Heights University Hospital

All Charges

Charge

Type

Setting

Price

WOUNDVAC DRSG BLACK SML 10PK

Facility

$156.54

Hospital Charge Code	270672865
Hospital Revenue Code	272
Min. Negotiated Rate	$20.35
Max. Negotiated Rate	$78.27
Rate for Payer: Aetna Commercial	$46.96
Rate for Payer: Aetna Medicare Advantage	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.92
Rate for Payer: Cigna Commercial	$78.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.35
Rate for Payer: Oxford Commercial	$78.27
Rate for Payer: Qualcare PPO/HMO/WC	$23.48
Rate for Payer: UnitedHealthcare Commercial	$78.27

WOUNDVAC DRSG BLACK SML 5PK

Facility

$172.89

Hospital Charge Code	270100010
Hospital Revenue Code	272
Min. Negotiated Rate	$25.93
Max. Negotiated Rate	$25.93
Rate for Payer: Qualcare PPO/HMO/WC	$25.93

WOUNDVAC DRSG BLACK SML 5PK

Facility

$172.89

Hospital Charge Code	270100010
Hospital Revenue Code	272
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$86.44
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$51.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.09
Rate for Payer: Cigna Commercial	$86.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.48
Rate for Payer: Oxford Commercial	$86.44
Rate for Payer: Qualcare PPO/HMO/WC	$25.93
Rate for Payer: UnitedHealthcare Commercial	$86.44

WOUNDVAC DRSG GRANUFOAM MED

Facility

$256.26

Hospital Charge Code	270655349
Hospital Revenue Code	272
Min. Negotiated Rate	$33.31
Max. Negotiated Rate	$128.13
Rate for Payer: Aetna Commercial	$76.88
Rate for Payer: Aetna Medicare Advantage	$76.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.35
Rate for Payer: Cigna Commercial	$128.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.31
Rate for Payer: Oxford Commercial	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$38.44
Rate for Payer: UnitedHealthcare Commercial	$128.13

WOUNDVAC DRSG GRANUFOAM MED

Facility

$256.26

Hospital Charge Code	270655349
Hospital Revenue Code	272
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$38.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

WOUNDVAC DRSG SILVER MEDIUM

Facility

$308.30

Hospital Charge Code	270100035
Hospital Revenue Code	272
Min. Negotiated Rate	$40.08
Max. Negotiated Rate	$154.15
Rate for Payer: Aetna Commercial	$92.49
Rate for Payer: Aetna Medicare Advantage	$92.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.62
Rate for Payer: Cigna Commercial	$154.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.08
Rate for Payer: Oxford Commercial	$154.15
Rate for Payer: Qualcare PPO/HMO/WC	$46.24
Rate for Payer: UnitedHealthcare Commercial	$154.15

WOUNDVAC DRSG SILVER MEDIUM

Facility

$308.30

Hospital Charge Code	270100035
Hospital Revenue Code	272
Min. Negotiated Rate	$46.24
Max. Negotiated Rate	$46.24
Rate for Payer: Qualcare PPO/HMO/WC	$46.24

WOUNDVAC DRSG SILVER SM

Facility

$258.45

Hospital Charge Code	270677273
Hospital Revenue Code	272
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$38.77
Rate for Payer: Qualcare PPO/HMO/WC	$38.77

WOUNDVAC DRSG SILVER SM

Facility

$258.45

Hospital Charge Code	270677273
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$129.22
Rate for Payer: Aetna Commercial	$77.53
Rate for Payer: Aetna Medicare Advantage	$77.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.90
Rate for Payer: Cigna Commercial	$129.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$129.22
Rate for Payer: Qualcare PPO/HMO/WC	$38.77
Rate for Payer: UnitedHealthcare Commercial	$129.22

WOUNDVAC DRSG WHITEFOAM SM

Facility

$51.36

Hospital Charge Code	270636063
Hospital Revenue Code	270
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

WOUNDVAC DRSG WHITEFOAM SM

Facility

$237.31

Hospital Charge Code	270641761
Hospital Revenue Code	272
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$118.66
Rate for Payer: Aetna Commercial	$71.19
Rate for Payer: Aetna Medicare Advantage	$71.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.51
Rate for Payer: Cigna Commercial	$118.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.85
Rate for Payer: Oxford Commercial	$118.66
Rate for Payer: Qualcare PPO/HMO/WC	$35.60
Rate for Payer: UnitedHealthcare Commercial	$118.66

