Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUPPORT ALM DLX ARTERIO 95985

Facility

$30.45

Hospital Charge Code	270617244
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

SUPPORT CATH 5F .035X135CM

Facility

$775.00

Service Code	HCPCS C1887
Hospital Charge Code	270670063
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

SUPPORT CATH 5F .035X135CM

Facility

$775.00

Service Code	HCPCS C1887
Hospital Charge Code	270670063
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$232.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

SUPPORTER ******

Facility

$24.00

Hospital Charge Code	8001638
Hospital Revenue Code	279
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

SUPPORTER ******

Facility

$24.00

Hospital Charge Code	8001638
Hospital Revenue Code	279
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

SUPPORTER ADULT ELASTIC SML

Facility

$42.35

Hospital Charge Code	270649799
Hospital Revenue Code	272
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$6.35
Rate for Payer: Qualcare PPO/HMO/WC	$6.35

SUPPORTER ADULT ELASTIC SML

Facility

$42.35

Hospital Charge Code	270649799
Hospital Revenue Code	272
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$21.18
Rate for Payer: Aetna Commercial	$12.71
Rate for Payer: Aetna Medicare Advantage	$12.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.80
Rate for Payer: Cigna Commercial	$21.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.51
Rate for Payer: Oxford Commercial	$21.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.35
Rate for Payer: UnitedHealthcare Commercial	$21.18

SUPPORT FOOT UNIVERSL 82652000

Facility

$845.00

Hospital Charge Code	270643408
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$126.75
Rate for Payer: Qualcare PPO/HMO/WC	$126.75

SUPPORT FOOT UNIVERSL 82652000

Facility

$845.00

Hospital Charge Code	270643408
Hospital Revenue Code	272
Min. Negotiated Rate	$109.85
Max. Negotiated Rate	$422.50
Rate for Payer: Aetna Commercial	$253.50
Rate for Payer: Aetna Medicare Advantage	$253.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.47
Rate for Payer: Cigna Commercial	$422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.85
Rate for Payer: Oxford Commercial	$422.50
Rate for Payer: Qualcare PPO/HMO/WC	$126.75
Rate for Payer: UnitedHealthcare Commercial	$422.50

SUPPORT L-S

Facility

$716.00

Hospital Charge Code	270606573
Hospital Revenue Code	270
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

SUPPORT L-S

Facility

$716.00

Hospital Charge Code	270606573
Hospital Revenue Code	270
Min. Negotiated Rate	$93.08
Max. Negotiated Rate	$358.00
Rate for Payer: Aetna Commercial	$214.80
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.08
Rate for Payer: Oxford Commercial	$358.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$358.00

SUPPORTOR A-3 LG ELAST

Facility

$27.10

Hospital Charge Code	270303080
Hospital Revenue Code	272
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$4.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.07

SUPPORTOR A-3 LG ELAST

Facility

$27.10

Hospital Charge Code	270303080
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$13.55
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.91
Rate for Payer: Cigna Commercial	$13.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Oxford Commercial	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.07
Rate for Payer: UnitedHealthcare Commercial	$13.55

SUPPORTOR A-3 MED ELAST

Facility

$27.05

Hospital Charge Code	270303075
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$13.53
Rate for Payer: Aetna Commercial	$8.12
Rate for Payer: Aetna Medicare Advantage	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.90
Rate for Payer: Cigna Commercial	$13.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Oxford Commercial	$13.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.06
Rate for Payer: UnitedHealthcare Commercial	$13.53

SUPPORTOR A-3 MED ELAST

Facility

$27.05

Hospital Charge Code	270303075
Hospital Revenue Code	272
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$4.06

SUPPORT RING 180 49630118

Facility

$4,765.00

Hospital Charge Code	270643411
Hospital Revenue Code	272
Min. Negotiated Rate	$619.45
Max. Negotiated Rate	$2,382.50
Rate for Payer: Aetna Commercial	$1,429.50
Rate for Payer: Aetna Medicare Advantage	$1,429.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,215.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,215.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,215.08
Rate for Payer: Cigna Commercial	$2,382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$619.45
Rate for Payer: Oxford Commercial	$2,382.50
Rate for Payer: Qualcare PPO/HMO/WC	$714.75
Rate for Payer: UnitedHealthcare Commercial	$2,382.50

SUPPORT RING 180 49630118

Facility

$4,765.00

Hospital Charge Code	270643411
Hospital Revenue Code	272
Min. Negotiated Rate	$714.75
Max. Negotiated Rate	$714.75
Rate for Payer: Qualcare PPO/HMO/WC	$714.75

SUPPORT SCROTUM XL NVC

Facility

$36.00

Hospital Charge Code	270624861
Hospital Revenue Code	270
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

SUPPORT SCROTUM XL NVC

Facility

$36.00

Hospital Charge Code	270624861
Hospital Revenue Code	270
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$18.00

SUPPORT TUBE

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703248
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SUPPORT TUBE

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703248
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SUPPORT WRIST COMFORT MED LEFT

Facility

$27.65

Hospital Charge Code	270653967
Hospital Revenue Code	270
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.82
Rate for Payer: Aetna Commercial	$8.29
Rate for Payer: Aetna Medicare Advantage	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.05
Rate for Payer: Cigna Commercial	$13.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.15
Rate for Payer: UnitedHealthcare Commercial	$13.82

SUPPORT WRIST COMFORT MED LEFT

Facility

$27.65

Hospital Charge Code	270653967
Hospital Revenue Code	270
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$4.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.15

SUPRA ENTRY GUIDEWIRE 3.0MM

Facility

$687.50

Hospital Charge Code	270703325
Hospital Revenue Code	272
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$103.12
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

SUPRA ENTRY GUIDEWIRE 3.0MM

Facility

$687.50

Hospital Charge Code	270703325
Hospital Revenue Code	272
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$206.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.38
Rate for Payer: Oxford Commercial	$343.75
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Commercial	$343.75

Know your out-of-pocket cost for care.

All Charges