Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH ******

Facility

$118.00

Hospital Charge Code	8001737
Hospital Revenue Code	279
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

TUBE TRACH ******

Facility

$118.00

Hospital Charge Code	8001737
Hospital Revenue Code	279
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

TUBE TRACH 14FR

Facility

$117.00

Service Code	HCPCS A4622
Hospital Charge Code	270600661
Hospital Revenue Code	274
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

TUBE TRACH 14FR

Facility

$117.00

Service Code	HCPCS A4622
Hospital Charge Code	270600661
Hospital Revenue Code	274
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$35.10
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

TUBE TRACH 6.0mm XLT UNCUFFED

Facility

$319.30

Hospital Charge Code	270643229
Hospital Revenue Code	272
Min. Negotiated Rate	$41.51
Max. Negotiated Rate	$159.65
Rate for Payer: Aetna Commercial	$95.79
Rate for Payer: Aetna Medicare Advantage	$95.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.42
Rate for Payer: Cigna Commercial	$159.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.51
Rate for Payer: Oxford Commercial	$159.65
Rate for Payer: Qualcare PPO/HMO/WC	$47.90
Rate for Payer: UnitedHealthcare Commercial	$159.65

TUBE TRACH 6.0mm XLT UNCUFFED

Facility

$319.30

Hospital Charge Code	270643229
Hospital Revenue Code	272
Min. Negotiated Rate	$47.90
Max. Negotiated Rate	$47.90
Rate for Payer: Qualcare PPO/HMO/WC	$47.90

TUBE TRACH #6DCT

Facility

$194.55

Hospital Charge Code	270649905
Hospital Revenue Code	272
Min. Negotiated Rate	$25.29
Max. Negotiated Rate	$97.28
Rate for Payer: Aetna Commercial	$58.37
Rate for Payer: Aetna Medicare Advantage	$58.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.61
Rate for Payer: Cigna Commercial	$97.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.29
Rate for Payer: Oxford Commercial	$97.28
Rate for Payer: Qualcare PPO/HMO/WC	$29.18
Rate for Payer: UnitedHealthcare Commercial	$97.28

TUBE TRACH #6DCT

Facility

$194.55

Hospital Charge Code	270649905
Hospital Revenue Code	272
Min. Negotiated Rate	$29.18
Max. Negotiated Rate	$29.18
Rate for Payer: Qualcare PPO/HMO/WC	$29.18

TUBE TRACH 7.0mm XLT CUFFED

Facility

$319.30

Hospital Charge Code	270643231
Hospital Revenue Code	272
Min. Negotiated Rate	$41.51
Max. Negotiated Rate	$159.65
Rate for Payer: Aetna Commercial	$95.79
Rate for Payer: Aetna Medicare Advantage	$95.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.42
Rate for Payer: Cigna Commercial	$159.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.51
Rate for Payer: Oxford Commercial	$159.65
Rate for Payer: Qualcare PPO/HMO/WC	$47.90
Rate for Payer: UnitedHealthcare Commercial	$159.65

TUBE TRACH 7.0mm XLT CUFFED

Facility

$319.30

Hospital Charge Code	270643231
Hospital Revenue Code	272
Min. Negotiated Rate	$47.90
Max. Negotiated Rate	$47.90
Rate for Payer: Qualcare PPO/HMO/WC	$47.90

TUBE TRACH #7 W/SINGLE CANNULA

Facility

$120.00

Hospital Charge Code	270620412
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

TUBE TRACH #7 W/SINGLE CANNULA

Facility

$120.00

Hospital Charge Code	270620412
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

TUBE TRACH 8.0 DBL CUFF 531080

Facility

$325.00

Hospital Charge Code	270617486
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

TUBE TRACH 8.0 DBL CUFF 531080

Facility

$325.00

Hospital Charge Code	270617486
Hospital Revenue Code	272
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

