Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE IRRIGATION

Facility

$375.00

Hospital Charge Code	270688485
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

TUBE IRRIGATION*****

Facility

$220.00

Hospital Charge Code	27060478
Hospital Revenue Code	279
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

TUBE IRRIGATION*****

Facility

$220.00

Hospital Charge Code	27060478
Hospital Revenue Code	279
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$110.00

TUBE IRRIGATION PENTAX 0F-B113

Facility

$562.45

Hospital Charge Code	270604788
Hospital Revenue Code	270
Min. Negotiated Rate	$73.12
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$168.74
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.12
Rate for Payer: Oxford Commercial	$281.23
Rate for Payer: Qualcare PPO/HMO/WC	$84.37
Rate for Payer: UnitedHealthcare Commercial	$281.23

TUBE IRRIGATION PENTAX 0F-B113

Facility

$562.45

Hospital Charge Code	270604788
Hospital Revenue Code	270
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$84.37
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

TUBE IRRIGATION PENTAX 0F-B72

Facility

$562.45

Hospital Charge Code	270601169
Hospital Revenue Code	270
Min. Negotiated Rate	$73.12
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$168.74
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.12
Rate for Payer: Oxford Commercial	$281.23
Rate for Payer: Qualcare PPO/HMO/WC	$84.37
Rate for Payer: UnitedHealthcare Commercial	$281.23

TUBE IRRIGATION PENTAX 0F-B72

Facility

$562.45

Hospital Charge Code	270601169
Hospital Revenue Code	270
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$84.37
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

TUBE IRRIGATION POLY

Facility

$235.00

Hospital Charge Code	270669171
Hospital Revenue Code	272
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

TUBE IRRIGATION POLY

Facility

$235.00

Hospital Charge Code	270669171
Hospital Revenue Code	272
Min. Negotiated Rate	$30.55
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$70.50
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.55
Rate for Payer: Oxford Commercial	$117.50
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$117.50

TUBE IRRIGATION SET

Facility

$90.20

Hospital Charge Code	270664634
Hospital Revenue Code	272
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$13.53
Rate for Payer: Qualcare PPO/HMO/WC	$13.53

TUBE IRRIGATION SET

Facility

$90.20

Hospital Charge Code	270664634
Hospital Revenue Code	272
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$45.10
Rate for Payer: Aetna Commercial	$27.06
Rate for Payer: Aetna Medicare Advantage	$27.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.00
Rate for Payer: Cigna Commercial	$45.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.73
Rate for Payer: Oxford Commercial	$45.10
Rate for Payer: Qualcare PPO/HMO/WC	$13.53
Rate for Payer: UnitedHealthcare Commercial	$45.10

TUBE JEJUNAL***

Facility

$226.00

Service Code	HCPCS 999999
Hospital Charge Code	2300523
Hospital Revenue Code	279
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

TUBE JEJUNAL***

Facility

$226.00

Service Code	HCPCS 999999
Hospital Charge Code	2300523
Hospital Revenue Code	279
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$113.00
Rate for Payer: Aetna Commercial	$67.80
Rate for Payer: Aetna Medicare Advantage	$67.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.63
Rate for Payer: Cigna Commercial	$113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.38
Rate for Payer: Oxford Commercial	$113.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$113.00

TUBE JEJUNOSTOMY 20FRx270CM

Facility

$647.35

Hospital Charge Code	270621564
Hospital Revenue Code	272
Min. Negotiated Rate	$97.10
Max. Negotiated Rate	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$97.10

TUBE JEJUNOSTOMY 20FRx270CM

Facility

$647.35

Hospital Charge Code	270621564
Hospital Revenue Code	272
Min. Negotiated Rate	$84.16
Max. Negotiated Rate	$323.68
Rate for Payer: Aetna Commercial	$194.21
Rate for Payer: Aetna Medicare Advantage	$194.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.07
Rate for Payer: Cigna Commercial	$323.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.16
Rate for Payer: Oxford Commercial	$323.68
Rate for Payer: Qualcare PPO/HMO/WC	$97.10
Rate for Payer: UnitedHealthcare Commercial	$323.68

TUBE JEJUNOSTOMY FLEXIFLO 10FR

Facility

$931.15

Hospital Charge Code	270649937
Hospital Revenue Code	272
Min. Negotiated Rate	$139.67
Max. Negotiated Rate	$139.67
Rate for Payer: Qualcare PPO/HMO/WC	$139.67

TUBE JEJUNOSTOMY FLEXIFLO 10FR

Facility

$931.15

Hospital Charge Code	270649937
Hospital Revenue Code	272
Min. Negotiated Rate	$121.05
Max. Negotiated Rate	$465.57
Rate for Payer: Aetna Commercial	$279.35
Rate for Payer: Aetna Medicare Advantage	$279.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.44
Rate for Payer: Cigna Commercial	$465.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.05
Rate for Payer: Oxford Commercial	$465.57
Rate for Payer: Qualcare PPO/HMO/WC	$139.67
Rate for Payer: UnitedHealthcare Commercial	$465.57

TUBE JONES 3.0x18mm FLANGE

Facility

$310.00

Hospital Charge Code	270650020
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

TUBE JONES 3.0x18mm FLANGE

Facility

$310.00

Hospital Charge Code	270650020
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$155.00

TUBE JONES 3.0x19mm FLANGE

Facility

$310.00

Hospital Charge Code	270650024
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

TUBE JONES 3.0x19mm FLANGE

Facility

$310.00

Hospital Charge Code	270650024
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$155.00

TUBE JONES 3.0x20mm FLANGE

Facility

$310.00

Hospital Charge Code	270650025
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

TUBE JONES 3.0x20mm FLANGE

Facility

$310.00

Hospital Charge Code	270650025
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$155.00

TUBE JONES 3.0x21mm FLANGE

Facility

$310.00

Hospital Charge Code	270650027
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$155.00

TUBE JONES 3.0x21mm FLANGE

Facility

$310.00

Hospital Charge Code	270650027
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

Know your out-of-pocket cost for care.

All Charges