Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRAY ORTHOPEDIC USAGE 2.0/2.4

Facility

$1,250.00

Hospital Charge Code	270658656
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

TRAY ORTHOPEDIC USAGE 2.0/2.4

Facility

$1,250.00

Hospital Charge Code	270658656
Hospital Revenue Code	272
Min. Negotiated Rate	$162.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$625.00

TRAY PAIN MGMT TRAX TUN L XL

Facility

$951.25

Hospital Charge Code	270600885
Hospital Revenue Code	272
Min. Negotiated Rate	$123.66
Max. Negotiated Rate	$475.62
Rate for Payer: Aetna Commercial	$285.38
Rate for Payer: Aetna Medicare Advantage	$285.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.57
Rate for Payer: Cigna Commercial	$475.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.66
Rate for Payer: Oxford Commercial	$475.62
Rate for Payer: Qualcare PPO/HMO/WC	$142.69
Rate for Payer: UnitedHealthcare Commercial	$475.62

TRAY PAIN MGMT TRAX TUN L XL

Facility

$951.25

Hospital Charge Code	270600885
Hospital Revenue Code	272
Min. Negotiated Rate	$142.69
Max. Negotiated Rate	$142.69
Rate for Payer: Qualcare PPO/HMO/WC	$142.69

TRAY PARACENTESIS

Facility

$305.75

Hospital Charge Code	270650090
Hospital Revenue Code	271
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$152.88
Rate for Payer: Aetna Commercial	$91.72
Rate for Payer: Aetna Medicare Advantage	$91.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.97
Rate for Payer: Cigna Commercial	$152.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.75
Rate for Payer: Oxford Commercial	$152.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.86
Rate for Payer: UnitedHealthcare Commercial	$152.88

TRAY PARACENTESIS

Facility

$305.75

Hospital Charge Code	270650090
Hospital Revenue Code	271
Min. Negotiated Rate	$45.86
Max. Negotiated Rate	$45.86
Rate for Payer: Qualcare PPO/HMO/WC	$45.86

TRAY PARACENTESIS

Facility

$305.08

Hospital Charge Code	270302240
Hospital Revenue Code	270
Min. Negotiated Rate	$45.76
Max. Negotiated Rate	$45.76
Rate for Payer: Qualcare PPO/HMO/WC	$45.76

TRAY PARACENTESIS

Facility

$305.08

Hospital Charge Code	270302240
Hospital Revenue Code	270
Min. Negotiated Rate	$39.66
Max. Negotiated Rate	$152.54
Rate for Payer: Aetna Commercial	$91.52
Rate for Payer: Aetna Medicare Advantage	$91.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.80
Rate for Payer: Cigna Commercial	$152.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.66
Rate for Payer: Oxford Commercial	$152.54
Rate for Payer: Qualcare PPO/HMO/WC	$45.76
Rate for Payer: UnitedHealthcare Commercial	$152.54

TRAY PARACENTESIS****

Facility

$141.00

Hospital Charge Code	8003261
Hospital Revenue Code	279
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$70.50
Rate for Payer: Aetna Commercial	$42.30
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.33
Rate for Payer: Oxford Commercial	$70.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$70.50

TRAY PARACENTESIS****

Facility

$141.00

Hospital Charge Code	8003261
Hospital Revenue Code	279
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

TRAY PASPORT ELITE 21-4591

Facility

$2,415.60

Hospital Charge Code	270630573
Hospital Revenue Code	272
Min. Negotiated Rate	$314.03
Max. Negotiated Rate	$1,207.80
Rate for Payer: Qualcare PPO/HMO/WC	$362.34
Rate for Payer: Aetna Commercial	$724.68
Rate for Payer: Aetna Medicare Advantage	$724.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$615.98
Rate for Payer: Cigna Commercial	$1,207.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.03
Rate for Payer: Oxford Commercial	$1,207.80
Rate for Payer: UnitedHealthcare Commercial	$1,207.80