TUBE TRACH CUFFED 7MM

Facility

$549.85

Service Code	HCPCS A7521
Hospital Charge Code	270699906
Hospital Revenue Code	272
Min. Negotiated Rate	$40.22
Max. Negotiated Rate	$274.93
Rate for Payer: Aetna Commercial	$164.96
Rate for Payer: Aetna Medicare Advantage	$164.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.21
Rate for Payer: Cigna Commercial	$67.04
Rate for Payer: Cigna Medicare Advantage	$40.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.48
Rate for Payer: Oxford Commercial	$274.93
Rate for Payer: Qualcare PPO/HMO/WC	$82.48
Rate for Payer: UnitedHealthcare Commercial	$274.93

TUBE TRACH CUFFED 7MM

Facility

$549.85

Service Code	HCPCS A7521
Hospital Charge Code	270699906
Hospital Revenue Code	272
Min. Negotiated Rate	$82.48
Max. Negotiated Rate	$82.48
Rate for Payer: Qualcare PPO/HMO/WC	$82.48

TUBE TRACH CUFFED FEN SZ6

Facility

$250.55

Hospital Charge Code	270649903
Hospital Revenue Code	272
Min. Negotiated Rate	$32.57
Max. Negotiated Rate	$125.28
Rate for Payer: Aetna Commercial	$75.17
Rate for Payer: Aetna Medicare Advantage	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.89
Rate for Payer: Cigna Commercial	$125.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: Oxford Commercial	$125.28
Rate for Payer: Qualcare PPO/HMO/WC	$37.58
Rate for Payer: UnitedHealthcare Commercial	$125.28

TUBE TRACH CUFFED FEN SZ6

Facility

$250.55

Hospital Charge Code	270649903
Hospital Revenue Code	272
Min. Negotiated Rate	$37.58
Max. Negotiated Rate	$37.58
Rate for Payer: Qualcare PPO/HMO/WC	$37.58

TUBE TRACH CUFF FENEST SZ4

Facility

$207.65

Hospital Charge Code	270649308
Hospital Revenue Code	272
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$31.15
Rate for Payer: Qualcare PPO/HMO/WC	$31.15

TUBE TRACH CUFF FENEST SZ4

Facility

$207.65

Hospital Charge Code	270649308
Hospital Revenue Code	272
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$103.83
Rate for Payer: Aetna Commercial	$62.30
Rate for Payer: Aetna Medicare Advantage	$62.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.95
Rate for Payer: Cigna Commercial	$103.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.99
Rate for Payer: Oxford Commercial	$103.83
Rate for Payer: Qualcare PPO/HMO/WC	$31.15
Rate for Payer: UnitedHealthcare Commercial	$103.83

TUBE TRACH CUFF FENEST SZ8

Facility

$184.50

Hospital Charge Code	270649307
Hospital Revenue Code	272
Min. Negotiated Rate	$27.68
Max. Negotiated Rate	$27.68
Rate for Payer: Qualcare PPO/HMO/WC	$27.68

TUBE TRACH CUFF FENEST SZ8

Facility

$184.50

Hospital Charge Code	270649307
Hospital Revenue Code	272
Min. Negotiated Rate	$23.98
Max. Negotiated Rate	$92.25
Rate for Payer: Aetna Commercial	$55.35
Rate for Payer: Aetna Medicare Advantage	$55.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.05
Rate for Payer: Cigna Commercial	$92.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.98
Rate for Payer: Oxford Commercial	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.68
Rate for Payer: UnitedHealthcare Commercial	$92.25

TUBE TRACH CUFFL #4

Facility

$408.85

Hospital Charge Code	270600045
Hospital Revenue Code	274
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

TUBE TRACH CUFFL #4

Facility

$408.85

Hospital Charge Code	270600045
Hospital Revenue Code	274
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$122.66
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

TUBE TRACH CUFFL #4 NON-FEN

Facility

$388.85

Hospital Charge Code	270600037
Hospital Revenue Code	272
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$194.43
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$116.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.16
Rate for Payer: Cigna Commercial	$194.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.55
Rate for Payer: Oxford Commercial	$194.43
Rate for Payer: Qualcare PPO/HMO/WC	$58.33
Rate for Payer: UnitedHealthcare Commercial	$194.43

Know your out-of-pocket cost for care.

All Charges