Heights University Hospital

All Charges

Charge

Type

Setting

Price

BRUSH MCV CMBO CATH CYTOL 1635

Facility

$842.45

Hospital Charge Code	270601178
Hospital Revenue Code	272
Min. Negotiated Rate	$126.37
Max. Negotiated Rate	$126.37
Rate for Payer: Qualcare PPO/HMO/WC	$126.37

BRUSH MCV MICRO SPEC 1650

Facility

$120.00

Hospital Charge Code	270607436
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

BRUSH MCV MICRO SPEC 1650

Facility

$120.00

Hospital Charge Code	270607436
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

BRUSH PEG CLEANING ******

Facility

$27.00

Hospital Charge Code	2300812
Hospital Revenue Code	279
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

BRUSH PEG CLEANING ******

Facility

$27.00

Hospital Charge Code	2300812
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

BRUSH SCRUB

Facility

$757.55

Hospital Charge Code	270651673
Hospital Revenue Code	272
Min. Negotiated Rate	$98.48
Max. Negotiated Rate	$378.77
Rate for Payer: Aetna Commercial	$227.26
Rate for Payer: Aetna Medicare Advantage	$227.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.18
Rate for Payer: Cigna Commercial	$378.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.48
Rate for Payer: Oxford Commercial	$378.77
Rate for Payer: Qualcare PPO/HMO/WC	$113.63
Rate for Payer: UnitedHealthcare Commercial	$378.77

BRUSH SCRUB

Facility

$757.55

Hospital Charge Code	270651673
Hospital Revenue Code	272
Min. Negotiated Rate	$113.63
Max. Negotiated Rate	$113.63
Rate for Payer: Qualcare PPO/HMO/WC	$113.63

BRUSH SCRUB ALOE W/PCMX

Facility

$1.99

Hospital Charge Code	270648959
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

BRUSH SCRUB ALOE W/PCMX

Facility

$1.99

Hospital Charge Code	270648959
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

BRUSH SCRUB W/IODINE

Facility

$1.35

Hospital Charge Code	270648960
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.68
Rate for Payer: Aetna Commercial	$0.41
Rate for Payer: Aetna Medicare Advantage	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.34
Rate for Payer: Cigna Commercial	$0.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.18
Rate for Payer: Oxford Commercial	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.68

BRUSH SCRUB W/IODINE

Facility

$1.35

Hospital Charge Code	270648960
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

BRUSH STD CHANNEL CLEANING

Facility

$8.50

Hospital Charge Code	270634058
Hospital Revenue Code	270
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.25
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna Medicare Advantage	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.17
Rate for Payer: Cigna Commercial	$4.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.10
Rate for Payer: Oxford Commercial	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$4.25

BRUSH STD CHANNEL CLEANING

Facility

$8.50

Hospital Charge Code	270634058
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BSS

Facility

$193.30

Service Code	NDC 65079550
Hospital Charge Code	606350940
Hospital Revenue Code	250
Min. Negotiated Rate	$25.13
Max. Negotiated Rate	$96.65
Rate for Payer: Aetna Commercial	$57.99
Rate for Payer: Aetna Medicare Advantage	$57.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.29
Rate for Payer: Cigna Commercial	$96.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.13
Rate for Payer: Oxford Commercial	$96.65
Rate for Payer: Qualcare PPO/HMO/WC	$29.00
Rate for Payer: UnitedHealthcare Commercial	$96.65

BSS

Facility

$193.30

Service Code	NDC 65079550
Hospital Charge Code	606350940
Hospital Revenue Code	250
Min. Negotiated Rate	$29.00
Max. Negotiated Rate	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.00

BSS 20CC *******

Facility

$28.00

Hospital Charge Code	1600766
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

BSS 20CC *******

Facility

$28.00

Hospital Charge Code	1600766
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

BSS 500ML & ALCON NDC OPHTH***

Facility

$75.00

Hospital Charge Code	1600790
Hospital Revenue Code	279
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

BSS 500ML & ALCON NDC OPHTH***

Facility

$75.00

Hospital Charge Code	1600790
Hospital Revenue Code	279
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

BSS 500ML OPHTH *******

Facility

$60.00

Hospital Charge Code	1600782
Hospital Revenue Code	279
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

BSS 500ML OPHTH *******

Facility

$60.00

Hospital Charge Code	1600782
Hospital Revenue Code	279
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BSS BRAUNSTEIN E

Facility

$107.00

Hospital Charge Code	60635600
Hospital Revenue Code	250
Min. Negotiated Rate	$13.91
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) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

BSS BRAUNSTEIN E

Facility

$107.00

Hospital Charge Code	60635600
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS BRAUNSTEIN S

Facility

$107.00

Hospital Charge Code	60635601
Hospital Revenue Code	250
Min. Negotiated Rate	$13.91
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) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

BSS BRAUNSTEIN S

Facility

$107.00

Hospital Charge Code	60635601
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

Know your out-of-pocket cost for care.

All Charges