna Medicare Advantage	$62.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.75
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.89
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.03
Rate for Payer: UnitedHealthcare Commercial	$802.00

SUBC/IM INF ADDNL PUMP-NEW SIT

Facility

$206.86

Service Code	HCPCS 96371
Hospital Charge Code	3408030
Hospital Revenue Code	260
Min. Negotiated Rate	$31.03
Max. Negotiated Rate	$31.03
Rate for Payer: Qualcare PPO/HMO/WC	$31.03

SUBC/IM INF@ADDTN'L HR AFTR 91

Facility

$219.00

Service Code	HCPCS 96370
Hospital Charge Code	3408025
Hospital Revenue Code	260
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$65.70
Rate for Payer: Aetna Medicare Advantage	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.84
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.47
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.85
Rate for Payer: UnitedHealthcare Commercial	$802.00

SUBC/IM INF@ADDTN'L HR AFTR 91

Facility

$219.00

Service Code	HCPCS 96370
Hospital Charge Code	3408025
Hospital Revenue Code	260
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

SUBC INF/IM THERAPY,INT UP 1HR

Facility

$762.00

Service Code	HCPCS 96369
Hospital Charge Code	3408020
Hospital Revenue Code	260
Min. Negotiated Rate	$99.06
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$228.60
Rate for Payer: Aetna Medicare Advantage	$228.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.31
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.06
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.30
Rate for Payer: UnitedHealthcare Commercial	$802.00

SUBC INF/IM THERAPY,INT UP 1HR

Facility

$762.00

Service Code	HCPCS 96369
Hospital Charge Code	3408020
Hospital Revenue Code	260
Min. Negotiated Rate	$114.30
Max. Negotiated Rate	$114.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.30

SUBDUAL EVACUATING PORT SYSTEM

Facility

$9,192.40

Hospital Charge Code	270671362
Hospital Revenue Code	272
Min. Negotiated Rate	$1,195.01
Max. Negotiated Rate	$4,596.20
Rate for Payer: Aetna Commercial	$2,757.72
Rate for Payer: Aetna Medicare Advantage	$2,757.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,344.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,344.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,344.06
Rate for Payer: Cigna Commercial	$4,596.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.01
Rate for Payer: Oxford Commercial	$4,596.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,378.86
Rate for Payer: UnitedHealthcare Commercial	$4,596.20

Know your out-of-pocket cost for care.

All Charges