Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRAY SPINAL ANESTHESIA

Facility

$65.89

Hospital Charge Code	270649897
Hospital Revenue Code	272
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$32.95
Rate for Payer: Aetna Commercial	$19.77
Rate for Payer: Aetna Medicare Advantage	$19.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.80
Rate for Payer: Cigna Commercial	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.57
Rate for Payer: Oxford Commercial	$32.95
Rate for Payer: Qualcare PPO/HMO/WC	$9.88
Rate for Payer: UnitedHealthcare Commercial	$32.95

TRAY SPINAL ANESTHESIA

Facility

$113.65

Hospital Charge Code	270070095
Hospital Revenue Code	272
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$56.83
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: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$56.83

TRAY SPINAL ANESTHESIA ****

Facility

$61.00

Hospital Charge Code	1800135
Hospital Revenue Code	279
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

TRAY SPINAL ANESTHESIA ****

Facility

$61.00

Hospital Charge Code	1800135
Hospital Revenue Code	279
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

TRAY SPINAL ANESTHESIA *****

Facility

$43.00

Hospital Charge Code	1603091
Hospital Revenue Code	279
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

TRAY SPINAL ANESTHESIA *****

Facility

$43.00

Hospital Charge Code	1603091
Hospital Revenue Code	279
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

TRAY SPINAL PENCAN 24GAX4IN

Facility

$91.77

Service Code	HCPCS A4649
Hospital Charge Code	270698870
Hospital Revenue Code	270
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$13.77
Rate for Payer: Qualcare PPO/HMO/WC	$13.77

TRAY SPINAL PENCAN 24GAX4IN

Facility

$91.77

Service Code	HCPCS A4649
Hospital Charge Code	270698870
Hospital Revenue Code	270
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$45.88
Rate for Payer: Aetna Commercial	$27.53
Rate for Payer: Aetna Medicare Advantage	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.40
Rate for Payer: Cigna Commercial	$45.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.93
Rate for Payer: Oxford Commercial	$45.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.77
Rate for Payer: UnitedHealthcare Commercial	$45.88

TRAY SPINAL W/BUPIVCINE 333851

Facility

$94.66

Hospital Charge Code	270645719
Hospital Revenue Code	272
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$47.33
Rate for Payer: Aetna Commercial	$28.40
Rate for Payer: Aetna Medicare Advantage	$28.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.14
Rate for Payer: Cigna Commercial	$47.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.31
Rate for Payer: Oxford Commercial	$47.33
Rate for Payer: Qualcare PPO/HMO/WC	$14.20
Rate for Payer: UnitedHealthcare Commercial	$47.33

TRAY SPINAL W/BUPIVCINE 333851

Facility

$94.66

Hospital Charge Code	270645719
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.20

TRAY SPINAL WHITACRE 22G

Facility

$49.08

Hospital Charge Code	270649898
Hospital Revenue Code	272
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$7.36
Rate for Payer: Qualcare PPO/HMO/WC	$7.36

TRAY SPINAL WHITACRE 22G

Facility

$49.08

Hospital Charge Code	270649898
Hospital Revenue Code	272
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$24.54
Rate for Payer: Aetna Commercial	$14.72
Rate for Payer: Aetna Medicare Advantage	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.52
Rate for Payer: Cigna Commercial	$24.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.38
Rate for Payer: Oxford Commercial	$24.54
Rate for Payer: Qualcare PPO/HMO/WC	$7.36
Rate for Payer: UnitedHealthcare Commercial	$24.54

TRAY SPINAL W/TETRACAIE 333743

Facility

$114.70

Hospital Charge Code	270333743
Hospital Revenue Code	272
Min. Negotiated Rate	$17.20
Max. Negotiated Rate	$17.20
Rate for Payer: Qualcare PPO/HMO/WC	$17.20

TRAY SPINAL W/TETRACAIE 333743

Facility

$114.70

Hospital Charge Code	270333743
Hospital Revenue Code	272
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$57.35
Rate for Payer: Aetna Commercial	$34.41
Rate for Payer: Aetna Medicare Advantage	$34.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.25
Rate for Payer: Cigna Commercial	$57.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.91
Rate for Payer: Oxford Commercial	$57.35
Rate for Payer: Qualcare PPO/HMO/WC	$17.20
Rate for Payer: UnitedHealthcare Commercial	$57.35

TRAY SPINAL W/TETRACAIN 333743

Facility

$91.85

Hospital Charge Code	270621752
Hospital Revenue Code	272
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.78

TRAY SPINAL W/TETRACAIN 333743

Facility

$91.85

Hospital Charge Code	270621752
Hospital Revenue Code	272
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$45.92
Rate for Payer: Aetna Commercial	$27.55
Rate for Payer: Aetna Medicare Advantage	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.42
Rate for Payer: Cigna Commercial	$45.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.94
Rate for Payer: Oxford Commercial	$45.92
Rate for Payer: Qualcare PPO/HMO/WC	$13.78
Rate for Payer: UnitedHealthcare Commercial	$45.92

TRAY SPNL ANESTH SPROT B000110

Facility

$95.29

Hospital Charge Code	270644554
Hospital Revenue Code	272
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$47.65
Rate for Payer: Aetna Commercial	$28.59
Rate for Payer: Aetna Medicare Advantage	$28.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.30
Rate for Payer: Cigna Commercial	$47.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.39
Rate for Payer: Oxford Commercial	$47.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.29
Rate for Payer: UnitedHealthcare Commercial	$47.65

TRAY SPNL ANESTH SPROT B000110

Facility

$95.29

Hospital Charge Code	270644554
Hospital Revenue Code	272
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$14.29
Rate for Payer: Qualcare PPO/HMO/WC	$14.29

TRAY SPNL NDL W/TTRACAN 333854

Facility

$86.85

Hospital Charge Code	270635807
Hospital Revenue Code	272
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$13.03
Rate for Payer: Qualcare PPO/HMO/WC	$13.03

TRAY SPNL NDL W/TTRACAN 333854

Facility

$86.85

Hospital Charge Code	270635807
Hospital Revenue Code	272
Min. Negotiated Rate	$11.29
Max. Negotiated Rate	$43.42
Rate for Payer: Aetna Commercial	$26.05
Rate for Payer: Aetna Medicare Advantage	$26.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.15
Rate for Payer: Cigna Commercial	$43.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.29
Rate for Payer: Oxford Commercial	$43.42
Rate for Payer: Qualcare PPO/HMO/WC	$13.03
Rate for Payer: UnitedHealthcare Commercial	$43.42

TRAY SUCTION*****

Facility

$2.00

Hospital Charge Code	8001604
Hospital Revenue Code	279
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

TRAY SUCTION*****

Facility

$2.00

Hospital Charge Code	8001604
Hospital Revenue Code	279
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

TRAY SUCTION 14FR

Facility

$7.25

Hospital Charge Code	270302265
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

TRAY SUCTION 14FR

Facility

$7.25

Hospital Charge Code	270302265
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

TRAY SUCTION 14FR W/SALINE

Facility

$5.11

Hospital Charge Code	270649271
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$2.56
Rate for Payer: Aetna Commercial	$1.53
Rate for Payer: Aetna Medicare Advantage	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.30
Rate for Payer: Cigna Commercial	$2.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.66
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$2.56

Know your out-of-pocket cost for care.

All Charges