Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRAY FOLEY PEDIATRIN URI 6FR

Facility

$113.10

Hospital Charge Code	270669766
Hospital Revenue Code	272
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$16.96
Rate for Payer: Qualcare PPO/HMO/WC	$16.96

TRAY FOLEY PEDIATRIN URI 8FR

Facility

$106.90

Hospital Charge Code	270669764
Hospital Revenue Code	272
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Qualcare PPO/HMO/WC	$16.04

TRAY FOLEY PEDIATRIN URI 8FR

Facility

$106.90

Hospital Charge Code	270669764
Hospital Revenue Code	272
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$53.45
Rate for Payer: Aetna Commercial	$32.07
Rate for Payer: Aetna Medicare Advantage	$32.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.26
Rate for Payer: Cigna Commercial	$53.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.90
Rate for Payer: Oxford Commercial	$53.45
Rate for Payer: Qualcare PPO/HMO/WC	$16.04
Rate for Payer: UnitedHealthcare Commercial	$53.45

TRAY FOLEY TEMP SILVER IC 1

Facility

$128.50

Hospital Charge Code	270654036
Hospital Revenue Code	272
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$64.25
Rate for Payer: Aetna Commercial	$38.55
Rate for Payer: Aetna Medicare Advantage	$38.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.77
Rate for Payer: Cigna Commercial	$64.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.70
Rate for Payer: Oxford Commercial	$64.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.27
Rate for Payer: UnitedHealthcare Commercial	$64.25

TRAY FOLEY TEMP SILVER IC 1

Facility

$128.50

Hospital Charge Code	270654036
Hospital Revenue Code	272
Min. Negotiated Rate	$19.27
Max. Negotiated Rate	$19.27
Rate for Payer: Qualcare PPO/HMO/WC	$19.27

TRAY FOLEY W/16FR CATH

Facility

$107.14

Hospital Charge Code	270302238
Hospital Revenue Code	272
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$53.57
Rate for Payer: Aetna Commercial	$32.14
Rate for Payer: Aetna Medicare Advantage	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.32
Rate for Payer: Cigna Commercial	$53.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.93
Rate for Payer: Oxford Commercial	$53.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.07
Rate for Payer: UnitedHealthcare Commercial	$53.57

TRAY FOLEY W/16FR CATH

Facility

$107.14

Hospital Charge Code	270302238
Hospital Revenue Code	272
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$16.07
Rate for Payer: Qualcare PPO/HMO/WC	$16.07

TRAY FOLEY W/18FR CATH

Facility

$107.14

Hospital Charge Code	270302239
Hospital Revenue Code	272
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$53.57
Rate for Payer: Aetna Commercial	$32.14
Rate for Payer: Aetna Medicare Advantage	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.32
Rate for Payer: Cigna Commercial	$53.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.93
Rate for Payer: Oxford Commercial	$53.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.07
Rate for Payer: UnitedHealthcare Commercial	$53.57

TRAY FOLEY W/18FR CATH

Facility

$107.14

Hospital Charge Code	270302239
Hospital Revenue Code	272
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$16.07
Rate for Payer: Qualcare PPO/HMO/WC	$16.07

TRAY FOLEY W/18FR CATHETER

Facility

$174.00

Hospital Charge Code	270331128
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

TRAY FOLEY W/18FR CATHETER

Facility

$174.00

Hospital Charge Code	270331128
Hospital Revenue Code	272
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$52.20
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$87.00

TRAY FOLEY W/CATH *******

Facility

$118.00

Hospital Charge Code	8003477
Hospital Revenue Code	272
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

TRAY FOLEY W/CATH *******

Facility

$118.00

Hospital Charge Code	8003477
Hospital Revenue Code	272
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

TRAY FOLEY W/O CATH

Facility

$18.45

Hospital Charge Code	270302233
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$9.22
Rate for Payer: Aetna Commercial	$5.54
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.70
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$9.22

TRAY FOLEY W/O CATH

Facility

$18.45

Hospital Charge Code	270302233
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

TRAY FOLEY W/O CATHETER

Facility

$34.57

Hospital Charge Code	270649270
Hospital Revenue Code	272
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$17.29
Rate for Payer: Aetna Commercial	$10.37
Rate for Payer: Aetna Medicare Advantage	$10.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.49
Rate for Payer: Oxford Commercial	$17.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.29

TRAY FOLEY W/O CATHETER

Facility

$34.57

Hospital Charge Code	270649270
Hospital Revenue Code	272
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

TRAY FOLEY W/URINE METER 16FR

Facility

$84.57

Hospital Charge Code	270639722
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$12.69
Rate for Payer: Qualcare PPO/HMO/WC	$12.69

TRAY FOLEY W/URINE METER 16FR

Facility

$84.57

Hospital Charge Code	270639722
Hospital Revenue Code	272
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$42.28
Rate for Payer: Aetna Commercial	$25.37
Rate for Payer: Aetna Medicare Advantage	$25.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.57
Rate for Payer: Cigna Commercial	$42.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.99
Rate for Payer: Oxford Commercial	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$12.69
Rate for Payer: UnitedHealthcare Commercial	$42.28

TRAY FOLEY W/URINE METER 18FR

Facility

$107.00

Hospital Charge Code	270639723
Hospital Revenue Code	272
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

TRAY FOLEY W/URINE METER 18FR

Facility

$107.00

Hospital Charge Code	270639723
Hospital Revenue Code	272
Min. Negotiated Rate	$13.91
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

TRAY GBA OSTEOTOMY INSTR RENT

Facility

$3,793.65

Hospital Charge Code	270616691
Hospital Revenue Code	272
Min. Negotiated Rate	$569.05
Max. Negotiated Rate	$569.05
Rate for Payer: Qualcare PPO/HMO/WC	$569.05

TRAY GBA OSTEOTOMY INSTR RENT

Facility

$3,793.65

Hospital Charge Code	270616691
Hospital Revenue Code	272
Min. Negotiated Rate	$493.17
Max. Negotiated Rate	$1,896.83
Rate for Payer: Aetna Commercial	$1,138.10
Rate for Payer: Aetna Medicare Advantage	$1,138.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.38
Rate for Payer: Cigna Commercial	$1,896.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.17
Rate for Payer: Oxford Commercial	$1,896.83
Rate for Payer: Qualcare PPO/HMO/WC	$569.05
Rate for Payer: UnitedHealthcare Commercial	$1,896.83

TRAY GENERAL LAPAROSCOPY

Facility

$559.65

Hospital Charge Code	270654112
Hospital Revenue Code	272
Min. Negotiated Rate	$72.75
Max. Negotiated Rate	$279.82
Rate for Payer: Aetna Commercial	$167.90
Rate for Payer: Aetna Medicare Advantage	$167.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.71
Rate for Payer: Cigna Commercial	$279.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.75
Rate for Payer: Oxford Commercial	$279.82
Rate for Payer: Qualcare PPO/HMO/WC	$83.95
Rate for Payer: UnitedHealthcare Commercial	$279.82

TRAY GENERAL LAPAROSCOPY

Facility

$559.65

Hospital Charge Code	270654112
Hospital Revenue Code	272
Min. Negotiated Rate	$83.95
Max. Negotiated Rate	$83.95
Rate for Payer: Qualcare PPO/HMO/WC	$83.95

Know your out-of-pocket cost for care.

All Charges