WOUNDVAC DRSG WHITEFOAM SM

Facility

$51.36

Hospital Charge Code	270636063
Hospital Revenue Code	270
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$25.68
Rate for Payer: Aetna Commercial	$15.41
Rate for Payer: Aetna Medicare Advantage	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.10
Rate for Payer: Cigna Commercial	$25.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.68
Rate for Payer: Oxford Commercial	$25.68
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Commercial	$25.68

WOUNDVAC DRSG WHITEFOAM SM

Facility

$237.31

Hospital Charge Code	270641761
Hospital Revenue Code	272
Min. Negotiated Rate	$35.60
Max. Negotiated Rate	$35.60
Rate for Payer: Qualcare PPO/HMO/WC	$35.60

WOUNDVAC MACHINE INFOVAC

Facility

$297.25

Hospital Charge Code	270640148
Hospital Revenue Code	270
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$44.59
Rate for Payer: Qualcare PPO/HMO/WC	$44.59

WOUNDVAC MACHINE INFOVAC

Facility

$297.25

Hospital Charge Code	270640148
Hospital Revenue Code	270
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$148.62
Rate for Payer: Aetna Commercial	$89.17
Rate for Payer: Aetna Medicare Advantage	$89.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.80
Rate for Payer: Cigna Commercial	$148.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Oxford Commercial	$148.62
Rate for Payer: Qualcare PPO/HMO/WC	$44.59
Rate for Payer: UnitedHealthcare Commercial	$148.62

WOUNDVAC PICO NEG PRESS 5.9 X

Facility

$830.38

Service Code	HCPCS A6550
Hospital Charge Code	270689961
Hospital Revenue Code	270
Min. Negotiated Rate	$124.56
Max. Negotiated Rate	$124.56
Rate for Payer: Qualcare PPO/HMO/WC	$124.56

WOUNDVAC PICO NEG PRESS 5.9 X

Facility

$830.38

Service Code	HCPCS A6550
Hospital Charge Code	270689961
Hospital Revenue Code	270
Min. Negotiated Rate	$19.06
Max. Negotiated Rate	$415.19
Rate for Payer: Aetna Commercial	$249.11
Rate for Payer: Aetna Medicare Advantage	$249.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.75
Rate for Payer: Cigna Commercial	$31.76
Rate for Payer: Cigna Medicare Advantage	$19.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.95
Rate for Payer: Oxford Commercial	$415.19
Rate for Payer: Qualcare PPO/HMO/WC	$124.56
Rate for Payer: UnitedHealthcare Commercial	$415.19

WOUNDVAC TRAC PAD

Facility

$82.62

Hospital Charge Code	270100030
Hospital Revenue Code	272
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

WOUNDVAC TRAC PAD

Facility

$82.62

Hospital Charge Code	270100030
Hospital Revenue Code	272
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$41.31
Rate for Payer: Aetna Commercial	$24.79
Rate for Payer: Aetna Medicare Advantage	$24.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.07
Rate for Payer: Cigna Commercial	$41.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$41.31
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$41.31

WOUNDVAC Y CONNECTOR

Facility

$8.27

Hospital Charge Code	270100020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$4.13
Rate for Payer: Aetna Commercial	$2.48
Rate for Payer: Aetna Medicare Advantage	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.11
Rate for Payer: Cigna Commercial	$4.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$4.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$4.13

WOUNDVAC Y CONNECTOR

Facility

$8.27

Hospital Charge Code	270100020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

WRAP LEG MOIST HEAT THERAPY

Facility

$133.65

Hospital Charge Code	270649708
Hospital Revenue Code	270
Min. Negotiated Rate	$17.37
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$40.09
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.37
Rate for Payer: Oxford Commercial	$66.83
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$66.83

WRAP LEG MOIST HEAT THERAPY

Facility

$133.65

Hospital Charge Code	270649708
Hospital Revenue Code	270
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

WRAP LEG STERILE

Facility

$190.00

Hospital Charge Code	270668485
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

WRAP LEG STERILE

Facility

$190.00

Hospital Charge Code	270668485
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

Know your out-of-pocket cost for care.

All Charges