Heights University Hospital

All Charges

Charge

Type

Setting

Price

WAFER DURA PRECUT 1 1/4

Facility

$56.00

Hospital Charge Code	270303185
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 1 1/4

Facility

$56.00

Hospital Charge Code	270303185
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

WAFER DURA PRECUT 7/8

Facility

$56.00

Hospital Charge Code	270303182
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 7/8

Facility

$56.00

Hospital Charge Code	270303182
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

WAFER FLEX 2-3/4

Facility

$9.97

Hospital Charge Code	270648562
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

WAFER FLEX 2-3/4

Facility

$9.97

Hospital Charge Code	270648562
Hospital Revenue Code	270
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$4.99
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$4.99

WAFER STOMA 4 401906

Facility

$11.75

Service Code	HCPCS A4415
Hospital Charge Code	270303151
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.76

WAFER STOMA 4 401906

Facility

$11.75

Service Code	HCPCS A4415
Hospital Charge Code	270303151
Hospital Revenue Code	272
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$8.55
Rate for Payer: Aetna Commercial	$3.52
Rate for Payer: Aetna Medicare Advantage	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$8.55
Rate for Payer: Cigna Medicare Advantage	$5.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$5.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.76
Rate for Payer: UnitedHealthcare Commercial	$5.88

WAFER STOMAHESIVE 2-3/4

Facility

$14.78

Hospital Charge Code	270649672
Hospital Revenue Code	270
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.22

WAFER STOMAHESIVE 2-3/4

Facility

$14.78

Hospital Charge Code	270649672
Hospital Revenue Code	270
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$7.39
Rate for Payer: Aetna Commercial	$4.43
Rate for Payer: Aetna Medicare Advantage	$4.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.77
Rate for Payer: Cigna Commercial	$7.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$2.22
Rate for Payer: UnitedHealthcare Commercial	$7.39

WAFER UROSTOMY 1 1/2

Facility

$40.85

Hospital Charge Code	270303178
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$12.26
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.31
Rate for Payer: Oxford Commercial	$20.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$20.43

WAFER UROSTOMY 1 1/2

Facility

$40.85

Hospital Charge Code	270303178
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WAFER UROSTOMY 1 3/4

Facility

$40.85

Hospital Charge Code	270303179
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WAFER UROSTOMY 1 3/4

Facility

$40.85

Hospital Charge Code	270303179
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$12.26
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.31
Rate for Payer: Oxford Commercial	$20.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$20.43

WAFER UROSTOMY 2 3/4

Facility

$52.85

Hospital Charge Code	270303181
Hospital Revenue Code	272
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

WAFER UROSTOMY 2 3/4

Facility

$52.85

Hospital Charge Code	270303181
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$26.43
Rate for Payer: Aetna Commercial	$15.86
Rate for Payer: Aetna Medicare Advantage	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.48
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.87
Rate for Payer: Oxford Commercial	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Commercial	$26.43

WAGENSTEEN MACHINE

Facility

$63.25

Hospital Charge Code	2708002164
Hospital Revenue Code	279
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

WAGENSTEEN MACHINE

Facility

$63.25

Hospital Charge Code	2708002164
Hospital Revenue Code	279
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

WAGNER CONE 125DEG 15MM

Facility

$19,367.45

Service Code	HCPCS C1776
Hospital Charge Code	270706204
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.12
Max. Negotiated Rate	$9,683.73
Rate for Payer: Aetna Commercial	$5,810.23
Rate for Payer: Aetna Medicare Advantage	$5,810.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,938.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,938.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,873.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,938.70
Rate for Payer: Cigna Commercial	$9,683.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,686.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.12

WAGNER CONE 125DEG 15MM

Facility

$19,367.45

Service Code	HCPCS C1776
Hospital Charge Code	270706204
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.12
Max. Negotiated Rate	$4,686.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,873.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,686.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.12

WAGNER CONE 135DEG 17MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270686379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,619.00
Max. Negotiated Rate	$4,225.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00

WAGNER CONE 135DEG 17MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270686379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,619.00
Max. Negotiated Rate	$8,730.00
Rate for Payer: Aetna Commercial	$5,238.00
Rate for Payer: Aetna Medicare Advantage	$5,238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,452.30
Rate for Payer: Cigna Commercial	$8,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00

WAGNER SL REVISION DIA16/190

Facility

$30,870.45

Service Code	HCPCS C1776
Hospital Charge Code	270704225
Hospital Revenue Code	278
Min. Negotiated Rate	$4,630.57
Max. Negotiated Rate	$15,435.23
Rate for Payer: Aetna Commercial	$9,261.14
Rate for Payer: Aetna Medicare Advantage	$9,261.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,871.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,871.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,174.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,871.96
Rate for Payer: Cigna Commercial	$15,435.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,470.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,630.57

Know your out-of-pocket cost for care.

All Charges