Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE FLATUS*****

Facility

$30.00

Hospital Charge Code	8000705
Hospital Revenue Code	279
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

TUBE FLUORPLAST ARMSTRG 140242

Facility

$137.76

Hospital Charge Code	270620643
Hospital Revenue Code	272
Min. Negotiated Rate	$17.91
Max. Negotiated Rate	$68.88
Rate for Payer: Aetna Commercial	$41.33
Rate for Payer: Aetna Medicare Advantage	$41.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.13
Rate for Payer: Cigna Commercial	$68.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.91
Rate for Payer: Oxford Commercial	$68.88
Rate for Payer: Qualcare PPO/HMO/WC	$20.66
Rate for Payer: UnitedHealthcare Commercial	$68.88

TUBE FLUORPLAST ARMSTRG 140242

Facility

$137.76

Hospital Charge Code	270620643
Hospital Revenue Code	272
Min. Negotiated Rate	$20.66
Max. Negotiated Rate	$20.66
Rate for Payer: Qualcare PPO/HMO/WC	$20.66

TUBE FLUROPLASTIC .045 140035

Facility

$40.17

Hospital Charge Code	270605120
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$6.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

TUBE FLUROPLASTIC .045 140035

Facility

$40.17

Hospital Charge Code	270605120
Hospital Revenue Code	272
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$20.09
Rate for Payer: Aetna Commercial	$12.05
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.24
Rate for Payer: Cigna Commercial	$20.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.22
Rate for Payer: Oxford Commercial	$20.09
Rate for Payer: Qualcare PPO/HMO/WC	$6.03
Rate for Payer: UnitedHealthcare Commercial	$20.09

TUBE FRAZIER SUCT DISP 12FR

Facility

$8.97

Hospital Charge Code	270607601
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

TUBE FRAZIER SUCT DISP 12FR

Facility

$8.97

Hospital Charge Code	270607601
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.49
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.49

TUBE FREELOCK/SCP PLATE

Facility

$986.25

Hospital Charge Code	270656346
Hospital Revenue Code	271
Min. Negotiated Rate	$147.94
Max. Negotiated Rate	$147.94
Rate for Payer: Qualcare PPO/HMO/WC	$147.94

TUBE FREELOCK/SCP PLATE

Facility

$986.25

Hospital Charge Code	270656346
Hospital Revenue Code	271
Min. Negotiated Rate	$128.21
Max. Negotiated Rate	$493.12
Rate for Payer: Aetna Commercial	$295.88
Rate for Payer: Aetna Medicare Advantage	$295.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.49
Rate for Payer: Cigna Commercial	$493.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.21
Rate for Payer: Oxford Commercial	$493.12
Rate for Payer: Qualcare PPO/HMO/WC	$147.94
Rate for Payer: UnitedHealthcare Commercial	$493.12

TUBE FREE LOCK/SCP PLATE 130

Facility

$1,138.75

Hospital Charge Code	270656334
Hospital Revenue Code	271
Min. Negotiated Rate	$170.81
Max. Negotiated Rate	$170.81
Rate for Payer: Qualcare PPO/HMO/WC	$170.81

TUBE FREE LOCK/SCP PLATE 130

Facility

$1,138.75

Hospital Charge Code	270656334
Hospital Revenue Code	271
Min. Negotiated Rate	$148.04
Max. Negotiated Rate	$569.38
Rate for Payer: Aetna Commercial	$341.62
Rate for Payer: Aetna Medicare Advantage	$341.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.38
Rate for Payer: Cigna Commercial	$569.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.04
Rate for Payer: Oxford Commercial	$569.38
Rate for Payer: Qualcare PPO/HMO/WC	$170.81
Rate for Payer: UnitedHealthcare Commercial	$569.38

TUBE FREE LOCK/SCP PLATE 135

Facility

$1,241.25

Hospital Charge Code	270656339
Hospital Revenue Code	271
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$186.19
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

TUBE FREE LOCK/SCP PLATE 135

Facility

$1,241.25

Hospital Charge Code	270656339
Hospital Revenue Code	271
Min. Negotiated Rate	$161.36
Max. Negotiated Rate	$620.62
Rate for Payer: Aetna Commercial	$372.38
Rate for Payer: Aetna Medicare Advantage	$372.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.52
Rate for Payer: Cigna Commercial	$620.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.36
Rate for Payer: Oxford Commercial	$620.62
Rate for Payer: Qualcare PPO/HMO/WC	$186.19
Rate for Payer: UnitedHealthcare Commercial	$620.62

