Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYRINGE DIGIFLATOR INFLATIO

Facility

$158.00

Hospital Charge Code	270650911
Hospital Revenue Code	272
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

SYRINGE EAR IRRIGATING ******

Facility

$52.00

Hospital Charge Code	8002248
Hospital Revenue Code	279
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

SYRINGE EAR IRRIGATING ******

Facility

$52.00

Hospital Charge Code	8002248
Hospital Revenue Code	279
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

SYRINGE EAR & ULCER

Facility

$12.85

Hospital Charge Code	270302100
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$6.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$6.42

SYRINGE EAR & ULCER

Facility

$12.85

Hospital Charge Code	270302100
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

SYRINGE EMBO BLUE300-500 2.0ML

Facility

$1,265.00

Hospital Charge Code	2709003374
Hospital Revenue Code	272
Min. Negotiated Rate	$164.45
Max. Negotiated Rate	$632.50
Rate for Payer: Aetna Commercial	$379.50
Rate for Payer: Aetna Medicare Advantage	$379.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.57
Rate for Payer: Cigna Commercial	$632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.45
Rate for Payer: Oxford Commercial	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$189.75
Rate for Payer: UnitedHealthcare Commercial	$632.50

SYRINGE EMBO BLUE300-500 2.0ML

Facility

$1,265.00

Hospital Charge Code	2709003374
Hospital Revenue Code	272
Min. Negotiated Rate	$189.75
Max. Negotiated Rate	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$189.75

SYRINGE EMBO RED 500-700 2.0ML

Facility

$1,265.00

Hospital Charge Code	2709003375
Hospital Revenue Code	272
Min. Negotiated Rate	$189.75
Max. Negotiated Rate	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$189.75

SYRINGE EMBO RED 500-700 2.0ML

Facility

$1,265.00

Hospital Charge Code	2709003375
Hospital Revenue Code	272
Min. Negotiated Rate	$164.45
Max. Negotiated Rate	$632.50
Rate for Payer: Aetna Commercial	$379.50
Rate for Payer: Aetna Medicare Advantage	$379.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.57
Rate for Payer: Cigna Commercial	$632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.45
Rate for Payer: Oxford Commercial	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$189.75
Rate for Payer: UnitedHealthcare Commercial	$632.50

SYRINGE EMBOSPHERE 2ml GREEN

Facility

$1,535.00

Hospital Charge Code	2706931481
Hospital Revenue Code	272
Min. Negotiated Rate	$199.55
Max. Negotiated Rate	$767.50
Rate for Payer: Aetna Commercial	$460.50
Rate for Payer: Aetna Medicare Advantage	$460.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$391.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$391.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$391.43
Rate for Payer: Cigna Commercial	$767.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.55
Rate for Payer: Oxford Commercial	$767.50
Rate for Payer: Qualcare PPO/HMO/WC	$230.25
Rate for Payer: UnitedHealthcare Commercial	$767.50

SYRINGE EMBOSPHERE 2ml GREEN

Facility

$1,535.00

Hospital Charge Code	2706931481
Hospital Revenue Code	272
Min. Negotiated Rate	$230.25
Max. Negotiated Rate	$230.25
Rate for Payer: Qualcare PPO/HMO/WC	$230.25

SYRINGE EMBOSPHERE 2ML S420GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270658213
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$364.50
Rate for Payer: Aetna Medicare Advantage	$364.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.82
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S420GH

Facility

$253.00

Service Code	HCPCS L8699
Hospital Charge Code	270658213S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

SYRINGE EMBOSPHERE 2ML S420GH

Facility

$253.00

Service Code	HCPCS L8699
Hospital Charge Code	270658213S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

SYRINGE EMBOSPHERE 2ML S420GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270658213
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S420GHC

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270687184
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S420GHC

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270687184
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$364.50
Rate for Payer: Aetna Medicare Advantage	$364.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.82
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270631462
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$364.50
Rate for Payer: Aetna Medicare Advantage	$364.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.82
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$253.00

Hospital Charge Code	270631462N
Hospital Revenue Code	270
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270631462S
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$253.00

Hospital Charge Code	270631462N
Hospital Revenue Code	270
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.89
Rate for Payer: Oxford Commercial	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$126.50

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270631462
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPHERE 2ML S620GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270631462S
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$364.50
Rate for Payer: Aetna Medicare Advantage	$364.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.82
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

SYRINGE EMBOSPRE 2ML GR S820GH

Facility

$992.00

Hospital Charge Code	270631481N
Hospital Revenue Code	272
Min. Negotiated Rate	$128.96
Max. Negotiated Rate	$496.00
Rate for Payer: Aetna Commercial	$297.60
Rate for Payer: Aetna Medicare Advantage	$297.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.96
Rate for Payer: Cigna Commercial	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.96
Rate for Payer: Oxford Commercial	$496.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.80
Rate for Payer: UnitedHealthcare Commercial	$496.00

SYRINGE EMBOSPRE 2ML GR S820GH

Facility

$1,215.00

Service Code	HCPCS L8699
Hospital Charge Code	270631481S
Hospital Revenue Code	278
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

Know your out-of-pocket cost for care.

All Charges