Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE MIC-KEY GASTRO 18FR 4.0cm

Facility

$841.20

Hospital Charge Code	270672281
Hospital Revenue Code	272
Min. Negotiated Rate	$126.18
Max. Negotiated Rate	$126.18
Rate for Payer: Qualcare PPO/HMO/WC	$126.18

TUBE MIC-KEY GASTRO 18FR 4.0cm

Facility

$841.20

Hospital Charge Code	270672281
Hospital Revenue Code	272
Min. Negotiated Rate	$109.36
Max. Negotiated Rate	$420.60
Rate for Payer: Aetna Commercial	$252.36
Rate for Payer: Aetna Medicare Advantage	$252.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.51
Rate for Payer: Cigna Commercial	$420.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.36
Rate for Payer: Oxford Commercial	$420.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.18
Rate for Payer: UnitedHealthcare Commercial	$420.60

TUBE MICKY G 20FX4 0 01202040

Facility

$540.75

Hospital Charge Code	270637752
Hospital Revenue Code	272
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$81.11
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

TUBE MICKY G 20FX4 0 01202040

Facility

$540.75

Hospital Charge Code	270637752
Hospital Revenue Code	272
Min. Negotiated Rate	$70.30
Max. Negotiated Rate	$270.38
Rate for Payer: Aetna Commercial	$162.22
Rate for Payer: Aetna Medicare Advantage	$162.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.89
Rate for Payer: Cigna Commercial	$270.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.30
Rate for Payer: Oxford Commercial	$270.38
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Commercial	$270.38

TUBE MILLER ABBOTT 16FR

Facility

$651.25

Hospital Charge Code	270606390
Hospital Revenue Code	272
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$97.69
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

TUBE MILLER ABBOTT 16FR

Facility

$651.25

Hospital Charge Code	270606390
Hospital Revenue Code	272
Min. Negotiated Rate	$84.66
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$195.38
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.66
Rate for Payer: Oxford Commercial	$325.62
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Commercial	$325.62

TUBE MILLER ABBOTT 16FR***

Facility

$140.00

Hospital Charge Code	8001083
Hospital Revenue Code	279
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.20
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$70.00

TUBE MILLER ABBOTT 16FR***

Facility

$140.00

Hospital Charge Code	8001083
Hospital Revenue Code	279
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

TUBE MINNESOTA****

Facility

$344.00

Hospital Charge Code	8001075
Hospital Revenue Code	279
Min. Negotiated Rate	$44.72
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$103.20
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.60
Rate for Payer: UnitedHealthcare Commercial	$172.00

TUBE MINNESOTA****

Facility

$344.00

Hospital Charge Code	8001075
Hospital Revenue Code	279
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

TUBE MINNESOTA 4 LUMEN 18FR

Facility

$3,028.85

Hospital Charge Code	270607548
Hospital Revenue Code	270
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$1,514.42
Rate for Payer: Aetna Commercial	$908.65
Rate for Payer: Aetna Medicare Advantage	$908.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$772.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$772.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$772.36
Rate for Payer: Cigna Commercial	$1,514.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.75
Rate for Payer: Oxford Commercial	$1,514.42
Rate for Payer: Qualcare PPO/HMO/WC	$454.33
Rate for Payer: UnitedHealthcare Commercial	$1,514.42

TUBE MINNESOTA 4 LUMEN 18FR

Facility

$3,028.85

Hospital Charge Code	270607548
Hospital Revenue Code	270
Min. Negotiated Rate	$454.33
Max. Negotiated Rate	$454.33
Rate for Payer: Qualcare PPO/HMO/WC	$454.33

TUBE MIRCO W/MICROGARD EDTA

Facility

$114.90

Hospital Charge Code	270663954
Hospital Revenue Code	270
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$17.23
Rate for Payer: Qualcare PPO/HMO/WC	$17.23

