Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBERCULIN INJ 5ML

Facility

$43.55

Hospital Charge Code	6009112
Hospital Revenue Code	250
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.11
Rate for Payer: Cigna Commercial	$21.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$21.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.53
Rate for Payer: UnitedHealthcare Commercial	$21.77

TUBERCULIN SKIN TEST 5TU

Facility

$3.20

Hospital Charge Code	6022909
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

TUBERCULIN SKIN TEST 5TU

Facility

$3.20

Hospital Charge Code	6022909
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

TUBERCULOSIS PPD INTRDERM TEST

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	9400185
Hospital Revenue Code	302
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

TUBERCULOSIS PPD INTRDERM TEST

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	9400185
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TUBE RECTAL 18FR

Facility

$4.45

Hospital Charge Code	270649940
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$2.23
Rate for Payer: Aetna Commercial	$1.33
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.58
Rate for Payer: Oxford Commercial	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.67
Rate for Payer: UnitedHealthcare Commercial	$2.23

TUBE RECTAL 18FR

Facility

$4.45

Hospital Charge Code	270649940
Hospital Revenue Code	270
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Qualcare PPO/HMO/WC	$0.67

TUBE RECTAL TUBE 24FR

Facility

$9.65

Hospital Charge Code	270302310
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

TUBE RECTAL TUBE 24FR

Facility

$9.65

Hospital Charge Code	270302310
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

TUBE REPLACEMENT

Facility

$1,000.00

Hospital Charge Code	1001161
Hospital Revenue Code	360
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

TUBE REPLACEMENT

Facility

$1,000.00

Hospital Charge Code	1001161
Hospital Revenue Code	360
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

TUBE SALEM SUMP ********

Facility

$34.00

Hospital Charge Code	8000838
Hospital Revenue Code	279
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

TUBE SALEM SUMP ********

Facility

$34.00

Hospital Charge Code	8000838
Hospital Revenue Code	279
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$17.00

TUBE SALEM SUMP 06200046180

Facility

$18.29

Hospital Charge Code	270302275
Hospital Revenue Code	272
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$9.14
Rate for Payer: Aetna Commercial	$5.49
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.66
Rate for Payer: Cigna Commercial	$9.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.38
Rate for Payer: Oxford Commercial	$9.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.74
Rate for Payer: UnitedHealthcare Commercial	$9.14

TUBE SALEM SUMP 06200046180

Facility

$18.29

Hospital Charge Code	270302275
Hospital Revenue Code	272
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$2.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.74

TUBE SALEM SUMP 12FR 48

Facility

$7.97

Service Code	HCPCS C1729
Hospital Charge Code	270649983
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

TUBE SALEM SUMP 12FR 48

Facility

$7.97

Service Code	HCPCS C1729
Hospital Charge Code	270649983
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$2.39
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$3.98

TUBE SALEM SUMP 14FR

Facility

$8.04

Service Code	HCPCS C1729
Hospital Charge Code	270649982
Hospital Revenue Code	278
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

TUBE SALEM SUMP 14FR

Facility

$8.04

Service Code	HCPCS C1729
Hospital Charge Code	270649982
Hospital Revenue Code	278
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$4.02
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

TUBE SALEM SUMP 16FR

Facility

$8.04

Hospital Charge Code	270649942
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.02
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.02

TUBE SALEM SUMP 16FR

Facility

$8.04

Hospital Charge Code	270649942
Hospital Revenue Code	270
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

TUBE SALEM SUMP 16FR 48

Facility

$5.63

Hospital Charge Code	270649981
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

TUBE SALEM SUMP 16FR 48

Facility

$5.63

Hospital Charge Code	270649981
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$2.81

TUBE SALEM SUMP 18FR

Facility

$8.04

Hospital Charge Code	270649939
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

TUBE SALEM SUMP 18FR

Facility

$8.04

Hospital Charge Code	270649939
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.02
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.02

Know your out-of-pocket cost for care.

All Charges