Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRAY EPIDURAL PERIFIX 20G

Facility

$120.59

Hospital Charge Code	270692059
Hospital Revenue Code	272
Min. Negotiated Rate	$18.09
Max. Negotiated Rate	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.09

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$34.10
Max. Negotiated Rate	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$34.10

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$29.55
Max. Negotiated Rate	$113.66
Rate for Payer: Aetna Commercial	$68.20
Rate for Payer: Aetna Medicare Advantage	$68.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$113.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.55
Rate for Payer: Oxford Commercial	$113.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.10
Rate for Payer: UnitedHealthcare Commercial	$113.66

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$37.20
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$62.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$62.00

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

TRAY EPIDURAL SNGL SHOT S00201

Facility

$100.85

Hospital Charge Code	270613761
Hospital Revenue Code	272
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

TRAY EPIDURAL SNGL SHOT S00201

Facility

$100.85

Hospital Charge Code	270613761
Hospital Revenue Code	272
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$30.25
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.11
Rate for Payer: Oxford Commercial	$50.42
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$50.42

TRAY EPIDURAL SNGL SHOT SSET01

Facility

$113.65

Hospital Charge Code	270605412
Hospital Revenue Code	272
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: Aetna Commercial	$34.09
Rate for Payer: Aetna Medicare Advantage	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.98
Rate for Payer: Cigna Commercial	$56.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Oxford Commercial	$56.83
Rate for Payer: UnitedHealthcare Commercial	$56.83

TRAY EPIDURAL SNGL SHOT SSET01

Facility

$113.65

Hospital Charge Code	270605412
Hospital Revenue Code	272
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

TRAY EPIDURAL/SPINAL

Facility

$188.00

Hospital Charge Code	270666517
Hospital Revenue Code	270
Min. Negotiated Rate	$24.44
Max. Negotiated Rate	$94.00
Rate for Payer: Aetna Commercial	$56.40
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$94.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Commercial	$94.00

TRAY EPIDURAL/SPINAL

Facility

$188.00

Hospital Charge Code	270666517
Hospital Revenue Code	270
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

TRAY EPIDURAL W/TUOHY

Facility

$141.70

Hospital Charge Code	270677807
Hospital Revenue Code	272
Min. Negotiated Rate	$18.42
Max. Negotiated Rate	$70.85
Rate for Payer: Aetna Commercial	$42.51
Rate for Payer: Aetna Medicare Advantage	$42.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.13
Rate for Payer: Cigna Commercial	$70.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.42
Rate for Payer: Oxford Commercial	$70.85
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$70.85

TRAY EPIDURAL W/TUOHY

Facility

$141.70

Hospital Charge Code	270677807
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

TRAY EPIDUR SNG SHOT A2532-20

Facility

$70.79

Hospital Charge Code	270626734
Hospital Revenue Code	272
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$10.62
Rate for Payer: Qualcare PPO/HMO/WC	$10.62

TRAY EPIDUR SNG SHOT A2532-20

Facility

$70.79

Hospital Charge Code	270626734
Hospital Revenue Code	272
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$35.40
Rate for Payer: Aetna Commercial	$21.24
Rate for Payer: Aetna Medicare Advantage	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.05
Rate for Payer: Cigna Commercial	$35.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.20
Rate for Payer: Oxford Commercial	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.62
Rate for Payer: UnitedHealthcare Commercial	$35.40

TRAY EPIDUR SNG SHOT CUS002-02

Facility

$72.00

Hospital Charge Code	270615564
Hospital Revenue Code	279
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$21.60
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$36.00

TRAY EPIDUR SNG SHOT CUS002-02

Facility

$72.00

Hospital Charge Code	270615564
Hospital Revenue Code	279
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TRAY ERASE ADD-A-CATH

Facility

$52.49

Service Code	HCPCS C1729
Hospital Charge Code	270649649
Hospital Revenue Code	278
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.87

TRAY ERASE ADD-A-CATH

Facility

$52.49

Service Code	HCPCS C1729
Hospital Charge Code	270649649
Hospital Revenue Code	278
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.38
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.87

TRAY ERASE CAUTI 14FR

Facility

$73.37

Hospital Charge Code	270649651
Hospital Revenue Code	278
Min. Negotiated Rate	$11.01
Max. Negotiated Rate	$36.69
Rate for Payer: Aetna Commercial	$22.01
Rate for Payer: Aetna Medicare Advantage	$22.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.71
Rate for Payer: Cigna Commercial	$36.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.01

TRAY ERASE CAUTI 14FR

Facility

$73.37

Hospital Charge Code	270649651
Hospital Revenue Code	278
Min. Negotiated Rate	$11.01
Max. Negotiated Rate	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.01

TRAY ERASE CAUTI 16FR

Facility

$77.30

Hospital Charge Code	270649652
Hospital Revenue Code	270
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$38.65
Rate for Payer: Aetna Commercial	$23.19
Rate for Payer: Aetna Medicare Advantage	$23.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.71
Rate for Payer: Cigna Commercial	$38.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.05
Rate for Payer: Oxford Commercial	$38.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.60
Rate for Payer: UnitedHealthcare Commercial	$38.65

TRAY ERASE CAUTI 16FR

Facility

$77.30

Hospital Charge Code	270649652
Hospital Revenue Code	270
Min. Negotiated Rate	$11.60
Max. Negotiated Rate	$11.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.60

TRAY EXCHANGE TRANSFUSION

Facility

$617.65

Hospital Charge Code	270600473
Hospital Revenue Code	272
Min. Negotiated Rate	$92.65
Max. Negotiated Rate	$92.65
Rate for Payer: Qualcare PPO/HMO/WC	$92.65

TRAY EXCHANGE TRANSFUSION

Facility

$617.65

Hospital Charge Code	270600473
Hospital Revenue Code	272
Min. Negotiated Rate	$80.29
Max. Negotiated Rate	$308.82
Rate for Payer: Aetna Commercial	$185.29
Rate for Payer: Aetna Medicare Advantage	$185.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.50
Rate for Payer: Cigna Commercial	$308.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.29
Rate for Payer: Oxford Commercial	$308.82
Rate for Payer: Qualcare PPO/HMO/WC	$92.65
Rate for Payer: UnitedHealthcare Commercial	$308.82

Know your out-of-pocket cost for care.

All Charges