TUBE FREELOCK/SCP PLATE 145

Facility

$1,305.70

Hospital Charge Code	270656341
Hospital Revenue Code	271
Min. Negotiated Rate	$169.74
Max. Negotiated Rate	$652.85
Rate for Payer: Aetna Commercial	$391.71
Rate for Payer: Aetna Medicare Advantage	$391.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.95
Rate for Payer: Cigna Commercial	$652.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.74
Rate for Payer: Oxford Commercial	$652.85
Rate for Payer: Qualcare PPO/HMO/WC	$195.85
Rate for Payer: UnitedHealthcare Commercial	$652.85

TUBE FREELOCK/SCP PLATE 145

Facility

$1,305.70

Hospital Charge Code	270656341
Hospital Revenue Code	271
Min. Negotiated Rate	$195.85
Max. Negotiated Rate	$195.85
Rate for Payer: Qualcare PPO/HMO/WC	$195.85

TUBE FREELOCK/SCP PLATE 150 DE

Facility

$1,138.75

Hospital Charge Code	270656349
Hospital Revenue Code	271
Min. Negotiated Rate	$148.04
Max. Negotiated Rate	$569.38
Rate for Payer: Aetna Commercial	$341.62
Rate for Payer: Aetna Medicare Advantage	$341.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.38
Rate for Payer: Cigna Commercial	$569.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.04
Rate for Payer: Oxford Commercial	$569.38
Rate for Payer: Qualcare PPO/HMO/WC	$170.81
Rate for Payer: UnitedHealthcare Commercial	$569.38

TUBE FREELOCK/SCP PLATE 150 DE

Facility

$1,138.75

Hospital Charge Code	270656349
Hospital Revenue Code	271
Min. Negotiated Rate	$170.81
Max. Negotiated Rate	$170.81
Rate for Payer: Qualcare PPO/HMO/WC	$170.81

TUBE GASTRO20FR REPLA/TRL51364

Facility

$145.00

Hospital Charge Code	270102276
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

TUBE GASTRO20FR REPLA/TRL51364

Facility

$145.00

Hospital Charge Code	270102276
Hospital Revenue Code	272
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.85
Rate for Payer: Oxford Commercial	$72.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$72.50

TUBE GASTRO ENTERIC 16FR

Facility

$844.10

Hospital Charge Code	270670058
Hospital Revenue Code	272
Min. Negotiated Rate	$126.61
Max. Negotiated Rate	$126.61
Rate for Payer: Qualcare PPO/HMO/WC	$126.61

TUBE GASTRO ENTERIC 16FR

Facility

$844.10

Hospital Charge Code	270670058
Hospital Revenue Code	272
Min. Negotiated Rate	$109.73
Max. Negotiated Rate	$422.05
Rate for Payer: Aetna Commercial	$253.23
Rate for Payer: Aetna Medicare Advantage	$253.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.25
Rate for Payer: Cigna Commercial	$422.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.73
Rate for Payer: Oxford Commercial	$422.05
Rate for Payer: Qualcare PPO/HMO/WC	$126.61
Rate for Payer: UnitedHealthcare Commercial	$422.05

TUBE GASTROENTERIC 18F 021018

Facility

$873.00

Hospital Charge Code	270661988
Hospital Revenue Code	278
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna Commercial	$261.90
Rate for Payer: Aetna Medicare Advantage	$261.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.62
Rate for Payer: Cigna Commercial	$436.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.27
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

TUBE GASTROENTERIC 18F 021018

Facility

$873.00

Hospital Charge Code	270661988
Hospital Revenue Code	278
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.27
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

TUBE GASTRONOMY FEEDING 24 FR

Facility

$973.10

Hospital Charge Code	270678518
Hospital Revenue Code	272
Min. Negotiated Rate	$145.97
Max. Negotiated Rate	$145.97
Rate for Payer: Qualcare PPO/HMO/WC	$145.97

TUBE GASTRONOMY FEEDING 24 FR

Facility

$973.10

Hospital Charge Code	270678518
Hospital Revenue Code	272
Min. Negotiated Rate	$126.50
Max. Negotiated Rate	$486.55
Rate for Payer: Aetna Commercial	$291.93
Rate for Payer: Aetna Medicare Advantage	$291.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.14
Rate for Payer: Cigna Commercial	$486.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.50
Rate for Payer: Oxford Commercial	$486.55
Rate for Payer: Qualcare PPO/HMO/WC	$145.97
Rate for Payer: UnitedHealthcare Commercial	$486.55

Know your out-of-pocket cost for care.

All Charges