TRAY PASPORT ELITE 21-4591

Facility

$2,415.60

Hospital Charge Code	270630573
Hospital Revenue Code	272
Min. Negotiated Rate	$362.34
Max. Negotiated Rate	$362.34
Rate for Payer: Qualcare PPO/HMO/WC	$362.34

TRAY PASSING HANDS FR 252244V

Facility

$10.14

Hospital Charge Code	270629845
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.32
Rate for Payer: Oxford Commercial	$5.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$5.07

TRAY PASSING HANDS FR 252244V

Facility

$10.14

Hospital Charge Code	270629845
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

TRAY PELVIC

Facility

$75.00

Hospital Charge Code	8001224
Hospital Revenue Code	279
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

TRAY PELVIC

Facility

$75.00

Hospital Charge Code	8001224
Hospital Revenue Code	279
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

TRAY PELVIC EXAM SMALL

Facility

$16.59

Hospital Charge Code	270638654
Hospital Revenue Code	270
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$8.29
Rate for Payer: Aetna Commercial	$4.98
Rate for Payer: Aetna Medicare Advantage	$4.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.23
Rate for Payer: Cigna Commercial	$8.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$8.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.49
Rate for Payer: UnitedHealthcare Commercial	$8.29

TRAY PELVIC EXAM SMALL

Facility

$16.59

Hospital Charge Code	270638654
Hospital Revenue Code	270
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$2.49
Rate for Payer: Qualcare PPO/HMO/WC	$2.49

TRAY PELVIC NON-DISP

Facility

$192.85

Hospital Charge Code	2708001224
Hospital Revenue Code	272
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

TRAY PELVIC NON-DISP

Facility

$192.85

Hospital Charge Code	2708001224
Hospital Revenue Code	272
Min. Negotiated Rate	$25.07
Max. Negotiated Rate	$96.42
Rate for Payer: Aetna Commercial	$57.85
Rate for Payer: Aetna Medicare Advantage	$57.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.18
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.07
Rate for Payer: Oxford Commercial	$96.42
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$96.42

TRAY PELVIX EXAM 8E7390

Facility

$27.25

Hospital Charge Code	270622672
Hospital Revenue Code	272
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

TRAY PELVIX EXAM 8E7390

Facility

$27.25

Hospital Charge Code	270622672
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$13.62
Rate for Payer: Aetna Commercial	$8.18
Rate for Payer: Aetna Medicare Advantage	$8.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.95
Rate for Payer: Cigna Commercial	$13.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.54
Rate for Payer: Oxford Commercial	$13.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$13.62

TRAY PERC S DIL 8.0 W SUCTION

Facility

$1,709.25

Hospital Charge Code	270689359
Hospital Revenue Code	272
Min. Negotiated Rate	$256.39
Max. Negotiated Rate	$256.39
Rate for Payer: Qualcare PPO/HMO/WC	$256.39

TRAY PERC S DIL 8.0 W SUCTION

Facility

$1,709.25

Hospital Charge Code	270689359
Hospital Revenue Code	272
Min. Negotiated Rate	$222.20
Max. Negotiated Rate	$854.62
Rate for Payer: Aetna Commercial	$512.77
Rate for Payer: Aetna Medicare Advantage	$512.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.86
Rate for Payer: Cigna Commercial	$854.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.20
Rate for Payer: Oxford Commercial	$854.62
Rate for Payer: Qualcare PPO/HMO/WC	$256.39
Rate for Payer: UnitedHealthcare Commercial	$854.62

TRAY PERCU-SET BIOPSY 43825A

Facility

$73.43

Hospital Charge Code	270605455
Hospital Revenue Code	270
Min. Negotiated Rate	$11.01
Max. Negotiated Rate	$11.01
Rate for Payer: Qualcare PPO/HMO/WC	$11.01

Know your out-of-pocket cost for care.

All Charges