Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH FENESTRATED SZ10

Facility

$210.15

Hospital Charge Code	270649902
Hospital Revenue Code	270
Min. Negotiated Rate	$27.32
Max. Negotiated Rate	$105.08
Rate for Payer: Aetna Commercial	$63.05
Rate for Payer: Aetna Medicare Advantage	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.59
Rate for Payer: Cigna Commercial	$105.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.32
Rate for Payer: Oxford Commercial	$105.08
Rate for Payer: Qualcare PPO/HMO/WC	$31.52
Rate for Payer: UnitedHealthcare Commercial	$105.08

TUBE TRACH FENESTRATED SZ8

Facility

$207.15

Hospital Charge Code	270649904
Hospital Revenue Code	272
Min. Negotiated Rate	$31.07
Max. Negotiated Rate	$31.07
Rate for Payer: Qualcare PPO/HMO/WC	$31.07

TUBE TRACH FENESTRATED SZ8

Facility

$207.15

Hospital Charge Code	270649904
Hospital Revenue Code	272
Min. Negotiated Rate	$26.93
Max. Negotiated Rate	$103.58
Rate for Payer: Aetna Commercial	$62.15
Rate for Payer: Aetna Medicare Advantage	$62.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.82
Rate for Payer: Cigna Commercial	$103.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.93
Rate for Payer: Oxford Commercial	$103.58
Rate for Payer: Qualcare PPO/HMO/WC	$31.07
Rate for Payer: UnitedHealthcare Commercial	$103.58

TUBE TRACH FENEST SZ 4

Facility

$604.00

Hospital Charge Code	270302410
Hospital Revenue Code	272
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

TUBE TRACH FENEST SZ 4

Facility

$604.00

Hospital Charge Code	270302410
Hospital Revenue Code	272
Min. Negotiated Rate	$78.52
Max. Negotiated Rate	$302.00
Rate for Payer: Aetna Commercial	$181.20
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.02
Rate for Payer: Cigna Commercial	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.52
Rate for Payer: Oxford Commercial	$302.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$302.00

TUBE TRACH FENEST SZ 6

Facility

$604.00

Hospital Charge Code	270302415
Hospital Revenue Code	270
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

TUBE TRACH FENEST SZ 6

Facility

$604.00

Hospital Charge Code	270302415
Hospital Revenue Code	270
Min. Negotiated Rate	$78.52
Max. Negotiated Rate	$302.00
Rate for Payer: Aetna Commercial	$181.20
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.02
Rate for Payer: Cigna Commercial	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.52
Rate for Payer: Oxford Commercial	$302.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$302.00

TUBE TRACH FENEST SZ 8

Facility

$308.15

Hospital Charge Code	270302420
Hospital Revenue Code	272
Min. Negotiated Rate	$46.22
Max. Negotiated Rate	$46.22
Rate for Payer: Qualcare PPO/HMO/WC	$46.22

TUBE TRACH FENEST SZ 8

Facility

$308.15

Hospital Charge Code	270302420
Hospital Revenue Code	272
Min. Negotiated Rate	$40.06
Max. Negotiated Rate	$154.07
Rate for Payer: Aetna Commercial	$92.44
Rate for Payer: Aetna Medicare Advantage	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.58
Rate for Payer: Cigna Commercial	$154.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.06
Rate for Payer: Oxford Commercial	$154.07
Rate for Payer: Qualcare PPO/HMO/WC	$46.22
Rate for Payer: UnitedHealthcare Commercial	$154.07

TUBE TRACH FOME CUFF 8MM

Facility

$831.00

Service Code	HCPCS A4622
Hospital Charge Code	270600632
Hospital Revenue Code	274
Min. Negotiated Rate	$124.65
Max. Negotiated Rate	$201.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.10
Rate for Payer: Qualcare PPO/HMO/WC	$124.65

TUBE TRACH FOME CUFF 8MM

Facility

$831.00

Service Code	HCPCS A4622
Hospital Charge Code	270600632
Hospital Revenue Code	274
Min. Negotiated Rate	$124.65
Max. Negotiated Rate	$415.50
Rate for Payer: Aetna Commercial	$249.30
Rate for Payer: Aetna Medicare Advantage	$249.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.91
Rate for Payer: Cigna Commercial	$415.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.10
Rate for Payer: Qualcare PPO/HMO/WC	$124.65

