Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE AFT STRAIGHT 1/2 FILL

Facility

$900.00

Hospital Charge Code	270674909
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

TUBE AFT STRAIGHT 1/2 FILL

Facility

$900.00

Hospital Charge Code	270674909
Hospital Revenue Code	272
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$450.00

TUBE ARMSTRONG BEVELED GROMMET

Facility

$61.53

Hospital Charge Code	270659919
Hospital Revenue Code	270
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.23

TUBE ARMSTRONG BEVELED GROMMET

Facility

$61.53

Hospital Charge Code	270659919
Hospital Revenue Code	270
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$30.77
Rate for Payer: Aetna Commercial	$18.46
Rate for Payer: Aetna Medicare Advantage	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.69
Rate for Payer: Cigna Commercial	$30.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.00
Rate for Payer: Oxford Commercial	$30.77
Rate for Payer: Qualcare PPO/HMO/WC	$9.23
Rate for Payer: UnitedHealthcare Commercial	$30.77

TUBE ARMSTRONG VENT ******

Facility

$84.00

Hospital Charge Code	1608124
Hospital Revenue Code	272
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

TUBE ARMSTRONG VENT ******

Facility

$84.00

Hospital Charge Code	1608124
Hospital Revenue Code	272
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TUBE ARMSTRONG VENT *******

Facility

$28.00

Hospital Charge Code	1600675
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

TUBE ARMSTRONG VENT *******

Facility

$28.00

Hospital Charge Code	1600675
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

TUBE ARMSTRONG VENT TUBE

Facility

$56.18

Hospital Charge Code	270660213
Hospital Revenue Code	272
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$28.09
Rate for Payer: Aetna Commercial	$16.85
Rate for Payer: Aetna Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.33
Rate for Payer: Cigna Commercial	$28.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.30
Rate for Payer: Oxford Commercial	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.43
Rate for Payer: UnitedHealthcare Commercial	$28.09

TUBE ARMSTRONG VENT TUBE

Facility

$56.18

Hospital Charge Code	270660213
Hospital Revenue Code	272
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$8.43

TUBE ASPIRATING LUKI 6-1/4

Facility

$42.00

Hospital Charge Code	270331298
Hospital Revenue Code	272
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$12.60
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$21.00

TUBE ASPIRATING LUKI 6-1/4

Facility

$42.00

Hospital Charge Code	270331298
Hospital Revenue Code	272
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

TUBE ASSEMBLY RIA

Facility

$1,746.00

Hospital Charge Code	270671813
Hospital Revenue Code	272
Min. Negotiated Rate	$226.98
Max. Negotiated Rate	$873.00
Rate for Payer: Aetna Commercial	$523.80
Rate for Payer: Aetna Medicare Advantage	$523.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.23
Rate for Payer: Cigna Commercial	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.98
Rate for Payer: Oxford Commercial	$873.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.90
Rate for Payer: UnitedHealthcare Commercial	$873.00

TUBE ASSEMBLY RIA

Facility

$1,746.00

Hospital Charge Code	270671813
Hospital Revenue Code	272
Min. Negotiated Rate	$261.90
Max. Negotiated Rate	$261.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.90

TUBE ASSEMBLY RIA MIN 360MM

Facility

$1,746.00

Hospital Charge Code	270675629
Hospital Revenue Code	272
Min. Negotiated Rate	$261.90
Max. Negotiated Rate	$261.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.90

TUBE ASSEMBLY RIA MIN 360MM

Facility

$1,746.00

Hospital Charge Code	270675629
Hospital Revenue Code	272
Min. Negotiated Rate	$226.98
Max. Negotiated Rate	$873.00
Rate for Payer: Aetna Commercial	$523.80
Rate for Payer: Aetna Medicare Advantage	$523.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.23
Rate for Payer: Cigna Commercial	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.98
Rate for Payer: Oxford Commercial	$873.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.90
Rate for Payer: UnitedHealthcare Commercial	$873.00

TUBE BAKER JEJUNOSY 16F 655316

Facility

$652.15

Hospital Charge Code	270641723
Hospital Revenue Code	272
Min. Negotiated Rate	$97.82
Max. Negotiated Rate	$97.82
Rate for Payer: Qualcare PPO/HMO/WC	$97.82

TUBE BAKER JEJUNOSY 16F 655316

Facility

$652.15

Hospital Charge Code	270641723
Hospital Revenue Code	272
Min. Negotiated Rate	$84.78
Max. Negotiated Rate	$326.07
Rate for Payer: Aetna Commercial	$195.65
Rate for Payer: Aetna Medicare Advantage	$195.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.30
Rate for Payer: Cigna Commercial	$326.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.78
Rate for Payer: Oxford Commercial	$326.07
Rate for Payer: Qualcare PPO/HMO/WC	$97.82
Rate for Payer: UnitedHealthcare Commercial	$326.07

TUBE BMT MEDULLAR ALIGN 469389

Facility

$295.00

Hospital Charge Code	270612312
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

TUBE BMT MEDULLAR ALIGN 469389

Facility

$295.00

Hospital Charge Code	270612312
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$88.50
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

TUBE BMT MEDULLAR ALIGN 469391

Facility

$226.45

Hospital Charge Code	270607865
Hospital Revenue Code	272
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

TUBE BMT MEDULLAR ALIGN 469391

Facility

$226.45

Hospital Charge Code	270607865
Hospital Revenue Code	272
Min. Negotiated Rate	$29.44
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$67.94
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.44
Rate for Payer: Oxford Commercial	$113.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$113.22

TUBE BMT MEDULLAR ALIGN 469395

Facility

$226.45

Hospital Charge Code	270610878
Hospital Revenue Code	272
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

TUBE BMT MEDULLAR ALIGN 469395

Facility

$226.45

Hospital Charge Code	270610878
Hospital Revenue Code	272
Min. Negotiated Rate	$29.44
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$67.94
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.44
Rate for Payer: Oxford Commercial	$113.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$113.22

TUBE BRNC-CATH RT 39M 43161139

Facility

$251.15

Hospital Charge Code	270624527
Hospital Revenue Code	272
Min. Negotiated Rate	$37.67
Max. Negotiated Rate	$37.67
Rate for Payer: Qualcare PPO/HMO/WC	$37.67

Know your out-of-pocket cost for care.

All Charges