Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH CUFFL #4 NON-FEN

Facility

$388.85

Hospital Charge Code	270600037
Hospital Revenue Code	272
Min. Negotiated Rate	$58.33
Max. Negotiated Rate	$58.33
Rate for Payer: Qualcare PPO/HMO/WC	$58.33

TUBE TRACH CUFFL 5.0

Facility

$1,189.00

Service Code	HCPCS A4622
Hospital Charge Code	270600884
Hospital Revenue Code	274
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$287.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.74
Rate for Payer: Qualcare PPO/HMO/WC	$178.35

TUBE TRACH CUFFL 5.0

Facility

$1,189.00

Service Code	HCPCS A4622
Hospital Charge Code	270600884
Hospital Revenue Code	274
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$594.50
Rate for Payer: Aetna Commercial	$356.70
Rate for Payer: Aetna Medicare Advantage	$356.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.19
Rate for Payer: Cigna Commercial	$594.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.74
Rate for Payer: Qualcare PPO/HMO/WC	$178.35

TUBE TRACH CUFFL #6 FEN

Facility

$408.85

Hospital Charge Code	270600048
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 #6 FEN

Facility

$408.85

Hospital Charge Code	270600048
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 #6 NON-FEN

Facility

$388.85

Hospital Charge Code	270600040
Hospital Revenue Code	274
Min. Negotiated Rate	$58.33
Max. Negotiated Rate	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.10
Rate for Payer: Qualcare PPO/HMO/WC	$58.33

TUBE TRACH CUFFL #6 NON-FEN

Facility

$388.85

Hospital Charge Code	270600040
Hospital Revenue Code	274
Min. Negotiated Rate	$58.33
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) NJ Health	$77.77
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	$94.10
Rate for Payer: Qualcare PPO/HMO/WC	$58.33

TUBE TRACH CUFFL #8 FEN

Facility

$511.00

Service Code	HCPCS A4622
Hospital Charge Code	270600050
Hospital Revenue Code	274
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$255.50
Rate for Payer: Aetna Commercial	$153.30
Rate for Payer: Aetna Medicare Advantage	$153.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.31
Rate for Payer: Cigna Commercial	$255.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.66
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

TUBE TRACH CUFFL #8 FEN

Facility

$511.00

Service Code	HCPCS A4622
Hospital Charge Code	270600050
Hospital Revenue Code	274
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$123.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.66
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

TUBE TRACH CUFFL #8 NON-FEN

Facility

$486.00

Service Code	HCPCS A4622
Hospital Charge Code	270600042
Hospital Revenue Code	274
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$243.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.61
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

TUBE TRACH CUFFL #8 NON-FEN

Facility

$486.00

Service Code	HCPCS A4622
Hospital Charge Code	270600042
Hospital Revenue Code	274
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$117.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.61
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

TUBE TRACH CUFFLESS 6CFN

Facility

$222.45

Hospital Charge Code	270646379
Hospital Revenue Code	271
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$111.22
Rate for Payer: Aetna Commercial	$66.73
Rate for Payer: Aetna Medicare Advantage	$66.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.72
Rate for Payer: Cigna Commercial	$111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.92
Rate for Payer: Oxford Commercial	$111.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.37
Rate for Payer: UnitedHealthcare Commercial	$111.22

TUBE TRACH CUFFLESS 6CFN

Facility

$222.45

Hospital Charge Code	270646379
Hospital Revenue Code	271
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$33.37
Rate for Payer: Qualcare PPO/HMO/WC	$33.37

TUBE TRACH CUFFLESS FE 8 8DCFN

Facility

$173.65

Hospital Charge Code	270302423
Hospital Revenue Code	272
Min. Negotiated Rate	$26.05
Max. Negotiated Rate	$26.05
Rate for Payer: Qualcare PPO/HMO/WC	$26.05

TUBE TRACH CUFFLESS FE 8 8DCFN

Facility

$173.65

Hospital Charge Code	270302423
Hospital Revenue Code	272
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$86.83
Rate for Payer: Aetna Commercial	$52.09
Rate for Payer: Aetna Medicare Advantage	$52.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.28
Rate for Payer: Cigna Commercial	$86.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.57
Rate for Payer: Oxford Commercial	$86.83
Rate for Payer: Qualcare PPO/HMO/WC	$26.05
Rate for Payer: UnitedHealthcare Commercial	$86.83

