Heights University Hospital

All Charges

Charge

Type

Setting

Price

belts gait wipeable 70, blue

Facility

$93.75

Hospital Charge Code	270665773
Hospital Revenue Code	270
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$46.88
Rate for Payer: Aetna Commercial	$28.12
Rate for Payer: Aetna Medicare Advantage	$28.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.91
Rate for Payer: Cigna Commercial	$46.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.19
Rate for Payer: Oxford Commercial	$46.88
Rate for Payer: Qualcare PPO/HMO/WC	$14.06
Rate for Payer: UnitedHealthcare Commercial	$46.88

belts gait wipeable 70, blue

Facility

$93.75

Hospital Charge Code	270665773
Hospital Revenue Code	270
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$14.06
Rate for Payer: Qualcare PPO/HMO/WC	$14.06

BELT TORSO POSEY 3656

Facility

$108.00

Hospital Charge Code	270613228
Hospital Revenue Code	270
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

BELT TORSO POSEY 3656

Facility

$108.00

Hospital Charge Code	270613228
Hospital Revenue Code	270
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$32.40
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.04
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$54.00

BELT TRACTION TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654047
Hospital Revenue Code	272
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$43.40
Rate for Payer: Aetna Commercial	$26.04
Rate for Payer: Aetna Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$43.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.28
Rate for Payer: Oxford Commercial	$43.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.02
Rate for Payer: UnitedHealthcare Commercial	$43.40

BELT TRACTION TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654047
Hospital Revenue Code	272
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$13.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.02

BELT UNIV. MEN'S RIB 6 WIDE

Facility

$16.45

Hospital Charge Code	270650449
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

BELT UNIV. MEN'S RIB 6 WIDE

Facility

$16.45

Hospital Charge Code	270650449
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$8.22
Rate for Payer: Aetna Commercial	$4.93
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Oxford Commercial	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$8.22

BELT UROSTOMY 175507

Facility

$22.15

Hospital Charge Code	270633612
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$3.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.32

BELT UROSTOMY 175507

Facility

$22.15

Hospital Charge Code	270633612
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$11.07
Rate for Payer: Aetna Commercial	$6.64
Rate for Payer: Aetna Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.65
Rate for Payer: Cigna Commercial	$11.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.88
Rate for Payer: Oxford Commercial	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$3.32
Rate for Payer: UnitedHealthcare Commercial	$11.07

BELT W/SHOULDER STRAP LG

Facility

$41.50

Hospital Charge Code	270650466
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP LG

Facility

$41.50

Hospital Charge Code	270650466
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.39
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$20.75

BELT W/SHOULDER STRAP MED

Facility

$41.50

Hospital Charge Code	270650473
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP MED

Facility

$41.50

Hospital Charge Code	270650473
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.39
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$20.75

BELT W/SHOULDER STRAP SM

Facility

$41.50

Hospital Charge Code	270650474
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP SM

Facility

$41.50

Hospital Charge Code	270650474
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.39
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$20.75

BELT W/SHOULDER STRAP XL

Facility

$41.50

Hospital Charge Code	270650465
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.39
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$20.75

BELT W/SHOULDER STRAP XL

Facility

$41.50

Hospital Charge Code	270650465
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BEN 30/KAO 30/EMYL 30ML

Facility

$41.00

Hospital Charge Code	60634886
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

BEN 30/KAO 30/EMYL 30ML

Facility

$41.00

Hospital Charge Code	60634886
Hospital Revenue Code	250
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$12.30
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.33
Rate for Payer: Oxford Commercial	$20.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$20.50

BENADRYL 1%/30GM

Facility

$8.00

Hospital Charge Code	60632540
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

BENADRYL 1%/30GM

Facility

$8.00

Hospital Charge Code	60632540
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

BENADRYL 1 % CREAM

Facility

$27.00

Service Code	NDC 12547017162
Hospital Charge Code	606350977
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

BENADRYL 1 % CREAM

Facility

$27.00

Service Code	NDC 12547017162
Hospital Charge Code	606350977
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

BENADRYL ELIX 12.5MG/5CC

Facility

$1.00

Hospital Charge Code	60634767
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

Know your out-of-pocket cost for care.

All Charges