Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUCTION LIPECTOMY,U EXTR

Facility

$26,848.40

Service Code	HCPCS 15878
Hospital Charge Code	16000163
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

SUCTION NASOTRACHEAL

Facility

$282.00

Service Code	HCPCS 31720
Hospital Charge Code	7411003
Hospital Revenue Code	361
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

SUCTION NASOTRACHEAL

Facility

$282.00

Service Code	HCPCS 31720
Hospital Charge Code	366831720
Hospital Revenue Code	361
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

SUCTION NASOTRACHEAL

Facility

$282.00

Service Code	HCPCS 31720
Hospital Charge Code	366831720
Hospital Revenue Code	361
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$1,864.00
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) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.91
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.66
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SUCTION NASOTRACHEAL

Facility

$282.00

Service Code	HCPCS 31720
Hospital Charge Code	7411003
Hospital Revenue Code	361
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$1,864.00
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) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.91
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.66
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SUCTION POOLE ***********

Facility

$12.00

Hospital Charge Code	1600535
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SUCTION POOLE ***********

Facility

$12.00

Hospital Charge Code	1600535
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

SUCTION SIGMOIDOSCOPE 0033040

Facility

$9.65

Hospital Charge Code	270613332
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SUCTION SIGMOIDOSCOPE 0033040

Facility

$9.65

Hospital Charge Code	270613332
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

SUCTION SYSTEM ORTHOPEDIC

Facility

$180.57

Hospital Charge Code	270600351
Hospital Revenue Code	272
Min. Negotiated Rate	$23.47
Max. Negotiated Rate	$90.28
Rate for Payer: Aetna Commercial	$54.17
Rate for Payer: Aetna Medicare Advantage	$54.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.05
Rate for Payer: Cigna Commercial	$90.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.47
Rate for Payer: Oxford Commercial	$90.28
Rate for Payer: Qualcare PPO/HMO/WC	$27.09
Rate for Payer: UnitedHealthcare Commercial	$90.28

SUCTION SYSTEM ORTHOPEDIC

Facility

$180.57

Hospital Charge Code	270600351
Hospital Revenue Code	272
Min. Negotiated Rate	$27.09
Max. Negotiated Rate	$27.09
Rate for Payer: Qualcare PPO/HMO/WC	$27.09

SUCTION TIP YANKAUER

Facility

$5.65

Hospital Charge Code	270061415
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

SUCTION TIP YANKAUER

Facility

$5.65

Hospital Charge Code	270061415
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

SUCTION TUBE KAMVAC MINI

Facility

$47.00

Hospital Charge Code	270332484
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$14.10
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$23.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$23.50

SUCTION TUBE KAMVAC MINI

Facility

$47.00

Hospital Charge Code	270332484
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

SUCTION YANKAUER

Facility

$1.60

Hospital Charge Code	270649944
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.80
Rate for Payer: Aetna Commercial	$0.48
Rate for Payer: Aetna Medicare Advantage	$0.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.41
Rate for Payer: Cigna Commercial	$0.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.21
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.24
Rate for Payer: UnitedHealthcare Commercial	$0.80

SUCTION YANKAUER

Facility

$1.60

Hospital Charge Code	270649944
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.24

SUFENTNL CIT INJ 50MCG/ML 1ML

Facility

$95.40

Hospital Charge Code	6005078
Hospital Revenue Code	250
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$14.31
Rate for Payer: Qualcare PPO/HMO/WC	$14.31

SUFENTNL CIT INJ 50MCG/ML 1ML

Facility

$95.40

Hospital Charge Code	6005078
Hospital Revenue Code	250
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$47.70
Rate for Payer: Aetna Commercial	$28.62
Rate for Payer: Aetna Medicare Advantage	$28.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.33
Rate for Payer: Cigna Commercial	$47.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.40
Rate for Payer: Oxford Commercial	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.31
Rate for Payer: UnitedHealthcare Commercial	$47.70

SUFENTNL CIT INJ 50MCG/ML 2ML

Facility

$174.75

Hospital Charge Code	6005086
Hospital Revenue Code	250
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$87.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.72
Rate for Payer: Oxford Commercial	$87.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$87.38

SUFENTNL CIT INJ 50MCG/ML 2ML

Facility

$174.75

Hospital Charge Code	6005086
Hospital Revenue Code	250
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SUFENTNL CIT INJ 50MCG/ML 5ML

Facility

$357.15

Hospital Charge Code	6005094
Hospital Revenue Code	250
Min. Negotiated Rate	$46.43
Max. Negotiated Rate	$178.57
Rate for Payer: Aetna Commercial	$107.14
Rate for Payer: Aetna Medicare Advantage	$107.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.07
Rate for Payer: Cigna Commercial	$178.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.43
Rate for Payer: Oxford Commercial	$178.57
Rate for Payer: Qualcare PPO/HMO/WC	$53.57
Rate for Payer: UnitedHealthcare Commercial	$178.57

SUFENTNL CIT INJ 50MCG/ML 5ML

Facility

$357.15

Hospital Charge Code	6005094
Hospital Revenue Code	250
Min. Negotiated Rate	$53.57
Max. Negotiated Rate	$53.57
Rate for Payer: Qualcare PPO/HMO/WC	$53.57

SUGAMMADEX 200MG VIAL

Facility

$763.80

Service Code	NDC 6542312
Hospital Charge Code	606390161
Hospital Revenue Code	250
Min. Negotiated Rate	$99.29
Max. Negotiated Rate	$381.90
Rate for Payer: Aetna Commercial	$229.14
Rate for Payer: Aetna Medicare Advantage	$229.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.77
Rate for Payer: Cigna Commercial	$381.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.29
Rate for Payer: Oxford Commercial	$381.90
Rate for Payer: Qualcare PPO/HMO/WC	$114.57
Rate for Payer: UnitedHealthcare Commercial	$381.90

SUGAMMADEX 200MG VIAL

Facility

$763.80

Service Code	NDC 6542312
Hospital Charge Code	606390161
Hospital Revenue Code	250
Min. Negotiated Rate	$114.57
Max. Negotiated Rate	$114.57
Rate for Payer: Qualcare PPO/HMO/WC	$114.57

Know your out-of-pocket cost for care.

All Charges