TUBE TRACH CUFFLESS FEN 10DCFN

Facility

$186.90

Hospital Charge Code	270302424
Hospital Revenue Code	272
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$93.45
Rate for Payer: Aetna Commercial	$56.07
Rate for Payer: Aetna Medicare Advantage	$56.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.66
Rate for Payer: Cigna Commercial	$93.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$93.45
Rate for Payer: Qualcare PPO/HMO/WC	$28.04
Rate for Payer: UnitedHealthcare Commercial	$93.45

TUBE TRACH CUFFLESS FEN 10DCFN

Facility

$186.90

Hospital Charge Code	270302424
Hospital Revenue Code	272
Min. Negotiated Rate	$28.04
Max. Negotiated Rate	$28.04
Rate for Payer: Qualcare PPO/HMO/WC	$28.04

TUBE TRACH CUFFLESS FENS 6DCFN

Facility

$232.05

Hospital Charge Code	270302422
Hospital Revenue Code	272
Min. Negotiated Rate	$34.81
Max. Negotiated Rate	$34.81
Rate for Payer: Qualcare PPO/HMO/WC	$34.81

TUBE TRACH CUFFLESS FENS 6DCFN

Facility

$232.05

Hospital Charge Code	270302422
Hospital Revenue Code	272
Min. Negotiated Rate	$30.17
Max. Negotiated Rate	$116.03
Rate for Payer: Aetna Commercial	$69.61
Rate for Payer: Aetna Medicare Advantage	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.17
Rate for Payer: Cigna Commercial	$116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.17
Rate for Payer: Oxford Commercial	$116.03
Rate for Payer: Qualcare PPO/HMO/WC	$34.81
Rate for Payer: UnitedHealthcare Commercial	$116.03

TUBE TRACH CUFFLESS FNES 4DCFN

Facility

$229.85

Hospital Charge Code	270302421
Hospital Revenue Code	272
Min. Negotiated Rate	$34.48
Max. Negotiated Rate	$34.48
Rate for Payer: Qualcare PPO/HMO/WC	$34.48

TUBE TRACH CUFFLESS FNES 4DCFN

Facility

$229.85

Hospital Charge Code	270302421
Hospital Revenue Code	272
Min. Negotiated Rate	$29.88
Max. Negotiated Rate	$114.92
Rate for Payer: Aetna Commercial	$68.95
Rate for Payer: Aetna Medicare Advantage	$68.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.61
Rate for Payer: Cigna Commercial	$114.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.88
Rate for Payer: Oxford Commercial	$114.92
Rate for Payer: Qualcare PPO/HMO/WC	$34.48
Rate for Payer: UnitedHealthcare Commercial	$114.92

TUBE TRACH CUFFLESS N/F 4DCFS

Facility

$182.05

Hospital Charge Code	270602428
Hospital Revenue Code	272
Min. Negotiated Rate	$23.67
Max. Negotiated Rate	$91.03
Rate for Payer: Aetna Commercial	$54.62
Rate for Payer: Aetna Medicare Advantage	$54.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.42
Rate for Payer: Cigna Commercial	$91.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.67
Rate for Payer: Oxford Commercial	$91.03
Rate for Payer: Qualcare PPO/HMO/WC	$27.31
Rate for Payer: UnitedHealthcare Commercial	$91.03

TUBE TRACH CUFFLESS N/F 4DCFS

Facility

$182.05

Hospital Charge Code	270602428
Hospital Revenue Code	272
Min. Negotiated Rate	$27.31
Max. Negotiated Rate	$27.31
Rate for Payer: Qualcare PPO/HMO/WC	$27.31

TUBE TRACH CUFFLESS N/F 8DCFS

Facility

$176.75

Hospital Charge Code	270602430
Hospital Revenue Code	272
Min. Negotiated Rate	$22.98
Max. Negotiated Rate	$88.38
Rate for Payer: Aetna Commercial	$53.02
Rate for Payer: Aetna Medicare Advantage	$53.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.07
Rate for Payer: Cigna Commercial	$88.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.98
Rate for Payer: Oxford Commercial	$88.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.51
Rate for Payer: UnitedHealthcare Commercial	$88.38

TUBE TRACH CUFFLESS N/F 8DCFS

Facility

$176.75

Hospital Charge Code	270602430
Hospital Revenue Code	272
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$26.51
Rate for Payer: Qualcare PPO/HMO/WC	$26.51

Know your out-of-pocket cost for care.

All Charges