Heights University Hospital

All Charges

Charge

Type

Setting

Price

WHITE PETRO MNRL OIL OPH OINUD

Facility

$17.95

Hospital Charge Code	60628096
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$156.52
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$361.20
Rate for Payer: Aetna Medicare Advantage	$361.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.02
Rate for Payer: Cigna Commercial	$602.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.52
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.60
Rate for Payer: UnitedHealthcare Commercial	$756.00

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$180.60
Max. Negotiated Rate	$180.60
Rate for Payer: Qualcare PPO/HMO/WC	$180.60

WHOLE BLOOD FOR TRANSFUSION

Facility

$1,584.00

Hospital Charge Code	3101499
Hospital Revenue Code	390
Min. Negotiated Rate	$237.60
Max. Negotiated Rate	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$237.60

WHOLE BLOOD FOR TRANSFUSION

Facility

$1,584.00

Hospital Charge Code	3101499
Hospital Revenue Code	390
Min. Negotiated Rate	$205.92
Max. Negotiated Rate	$792.00
Rate for Payer: Aetna Commercial	$475.20
Rate for Payer: Aetna Medicare Advantage	$475.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$403.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$403.92
Rate for Payer: Cigna Commercial	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.92
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$237.60
Rate for Payer: UnitedHealthcare Commercial	$756.00

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$78.01
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$180.01
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.01
Rate for Payer: Oxford Commercial	$300.02
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$300.02

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$78.01
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$180.01
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.01
Rate for Payer: Oxford Commercial	$300.02
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$300.02

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$93.90
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$66.88
Rate for Payer: Aetna Commercial	$40.12
Rate for Payer: Aetna Medicare Advantage	$40.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.11
Rate for Payer: Cigna Commercial	$66.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.39
Rate for Payer: Oxford Commercial	$66.88
Rate for Payer: Qualcare PPO/HMO/WC	$20.06
Rate for Payer: UnitedHealthcare Commercial	$66.88

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$20.06
Max. Negotiated Rate	$20.06
Rate for Payer: Qualcare PPO/HMO/WC	$20.06

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

WINRHO 5000U 2.5ML

Facility

$1,287.00

Hospital Charge Code	60635361
Hospital Revenue Code	636
Min. Negotiated Rate	$193.05
Max. Negotiated Rate	$311.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.45
Rate for Payer: Qualcare PPO/HMO/WC	$193.05

WINRHO 5000U 2.5ML

Facility

$1,287.00

Hospital Charge Code	60635361
Hospital Revenue Code	636
Min. Negotiated Rate	$193.05
Max. Negotiated Rate	$643.50
Rate for Payer: Aetna Commercial	$386.10
Rate for Payer: Aetna Medicare Advantage	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.19
Rate for Payer: Cigna Commercial	$643.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.45
Rate for Payer: Qualcare PPO/HMO/WC	$193.05

WIPE DISINFECTANT ANTIMICROBIL

Facility

$24.68

Hospital Charge Code	270653103
Hospital Revenue Code	270
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.70

WIPE DISINFECTANT ANTIMICROBIL

Facility

$24.68

Hospital Charge Code	270653103
Hospital Revenue Code	270
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$12.34
Rate for Payer: Aetna Commercial	$7.40
Rate for Payer: Aetna Medicare Advantage	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.29
Rate for Payer: Cigna Commercial	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.21
Rate for Payer: Oxford Commercial	$12.34
Rate for Payer: Qualcare PPO/HMO/WC	$3.70
Rate for Payer: UnitedHealthcare Commercial	$12.34

WIPE INSTRUMENT 3X3

Facility

$7.51

Hospital Charge Code	270658517
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$2.25
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.92
Rate for Payer: Cigna Commercial	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$3.75

WIPE INSTRUMENT 3X3

Facility

$7.51

Hospital Charge Code	270658517
Hospital Revenue Code	270
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

WIPE SANI HB DISINFECT

Facility

$20.58

Hospital Charge Code	270649958
Hospital Revenue Code	270
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$3.09
Rate for Payer: Qualcare PPO/HMO/WC	$3.09

WIPE SANI HB DISINFECT

Facility

$20.58

Hospital Charge Code	270649958
Hospital Revenue Code	270
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$10.29
Rate for Payer: Aetna Commercial	$6.17
Rate for Payer: Aetna Medicare Advantage	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.25
Rate for Payer: Cigna Commercial	$10.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.68
Rate for Payer: Oxford Commercial	$10.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.09
Rate for Payer: UnitedHealthcare Commercial	$10.29

WIPES BABY FRAGRANCE FREE

Facility

$148.40

Hospital Charge Code	270663231
Hospital Revenue Code	270
Min. Negotiated Rate	$19.29
Max. Negotiated Rate	$74.20
Rate for Payer: Aetna Commercial	$44.52
Rate for Payer: Aetna Medicare Advantage	$44.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.84
Rate for Payer: Cigna Commercial	$74.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.29
Rate for Payer: Oxford Commercial	$74.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.26
Rate for Payer: UnitedHealthcare Commercial	$74.20

WIPES BABY FRAGRANCE FREE

Facility

$148.40

Hospital Charge Code	270663231
Hospital Revenue Code	270
Min. Negotiated Rate	$22.26
Max. Negotiated Rate	$22.26
Rate for Payer: Qualcare PPO/HMO/WC	$22.26

Know your out-of-pocket cost for care.

All Charges