Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889S
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889N
Hospital Revenue Code	272
Min. Negotiated Rate	$28.64
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$66.09
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.64
Rate for Payer: Oxford Commercial	$110.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$110.15

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889
Hospital Revenue Code	272
Min. Negotiated Rate	$28.64
Max. Negotiated Rate	$110.15
Rate for Payer: Aetna Commercial	$66.09
Rate for Payer: Aetna Medicare Advantage	$66.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.18
Rate for Payer: Cigna Commercial	$110.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.64
Rate for Payer: Oxford Commercial	$110.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.05
Rate for Payer: UnitedHealthcare Commercial	$110.15

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$220.30

Hospital Charge Code	270669889
Hospital Revenue Code	272
Min. Negotiated Rate	$33.05
Max. Negotiated Rate	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$33.05

TUBE GASTROSTOMY MIC 18FR

Facility

$873.00

Hospital Charge Code	270661988S
Hospital Revenue Code	272
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$130.95
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

TUBE GASTROSTOMY MIC 18FR

Facility

$873.00

Hospital Charge Code	270661988S
Hospital Revenue Code	272
Min. Negotiated Rate	$113.49
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) PPO	$222.62
Rate for Payer: Cigna Commercial	$436.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.49
Rate for Payer: Oxford Commercial	$436.50
Rate for Payer: Qualcare PPO/HMO/WC	$130.95
Rate for Payer: UnitedHealthcare Commercial	$436.50

TUBE GASTROSTO REPLCMT***

Facility

$355.00

Hospital Charge Code	2300747
Hospital Revenue Code	279
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.15
Rate for Payer: Oxford Commercial	$177.50
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Commercial	$177.50

TUBE GASTROSTO REPLCMT***

Facility

$355.00

Hospital Charge Code	2300747
Hospital Revenue Code	279
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$53.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

TUBE GASTROST TRI 20F 000720

Facility

$338.45

Hospital Charge Code	270604824
Hospital Revenue Code	272
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$101.53
Rate for Payer: Aetna Medicare Advantage	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.30
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.00
Rate for Payer: Oxford Commercial	$169.22
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$169.22

TUBE GASTROST TRI 20F 000720

Facility

$338.45

Hospital Charge Code	270604824
Hospital Revenue Code	272
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

TUBE G FEEDING 14 FR

Facility

$112.50

Hospital Charge Code	270999004
Hospital Revenue Code	272
Min. Negotiated Rate	$14.62
Max. Negotiated Rate	$56.25
Rate for Payer: Aetna Commercial	$33.75
Rate for Payer: Aetna Medicare Advantage	$33.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.69
Rate for Payer: Cigna Commercial	$56.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.62
Rate for Payer: Oxford Commercial	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$16.88
Rate for Payer: UnitedHealthcare Commercial	$56.25

TUBE G FEEDING 14 FR

Facility

$112.50

Hospital Charge Code	270999004
Hospital Revenue Code	272
Min. Negotiated Rate	$16.88
Max. Negotiated Rate	$16.88
Rate for Payer: Qualcare PPO/HMO/WC	$16.88

TUBE GOODE T MYRINGOTOMY

Facility

$188.00

Hospital Charge Code	270602892
Hospital Revenue Code	272
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

TUBE GOODE T MYRINGOTOMY

Facility

$188.00

Hospital Charge Code	270602892
Hospital Revenue Code	272
Min. Negotiated Rate	$24.44
Max. Negotiated Rate	$94.00
Rate for Payer: Aetna Commercial	$56.40
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$94.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Commercial	$94.00

TUBE GRAFT KNITT STRAIGHT 6X60

Facility

$2,530.50

Hospital Charge Code	270664858
Hospital Revenue Code	270
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$379.57
Rate for Payer: Qualcare PPO/HMO/WC	$379.57

TUBE GRAFT KNITT STRAIGHT 6X60

Facility

$2,530.50

Hospital Charge Code	270664858
Hospital Revenue Code	270
Min. Negotiated Rate	$328.96
Max. Negotiated Rate	$1,265.25
Rate for Payer: Aetna Commercial	$759.15
Rate for Payer: Aetna Medicare Advantage	$759.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.28
Rate for Payer: Cigna Commercial	$1,265.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$328.96
Rate for Payer: Oxford Commercial	$1,265.25
Rate for Payer: Qualcare PPO/HMO/WC	$379.57
Rate for Payer: UnitedHealthcare Commercial	$1,265.25

TUBE G REPL STR 18FR

Facility

$138.33

Hospital Charge Code	270656976
Hospital Revenue Code	272
Min. Negotiated Rate	$17.98
Max. Negotiated Rate	$69.17
Rate for Payer: Aetna Commercial	$41.50
Rate for Payer: Aetna Medicare Advantage	$41.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.27
Rate for Payer: Cigna Commercial	$69.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: Oxford Commercial	$69.17
Rate for Payer: Qualcare PPO/HMO/WC	$20.75
Rate for Payer: UnitedHealthcare Commercial	$69.17

TUBE G REPL STR 18FR

Facility

$138.33

Hospital Charge Code	270656976
Hospital Revenue Code	272
Min. Negotiated Rate	$20.75
Max. Negotiated Rate	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.75

TUBE GSTRSTMY FLXFLO20FR 51364

Facility

$118.25

Hospital Charge Code	270302330
Hospital Revenue Code	272
Min. Negotiated Rate	$15.37
Max. Negotiated Rate	$59.12
Rate for Payer: Aetna Commercial	$35.48
Rate for Payer: Aetna Medicare Advantage	$35.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.15
Rate for Payer: Cigna Commercial	$59.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.37
Rate for Payer: Oxford Commercial	$59.12
Rate for Payer: Qualcare PPO/HMO/WC	$17.74
Rate for Payer: UnitedHealthcare Commercial	$59.12

TUBE GSTRSTMY FLXFLO20FR 51364

Facility

$118.25

Hospital Charge Code	270302330
Hospital Revenue Code	272
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$17.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.74

TUBE HI/LOW EVAC SZ 7

Facility

$179.96

Hospital Charge Code	270650103
Hospital Revenue Code	270
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$89.98
Rate for Payer: Aetna Commercial	$53.99
Rate for Payer: Aetna Medicare Advantage	$53.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.89
Rate for Payer: Cigna Commercial	$89.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.39
Rate for Payer: Oxford Commercial	$89.98
Rate for Payer: Qualcare PPO/HMO/WC	$26.99
Rate for Payer: UnitedHealthcare Commercial	$89.98

TUBE HI/LOW EVAC SZ 7

Facility

$179.96

Hospital Charge Code	270650103
Hospital Revenue Code	270
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99

TUBE HI/LOW EVAC SZ 7.5

Facility

$179.96

Hospital Charge Code	270650102
Hospital Revenue Code	270
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$89.98
Rate for Payer: Aetna Commercial	$53.99
Rate for Payer: Aetna Medicare Advantage	$53.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.89
Rate for Payer: Cigna Commercial	$89.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.39
Rate for Payer: Oxford Commercial	$89.98
Rate for Payer: Qualcare PPO/HMO/WC	$26.99
Rate for Payer: UnitedHealthcare Commercial	$89.98

TUBE HI/LOW EVAC SZ 7.5

Facility

$179.96

Hospital Charge Code	270650102
Hospital Revenue Code	270
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$26.99
Rate for Payer: Qualcare PPO/HMO/WC	$26.99

Know your out-of-pocket cost for care.

All Charges