TUBE MIRCO W/MICROGARD EDTA

Facility

$114.90

Hospital Charge Code	270663954
Hospital Revenue Code	270
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$57.45
Rate for Payer: Aetna Commercial	$34.47
Rate for Payer: Aetna Medicare Advantage	$34.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.30
Rate for Payer: Cigna Commercial	$57.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.94
Rate for Payer: Oxford Commercial	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$17.23
Rate for Payer: UnitedHealthcare Commercial	$57.45

TUBE MOSS GASTRO 18FR 18

Facility

$2,882.45

Hospital Charge Code	270605618
Hospital Revenue Code	272
Min. Negotiated Rate	$432.37
Max. Negotiated Rate	$432.37
Rate for Payer: Qualcare PPO/HMO/WC	$432.37

TUBE MOSS GASTRO 18FR 18

Facility

$2,882.45

Hospital Charge Code	270605618
Hospital Revenue Code	272
Min. Negotiated Rate	$374.72
Max. Negotiated Rate	$1,441.22
Rate for Payer: Aetna Commercial	$864.74
Rate for Payer: Aetna Medicare Advantage	$864.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.02
Rate for Payer: Cigna Commercial	$1,441.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.72
Rate for Payer: Oxford Commercial	$1,441.22
Rate for Payer: Qualcare PPO/HMO/WC	$432.37
Rate for Payer: UnitedHealthcare Commercial	$1,441.22

TUBE MOSS GASTROST 5-17722****

Facility

$1,171.00

Hospital Charge Code	1604388
Hospital Revenue Code	272
Min. Negotiated Rate	$175.65
Max. Negotiated Rate	$175.65
Rate for Payer: Qualcare PPO/HMO/WC	$175.65

TUBE MOSS GASTROST 5-17722****

Facility

$1,171.00

Hospital Charge Code	1604388
Hospital Revenue Code	272
Min. Negotiated Rate	$152.23
Max. Negotiated Rate	$585.50
Rate for Payer: Aetna Commercial	$351.30
Rate for Payer: Aetna Medicare Advantage	$351.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.61
Rate for Payer: Cigna Commercial	$585.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.23
Rate for Payer: Oxford Commercial	$585.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.65
Rate for Payer: UnitedHealthcare Commercial	$585.50

TUBE MYRINGOTOMY STR SHANK FLU

Facility

$176.00

Hospital Charge Code	270655886
Hospital Revenue Code	271
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

TUBE MYRINGOTOMY STR SHANK FLU

Facility

$176.00

Hospital Charge Code	270655886
Hospital Revenue Code	271
Min. Negotiated Rate	$22.88
Max. Negotiated Rate	$88.00
Rate for Payer: Aetna Commercial	$52.80
Rate for Payer: Aetna Medicare Advantage	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.88
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$88.00

TUBE NASAL MARK IV87167 MOSS**

Facility

$972.00

Hospital Charge Code	1604396
Hospital Revenue Code	272
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$145.80
Rate for Payer: Qualcare PPO/HMO/WC	$145.80

TUBE NASAL MARK IV87167 MOSS**

Facility

$972.00

Hospital Charge Code	1604396
Hospital Revenue Code	272
Min. Negotiated Rate	$126.36
Max. Negotiated Rate	$486.00
Rate for Payer: Aetna Commercial	$291.60
Rate for Payer: Aetna Medicare Advantage	$291.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.86
Rate for Payer: Cigna Commercial	$486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.36
Rate for Payer: Oxford Commercial	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.80
Rate for Payer: UnitedHealthcare Commercial	$486.00

TUBE NASAL RAE ENDOTRACH 6.0

Facility

$23.55

Hospital Charge Code	270677053
Hospital Revenue Code	272
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$11.78
Rate for Payer: Aetna Commercial	$7.07
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$11.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$11.78

TUBE NASAL RAE ENDOTRACH 6.0

Facility

$23.55

Hospital Charge Code	270677053
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

TUBE NASAL RAE ENDOTRACH 6.5

Facility

$23.55

Hospital Charge Code	270677054
Hospital Revenue Code	272
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$11.78
Rate for Payer: Aetna Commercial	$7.07
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$11.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$11.78

Know your out-of-pocket cost for care.

All Charges