Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE ORAL RAE ENDOTRACH 5.5

Facility

$374.90

Hospital Charge Code	270656038
Hospital Revenue Code	271
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$56.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.23

TUBE ORAL RAE ENDOTRACH 5.5

Facility

$374.90

Hospital Charge Code	270656038
Hospital Revenue Code	271
Min. Negotiated Rate	$48.74
Max. Negotiated Rate	$187.45
Rate for Payer: Aetna Commercial	$112.47
Rate for Payer: Aetna Medicare Advantage	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.60
Rate for Payer: Cigna Commercial	$187.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.74
Rate for Payer: Oxford Commercial	$187.45
Rate for Payer: Qualcare PPO/HMO/WC	$56.23
Rate for Payer: UnitedHealthcare Commercial	$187.45

TUBE ORAL RAY ENDOTRACH 4

Facility

$374.90

Hospital Charge Code	270656041
Hospital Revenue Code	271
Min. Negotiated Rate	$48.74
Max. Negotiated Rate	$187.45
Rate for Payer: Aetna Commercial	$112.47
Rate for Payer: Aetna Medicare Advantage	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.60
Rate for Payer: Cigna Commercial	$187.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.74
Rate for Payer: Oxford Commercial	$187.45
Rate for Payer: Qualcare PPO/HMO/WC	$56.23
Rate for Payer: UnitedHealthcare Commercial	$187.45

TUBE ORAL RAY ENDOTRACH 4

Facility

$374.90

Hospital Charge Code	270656041
Hospital Revenue Code	271
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$56.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.23

TUBE PAD NG SEALING 452040

Facility

$3.60

Hospital Charge Code	270641266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$0.54
Rate for Payer: Qualcare PPO/HMO/WC	$0.54

TUBE PAD NG SEALING 452040

Facility

$3.60

Hospital Charge Code	270641266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.80
Rate for Payer: Cigna Commercial	$1.80
Rate for Payer: Aetna Commercial	$1.08
Rate for Payer: Aetna Medicare Advantage	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.47
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.54
Rate for Payer: UnitedHealthcare Commercial	$1.80

TUBE PHYCON UNIVENT 7.0

Facility

$700.00

Hospital Charge Code	270618607
Hospital Revenue Code	271
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

TUBE PHYCON UNIVENT 7.0

Facility

$700.00

Hospital Charge Code	270618607
Hospital Revenue Code	271
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

TUBE PHYCON UNIVNT 7.5 1202531

Facility

$996.85

Hospital Charge Code	270617224
Hospital Revenue Code	272
Min. Negotiated Rate	$149.53
Max. Negotiated Rate	$149.53
Rate for Payer: Qualcare PPO/HMO/WC	$149.53

TUBE PHYCON UNIVNT 7.5 1202531

Facility

$996.85

Hospital Charge Code	270617224
Hospital Revenue Code	272
Min. Negotiated Rate	$129.59
Max. Negotiated Rate	$498.43
Rate for Payer: Aetna Commercial	$299.06
Rate for Payer: Aetna Medicare Advantage	$299.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.20
Rate for Payer: Cigna Commercial	$498.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.59
Rate for Payer: Oxford Commercial	$498.43
Rate for Payer: Qualcare PPO/HMO/WC	$149.53
Rate for Payer: UnitedHealthcare Commercial	$498.43

TUBE PHYCON UNIVNT 8.0 1202633

Facility

$694.45

Hospital Charge Code	270617225
Hospital Revenue Code	272
Min. Negotiated Rate	$90.28
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$208.34
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.28
Rate for Payer: Oxford Commercial	$347.23
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Commercial	$347.23

TUBE PHYCON UNIVNT 8.0 1202633

Facility

$694.45

Hospital Charge Code	270617225
Hospital Revenue Code	272
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

TUBE PHYCON UNVENT 8.5 1202635

Facility

$69.50

Hospital Charge Code	270618446
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$34.75
Rate for Payer: Aetna Commercial	$20.85
Rate for Payer: Aetna Medicare Advantage	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.72
Rate for Payer: Cigna Commercial	$34.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: Oxford Commercial	$34.75
Rate for Payer: Qualcare PPO/HMO/WC	$10.43
Rate for Payer: UnitedHealthcare Commercial	$34.75

