Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE JONES 3.0x22mm FLANGE

Facility

$310.00

Hospital Charge Code	270650028
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 3.0x22mm FLANGE

Facility

$310.00

Hospital Charge Code	270650028
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 3.0x22mm W/ANGLED

Facility

$310.00

Hospital Charge Code	270650032
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 3.0x22mm W/ANGLED

Facility

$310.00

Hospital Charge Code	270650032
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 3.0x23mm FLANGE

Facility

$310.00

Hospital Charge Code	270650030
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 3.0x23mm FLANGE

Facility

$310.00

Hospital Charge Code	270650030
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 KANGAROO FEEDING

Facility

$55.27

Hospital Charge Code	270649938
Hospital Revenue Code	272
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$27.64
Rate for Payer: Aetna Commercial	$16.58
Rate for Payer: Aetna Medicare Advantage	$16.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.09
Rate for Payer: Cigna Commercial	$27.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Oxford Commercial	$27.64
Rate for Payer: Qualcare PPO/HMO/WC	$8.29
Rate for Payer: UnitedHealthcare Commercial	$27.64

TUBE KANGAROO FEEDING

Facility

$55.27

Hospital Charge Code	270649938
Hospital Revenue Code	272
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$8.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.29

TUBE LARYNGECTOMY SIZE 8

Facility

$388.00

Hospital Charge Code	270331345
Hospital Revenue Code	272
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

TUBE LARYNGECTOMY SIZE 8

Facility

$388.00

Hospital Charge Code	270331345
Hospital Revenue Code	272
Min. Negotiated Rate	$50.44
Max. Negotiated Rate	$194.00
Rate for Payer: Aetna Commercial	$116.40
Rate for Payer: Aetna Medicare Advantage	$116.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.94
Rate for Payer: Cigna Commercial	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.44
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.20
Rate for Payer: UnitedHealthcare Commercial	$194.00

TUBE LARYNGECTOMY SZ 10 12.0mm

Facility

$499.00

Hospital Charge Code	270643554
Hospital Revenue Code	272
Min. Negotiated Rate	$64.87
Max. Negotiated Rate	$249.50
Rate for Payer: Aetna Commercial	$149.70
Rate for Payer: Aetna Medicare Advantage	$149.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.25
Rate for Payer: Cigna Commercial	$249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.87
Rate for Payer: Oxford Commercial	$249.50
Rate for Payer: Qualcare PPO/HMO/WC	$74.85
Rate for Payer: UnitedHealthcare Commercial	$249.50

TUBE LARYNGECTOMY SZ 10 12.0mm

Facility

$499.00

Hospital Charge Code	270643554
Hospital Revenue Code	272
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$74.85
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

TUBE LASER SHIELD 24 FR

Facility

$730.00

Hospital Charge Code	270600888
Hospital Revenue Code	272
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

TUBE LASER SHIELD 24 FR

Facility

$730.00

Hospital Charge Code	270600888
Hospital Revenue Code	272
Min. Negotiated Rate	$94.90
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$219.00
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.90
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Commercial	$365.00

TUBE LASER SHIELD 4.5MM

Facility

$920.00

Hospital Charge Code	270605824
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

TUBE LASER SHIELD 4.5MM

Facility

$920.00

Hospital Charge Code	270605824
Hospital Revenue Code	272
Min. Negotiated Rate	$119.60
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$276.00
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.60
Rate for Payer: Oxford Commercial	$460.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$460.00

TUBE LASER SHIELD II 27F

Facility

$800.00

Hospital Charge Code	270601166
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

TUBE LASER SHIELD II 27F

Facility

$800.00

Hospital Charge Code	270601166
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

TUBE LASER SHIELD II 4.0/6.6

Facility

$945.65

Hospital Charge Code	270600889
Hospital Revenue Code	272
Min. Negotiated Rate	$141.85
Max. Negotiated Rate	$141.85
Rate for Payer: Qualcare PPO/HMO/WC	$141.85

TUBE LASER SHIELD II 4.0/6.6

Facility

$945.65

Hospital Charge Code	270600889
Hospital Revenue Code	272
Min. Negotiated Rate	$122.93
Max. Negotiated Rate	$472.82
Rate for Payer: Aetna Commercial	$283.69
Rate for Payer: Aetna Medicare Advantage	$283.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.14
Rate for Payer: Cigna Commercial	$472.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.93
Rate for Payer: Oxford Commercial	$472.82
Rate for Payer: Qualcare PPO/HMO/WC	$141.85
Rate for Payer: UnitedHealthcare Commercial	$472.82

TUBE LASER SHIELD II 5.5MM

Facility

$873.65

Hospital Charge Code	270600887
Hospital Revenue Code	272
Min. Negotiated Rate	$113.57
Max. Negotiated Rate	$436.82
Rate for Payer: Aetna Commercial	$262.10
Rate for Payer: Aetna Medicare Advantage	$262.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.78
Rate for Payer: Cigna Commercial	$436.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.57
Rate for Payer: Oxford Commercial	$436.82
Rate for Payer: Qualcare PPO/HMO/WC	$131.05
Rate for Payer: UnitedHealthcare Commercial	$436.82

TUBE LASER SHIELD II 5.5MM

Facility

$873.65

Hospital Charge Code	270600887
Hospital Revenue Code	272
Min. Negotiated Rate	$131.05
Max. Negotiated Rate	$131.05
Rate for Payer: Qualcare PPO/HMO/WC	$131.05

TUBE LEVINE 12/16FR *******

Facility

$9.00

Hospital Charge Code	8000812
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

TUBE LEVINE 12/16FR *******

Facility

$9.00

Hospital Charge Code	8000812
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
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	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

TUBE LEVINE 12FR

Facility

$7.25

Hospital Charge Code	270302315
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

Know your out-of-pocket cost for care.

All Charges