Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA ENDOPATH XCEL 11x100MM

Facility

$90.00

Hospital Charge Code	270671543
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CANNULA END TARGET 11GA 120MML

Facility

$2,575.00

Hospital Charge Code	270680419
Hospital Revenue Code	272
Min. Negotiated Rate	$334.75
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$772.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.75
Rate for Payer: Oxford Commercial	$1,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$386.25
Rate for Payer: UnitedHealthcare Commercial	$1,287.50

CANNULA END TARGET 11GA 120MML

Facility

$2,575.00

Hospital Charge Code	270680419
Hospital Revenue Code	272
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

CANNULA ERCP CONTOUR

Facility

$230.00

Hospital Charge Code	270604751
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

CANNULA ERCP CONTOUR

Facility

$230.00

Hospital Charge Code	270604751
Hospital Revenue Code	272
Min. Negotiated Rate	$29.90
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$115.00

CANNULA ERCP FLUOR TIP 3096-10

Facility

$338.45

Hospital Charge Code	270611765
Hospital Revenue Code	272
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$101.53
Rate for Payer: Aetna Medicare Advantage	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.30
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.00
Rate for Payer: Oxford Commercial	$169.22
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$169.22

CANNULA ERCP FLUOR TIP 3096-10

Facility

$338.45

Hospital Charge Code	270611765
Hospital Revenue Code	272
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

CANNULA ERCP RX TAPERED TIP

Facility

$360.00

Hospital Charge Code	270627936
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CANNULA ERCP RX TAPERED TIP

Facility

$360.00

Hospital Charge Code	270627936
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

CANNULA ERCP TANDEM XL

Facility

$328.50

Hospital Charge Code	270604753
Hospital Revenue Code	272
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$164.25
Rate for Payer: Aetna Commercial	$98.55
Rate for Payer: Aetna Medicare Advantage	$98.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.77
Rate for Payer: Cigna Commercial	$164.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.70
Rate for Payer: Oxford Commercial	$164.25
Rate for Payer: Qualcare PPO/HMO/WC	$49.27
Rate for Payer: UnitedHealthcare Commercial	$164.25

CANNULA ERCP TANDEM XL

Facility

$328.50

Hospital Charge Code	270604753
Hospital Revenue Code	272
Min. Negotiated Rate	$49.27
Max. Negotiated Rate	$49.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.27

CANNULA ERCP TAPRD CONTOUR 5FR

Facility

$227.45

Hospital Charge Code	270600946
Hospital Revenue Code	272
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$113.72
Rate for Payer: Aetna Commercial	$68.23
Rate for Payer: Aetna Medicare Advantage	$68.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.00
Rate for Payer: Cigna Commercial	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: Oxford Commercial	$113.72
Rate for Payer: Qualcare PPO/HMO/WC	$34.12
Rate for Payer: UnitedHealthcare Commercial	$113.72

CANNULA ERCP TAPRD CONTOUR 5FR

Facility

$227.45

Hospital Charge Code	270600946
Hospital Revenue Code	272
Min. Negotiated Rate	$34.12
Max. Negotiated Rate	$34.12
Rate for Payer: Qualcare PPO/HMO/WC	$34.12

CANNULA ET02 GAS SAMPLING LINE

Facility

$11.85

Hospital Charge Code	270667014
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$3.56
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.54
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$5.92

CANNULA ET02 GAS SAMPLING LINE

Facility

$11.85

Hospital Charge Code	270667014
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.40

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.40

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

CANNULA ETCO2 W/7 GAS SAMPL

Facility

$12.80

Hospital Charge Code	270666779
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

CANNULA FLESIBLE 6.5mmx73mm

Facility

$50.00

Hospital Charge Code	270639290
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

CANNULA FLESIBLE 6.5mmx73mm

Facility

$50.00

Hospital Charge Code	270639290
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CANNULA FLOWPORT II

Facility

$1,954.05

Hospital Charge Code	270679419
Hospital Revenue Code	272
Min. Negotiated Rate	$293.11
Max. Negotiated Rate	$293.11
Rate for Payer: Qualcare PPO/HMO/WC	$293.11

CANNULA FLOWPORT II

Facility

$1,954.05

Hospital Charge Code	270679419
Hospital Revenue Code	272
Min. Negotiated Rate	$254.03
Max. Negotiated Rate	$977.02
Rate for Payer: Aetna Commercial	$586.22
Rate for Payer: Aetna Medicare Advantage	$586.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.28
Rate for Payer: Cigna Commercial	$977.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.03
Rate for Payer: Oxford Commercial	$977.02
Rate for Payer: Qualcare PPO/HMO/WC	$293.11
Rate for Payer: UnitedHealthcare Commercial	$977.02

CANNULA FLUORO TIP ERCP***

Facility

$236.00

Hospital Charge Code	2300804
Hospital Revenue Code	279
Min. Negotiated Rate	$30.68
Max. Negotiated Rate	$118.00
Rate for Payer: Aetna Commercial	$70.80
Rate for Payer: Aetna Medicare Advantage	$70.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.18
Rate for Payer: Cigna Commercial	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Oxford Commercial	$118.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.40
Rate for Payer: UnitedHealthcare Commercial	$118.00

CANNULA FLUORO TIP ERCP***

Facility

$236.00

Hospital Charge Code	2300804
Hospital Revenue Code	279
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

Know your out-of-pocket cost for care.

All Charges