TUBE PHYCON UNVENT 8.5 1202635

Facility

$69.50

Hospital Charge Code	270618446
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.43

TUBE POLY W/SCRW CAP14-959-38C

Facility

$0.75

Hospital Charge Code	270635401
Hospital Revenue Code	272
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Qualcare PPO/HMO/WC	$0.11

TUBE POLY W/SCRW CAP14-959-38C

Facility

$0.75

Hospital Charge Code	270635401
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.38
Rate for Payer: Aetna Commercial	$0.23
Rate for Payer: Aetna Medicare Advantage	$0.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.19
Rate for Payer: Cigna Commercial	$0.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.10
Rate for Payer: Oxford Commercial	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.11
Rate for Payer: UnitedHealthcare Commercial	$0.38

TUBE QUICK CHEST TRAY 12 FR

Facility

$713.00

Hospital Charge Code	270667392
Hospital Revenue Code	272
Min. Negotiated Rate	$92.69
Max. Negotiated Rate	$356.50
Rate for Payer: UnitedHealthcare Commercial	$356.50
Rate for Payer: Aetna Commercial	$213.90
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.69
Rate for Payer: Oxford Commercial	$356.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

TUBE QUICK CHEST TRAY 12 FR

Facility

$713.00

Hospital Charge Code	270667392
Hospital Revenue Code	272
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

TUBERCULIN 5 UNITS/0.1 ML INJ

Facility

$377.88

Service Code	NDC 49281075221
Hospital Charge Code	60627883
Hospital Revenue Code	250
Min. Negotiated Rate	$49.12
Max. Negotiated Rate	$188.94
Rate for Payer: Aetna Commercial	$113.36
Rate for Payer: Aetna Medicare Advantage	$113.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.36
Rate for Payer: Cigna Commercial	$188.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.12
Rate for Payer: Oxford Commercial	$188.94
Rate for Payer: Qualcare PPO/HMO/WC	$56.68
Rate for Payer: UnitedHealthcare Commercial	$188.94

TUBERCULIN 5 UNITS/0.1 ML INJ

Facility

$377.88

Service Code	NDC 49281075221
Hospital Charge Code	60627883
Hospital Revenue Code	250
Min. Negotiated Rate	$56.68
Max. Negotiated Rate	$56.68
Rate for Payer: Qualcare PPO/HMO/WC	$56.68

TUBERCULIN INJ 1ML VIAL

Facility

$21.15

Hospital Charge Code	6009104
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

TUBERCULIN INJ 1ML VIAL

Facility

$21.15

Hospital Charge Code	6009104
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

TUBERCULIN INJ 1TU/0.1ML 5ML

Facility

$1,375.24

Service Code	NDC 49281075222
Hospital Charge Code	60627882
Hospital Revenue Code	250
Min. Negotiated Rate	$206.29
Max. Negotiated Rate	$206.29
Rate for Payer: Qualcare PPO/HMO/WC	$206.29

TUBERCULIN INJ 1TU/0.1ML 5ML

Facility

$1,375.24

Service Code	NDC 49281075222
Hospital Charge Code	60627882
Hospital Revenue Code	250
Min. Negotiated Rate	$178.78
Max. Negotiated Rate	$687.62
Rate for Payer: Aetna Commercial	$412.57
Rate for Payer: Aetna Medicare Advantage	$412.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.69
Rate for Payer: Cigna Commercial	$687.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.78
Rate for Payer: Oxford Commercial	$687.62
Rate for Payer: Qualcare PPO/HMO/WC	$206.29
Rate for Payer: UnitedHealthcare Commercial	$687.62

TUBERCULIN INJ 5ML

Facility

$43.55

Hospital Charge Code	6009112
Hospital Revenue Code	250
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.53

Know your out-of-pocket cost for care.

All Charges