Heights University Hospital

All Charges

Charge

Type

Setting

Price

Swallowing Goal Status CI

Facility

$0.01

Service Code	HCPCS G8997GNCI
Hospital Charge Code	74204049CI
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

Swallowing Goal Status CJ

Facility

$0.01

Service Code	HCPCS G8997GNCJ
Hospital Charge Code	74204049CJ
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

Swallowing Goal Status CJ

Facility

$0.01

Service Code	HCPCS G8997GNCJ
Hospital Charge Code	74204049CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Swallowing Goal Status CK

Facility

$0.01

Service Code	HCPCS G8997GNCK
Hospital Charge Code	74204049CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Swallowing Goal Status CK

Facility

$0.01

Service Code	HCPCS G8997GNCK
Hospital Charge Code	74204049CK
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: UnitedHealthcare Commercial	$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

Swallowing Goal Status CL

Facility

$0.01

Service Code	HCPCS G8997GNCL
Hospital Charge Code	74204049CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Swallowing Goal Status CL

Facility

$0.01

Service Code	HCPCS G8997GNCL
Hospital Charge Code	74204049CL
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

Swallowing Goal Status CM

Facility

$0.01

Service Code	HCPCS G8997GNCM
Hospital Charge Code	74204049CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Swallowing Goal Status CM

Facility

$0.01

Service Code	HCPCS G8997GNCM
Hospital Charge Code	74204049CM
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

SWALLOWING GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8997GNCN
Hospital Charge Code	74204049CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SWALLOWING GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8997GNCN
Hospital Charge Code	74204049CN
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

SWAN GANZ 7FR TD 131F7

Facility

$450.00

Hospital Charge Code	270604687
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SWAN GANZ 7FR TD 131F7

Facility

$450.00

Hospital Charge Code	270604687
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

SWAN GANZ CATH 8.5F

Facility

$2,068.70

Service Code	HCPCS C1894
Hospital Charge Code	270692366
Hospital Revenue Code	278
Min. Negotiated Rate	$310.31
Max. Negotiated Rate	$1,034.35
Rate for Payer: Aetna Commercial	$620.61
Rate for Payer: Aetna Medicare Advantage	$620.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.52
Rate for Payer: Cigna Commercial	$1,034.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.63
Rate for Payer: Qualcare PPO/HMO/WC	$310.31

SWAN GANZ CATH 8.5F

Facility

$2,068.70

Service Code	HCPCS C1894
Hospital Charge Code	270692366
Hospital Revenue Code	278
Min. Negotiated Rate	$310.31
Max. Negotiated Rate	$500.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.63
Rate for Payer: Qualcare PPO/HMO/WC	$310.31

SWAN-GANZ PACEPORT ***********

Facility

$271.00

Hospital Charge Code	8003105
Hospital Revenue Code	279
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

SWAN-GANZ PACEPORT ***********

Facility

$271.00

Hospital Charge Code	8003105
Hospital Revenue Code	279
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$81.30
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.23
Rate for Payer: Oxford Commercial	$135.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Commercial	$135.50

SWANSON HINGE TOE SIZE L

Facility

$5,850.00

Hospital Charge Code	270656828
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$1,755.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

SWANSON HINGE TOE SIZE L

Facility

$5,850.00

Hospital Charge Code	270656828
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

SWANSON TOE

Facility

$1,211.00

Hospital Charge Code	270664024
Hospital Revenue Code	278
Min. Negotiated Rate	$181.65
Max. Negotiated Rate	$605.50
Rate for Payer: Aetna Commercial	$363.30
Rate for Payer: Aetna Medicare Advantage	$363.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.81
Rate for Payer: Cigna Commercial	$605.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.06
Rate for Payer: Qualcare PPO/HMO/WC	$181.65

SWANSON TOE

Facility

$1,211.00

Hospital Charge Code	270664024
Hospital Revenue Code	278
Min. Negotiated Rate	$181.65
Max. Negotiated Rate	$293.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.06
Rate for Payer: Qualcare PPO/HMO/WC	$181.65

SWBSTCK CHLORAPRP SGLAP 1.75ml

Facility

$2.75

Hospital Charge Code	270643109
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.41

SWBSTCK CHLORAPRP SGLAP 1.75ml

Facility

$2.75

Hospital Charge Code	270643109
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$1.38
Rate for Payer: Aetna Commercial	$0.83
Rate for Payer: Aetna Medicare Advantage	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.70
Rate for Payer: Cigna Commercial	$1.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.36
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.41
Rate for Payer: UnitedHealthcare Commercial	$1.38

SWEATBANDS 100/PK

Facility

$2.05

Hospital Charge Code	270650503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.31

SWEATBANDS 100/PK

Facility

$2.05

Hospital Charge Code	270650503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$1.02
Rate for Payer: Aetna Commercial	$0.62
Rate for Payer: Aetna Medicare Advantage	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.52
Rate for Payer: Cigna Commercial	$1.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.27
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.31
Rate for Payer: UnitedHealthcare Commercial	$1.02

Know your out-of-pocket cost for care.

All Charges