Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUBE TRACH NAS CUF 7.0 5-12614

Facility

$134.20

Hospital Charge Code	270634800
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 7.0 5-12614

Facility

$134.20

Hospital Charge Code	270634800
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 NASL CUF 7.5 512615

Facility

$169.25

Hospital Charge Code	270608894
Hospital Revenue Code	272
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$84.62
Rate for Payer: Aetna Commercial	$50.77
Rate for Payer: Aetna Medicare Advantage	$50.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.16
Rate for Payer: Cigna Commercial	$84.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.00
Rate for Payer: Oxford Commercial	$84.62
Rate for Payer: Qualcare PPO/HMO/WC	$25.39
Rate for Payer: UnitedHealthcare Commercial	$84.62

TUBE TRACH NASL CUF 7.5 512615

Facility

$169.25

Hospital Charge Code	270608894
Hospital Revenue Code	272
Min. Negotiated Rate	$25.39
Max. Negotiated Rate	$25.39
Rate for Payer: Qualcare PPO/HMO/WC	$25.39

TUBE TRACH NSL CFF 6MM

Facility

$107.00

Service Code	HCPCS A4622
Hospital Charge Code	270608607
Hospital Revenue Code	274
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

TUBE TRACH NSL CFF 6MM

Facility

$107.00

Service Code	HCPCS A4622
Hospital Charge Code	270608607
Hospital Revenue Code	274
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$25.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

TUBE TRACH ORAL CUFF 6.5

Facility

$63.25

Hospital Charge Code	270600895
Hospital Revenue Code	272
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$18.98
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$31.62

TUBE TRACH ORAL CUFF 6.5

Facility

$63.25

Hospital Charge Code	270600895
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

TUBE TRACH ORAL CUFF 6.6

Facility

$63.25

Hospital Charge Code	270600894
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

TUBE TRACH ORAL CUFF 6.6

Facility

$63.25

Hospital Charge Code	270600894
Hospital Revenue Code	272
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$18.98
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$31.62

TUBE TRACH ORAL CUFF 7.0

Facility

$97.65

Hospital Charge Code	270600892
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$48.83
Rate for Payer: Aetna Commercial	$29.30
Rate for Payer: Aetna Medicare Advantage	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.90
Rate for Payer: Cigna Commercial	$48.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.69
Rate for Payer: Oxford Commercial	$48.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.65
Rate for Payer: UnitedHealthcare Commercial	$48.83

TUBE TRACH ORAL CUFF 7.0

Facility

$97.65

Hospital Charge Code	270600892
Hospital Revenue Code	272
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$14.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.65

TUBE TRACH ORAL CUFF 7.5MM

Facility

$97.65

Hospital Charge Code	270606933
Hospital Revenue Code	272
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$14.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.65

TUBE TRACH ORAL CUFF 7.5MM

Facility

$97.65

Hospital Charge Code	270606933
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$48.83
Rate for Payer: Aetna Commercial	$29.30
Rate for Payer: Aetna Medicare Advantage	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.90
Rate for Payer: Cigna Commercial	$48.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.69
Rate for Payer: Oxford Commercial	$48.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.65
Rate for Payer: UnitedHealthcare Commercial	$48.83

TUBE TRACH ORAL CUFF 8.0

Facility

$97.65

Hospital Charge Code	270600893
Hospital Revenue Code	272
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$14.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.65

TUBE TRACH ORAL CUFF 8.0

Facility

$97.65

Hospital Charge Code	270600893
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$48.83
Rate for Payer: Aetna Commercial	$29.30
Rate for Payer: Aetna Medicare Advantage	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.90
Rate for Payer: Cigna Commercial	$48.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.69
Rate for Payer: Oxford Commercial	$48.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.65
Rate for Payer: UnitedHealthcare Commercial	$48.83

TUBE TRACH ORAL CUFF 8.5

Facility

$805.65

Hospital Charge Code	270600896
Hospital Revenue Code	272
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$120.85
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

TUBE TRACH ORAL CUFF 8.5

Facility

$805.65

Hospital Charge Code	270600896
Hospital Revenue Code	272
Min. Negotiated Rate	$104.73
Max. Negotiated Rate	$402.82
Rate for Payer: Aetna Commercial	$241.69
Rate for Payer: Aetna Medicare Advantage	$241.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.44
Rate for Payer: Cigna Commercial	$402.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.73
Rate for Payer: Oxford Commercial	$402.82
Rate for Payer: Qualcare PPO/HMO/WC	$120.85
Rate for Payer: UnitedHealthcare Commercial	$402.82

TUBE TRACH ORAL RAY 6.5 CUFF

Facility

$25.65

Hospital Charge Code	270666793
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.82
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$7.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.54
Rate for Payer: Cigna Commercial	$12.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.85
Rate for Payer: UnitedHealthcare Commercial	$12.82

TUBE TRACH ORAL RAY 6.5 CUFF

Facility

$25.65

Hospital Charge Code	270666793
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$3.85

TUBE TRACH ORAL RAY 7.0 CUFF

Facility

$25.65

Hospital Charge Code	270666794
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$3.85

TUBE TRACH ORAL RAY 7.0 CUFF

Facility

$25.65

Hospital Charge Code	270666794
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.82
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$7.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.54
Rate for Payer: Cigna Commercial	$12.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.85
Rate for Payer: UnitedHealthcare Commercial	$12.82

TUBE TRACH ORAL RAY 7.5 CUFF

Facility

$25.65

Hospital Charge Code	270666795
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.82
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$7.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.54
Rate for Payer: Cigna Commercial	$12.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.85
Rate for Payer: UnitedHealthcare Commercial	$12.82

TUBE TRACH ORAL RAY 7.5 CUFF

Facility

$25.65

Hospital Charge Code	270666795
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$3.85

TUBE TRACH SGL CANN 10.0 10SCT

Facility

$147.20

Hospital Charge Code	270632649
Hospital Revenue Code	272
Min. Negotiated Rate	$22.08
Max. Negotiated Rate	$22.08
Rate for Payer: Qualcare PPO/HMO/WC	$22.08

Know your out-of-pocket cost for care.

All Charges