TUBE TRACH INNER CANN 8 8DIC

Facility

$151.25

Hospital Charge Code	270302427
Hospital Revenue Code	272
Min. Negotiated Rate	$19.66
Max. Negotiated Rate	$75.62
Rate for Payer: Aetna Commercial	$45.38
Rate for Payer: Aetna Medicare Advantage	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.57
Rate for Payer: Cigna Commercial	$75.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.66
Rate for Payer: Oxford Commercial	$75.62
Rate for Payer: Qualcare PPO/HMO/WC	$22.69
Rate for Payer: UnitedHealthcare Commercial	$75.62

TUBE TRACH INNER CANN 8 8DIC

Facility

$151.25

Hospital Charge Code	270302427
Hospital Revenue Code	272
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$22.69

TUBE TRACH INNER CANN 8 8DIC**

Facility

$189.00

Hospital Charge Code	270602427
Hospital Revenue Code	274
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$56.70
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

TUBE TRACH INNER CANN 8 8DIC**

Facility

$189.00

Hospital Charge Code	270602427
Hospital Revenue Code	274
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$45.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

TUBE TRACH LOW PRESS SZ 6 6LPC

Facility

$573.65

Hospital Charge Code	270302385
Hospital Revenue Code	272
Min. Negotiated Rate	$74.57
Max. Negotiated Rate	$286.82
Rate for Payer: Aetna Commercial	$172.09
Rate for Payer: Aetna Medicare Advantage	$172.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.28
Rate for Payer: Cigna Commercial	$286.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.57
Rate for Payer: Oxford Commercial	$286.82
Rate for Payer: Qualcare PPO/HMO/WC	$86.05
Rate for Payer: UnitedHealthcare Commercial	$286.82

TUBE TRACH LOW PRESS SZ 6 6LPC

Facility

$573.65

Hospital Charge Code	270302385
Hospital Revenue Code	272
Min. Negotiated Rate	$86.05
Max. Negotiated Rate	$86.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.05

TUBE TRACH LOW PR SZ 8

Facility

$573.65

Hospital Charge Code	270302390
Hospital Revenue Code	270
Min. Negotiated Rate	$86.05
Max. Negotiated Rate	$86.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.05

TUBE TRACH LOW PR SZ 8

Facility

$573.65

Hospital Charge Code	270302390
Hospital Revenue Code	270
Min. Negotiated Rate	$74.57
Max. Negotiated Rate	$286.82
Rate for Payer: Aetna Commercial	$172.09
Rate for Payer: Aetna Medicare Advantage	$172.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.28
Rate for Payer: Cigna Commercial	$286.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.57
Rate for Payer: Oxford Commercial	$286.82
Rate for Payer: Qualcare PPO/HMO/WC	$86.05
Rate for Payer: UnitedHealthcare Commercial	$286.82

TUBE TRACH NAS 6.5 CUF 5-22313

Facility

$31.65

Hospital Charge Code	270614231
Hospital Revenue Code	272
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$15.82
Rate for Payer: Aetna Commercial	$9.49
Rate for Payer: Aetna Medicare Advantage	$9.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.07
Rate for Payer: Cigna Commercial	$15.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.11
Rate for Payer: Oxford Commercial	$15.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$15.82

TUBE TRACH NAS 6.5 CUF 5-22313

Facility

$31.65

Hospital Charge Code	270614231
Hospital Revenue Code	272
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

TUBE TRACH NAS CUF 6.0 5-12612

Facility

$134.20

Hospital Charge Code	270634798
Hospital Revenue Code	272
Min. Negotiated Rate	$17.45
Max. Negotiated Rate	$67.10
Rate for Payer: Aetna Commercial	$40.26
Rate for Payer: Aetna Medicare Advantage	$40.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$67.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.45
Rate for Payer: Oxford Commercial	$67.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.13
Rate for Payer: UnitedHealthcare Commercial	$67.10

TUBE TRACH NAS CUF 6.0 5-12612

Facility

$134.20

Hospital Charge Code	270634798
Hospital Revenue Code	272
Min. Negotiated Rate	$20.13
Max. Negotiated Rate	$20.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.13

TUBE TRACH NAS CUF 6.5 5-12613

Facility

$134.20

Hospital Charge Code	270634799
Hospital Revenue Code	272
Min. Negotiated Rate	$17.45
Max. Negotiated Rate	$67.10
Rate for Payer: Aetna Commercial	$40.26
Rate for Payer: Aetna Medicare Advantage	$40.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$67.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.45
Rate for Payer: Oxford Commercial	$67.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.13
Rate for Payer: UnitedHealthcare Commercial	$67.10

TUBE TRACH NAS CUF 6.5 5-12613

Facility

$134.20

Hospital Charge Code	270634799
Hospital Revenue Code	272
Min. Negotiated Rate	$20.13
Max. Negotiated Rate	$20.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.13

Know your out-of-pocket cost for care.

All Charges