Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA GEMINI SR8 ARTHREX

Facility

$160.00

Hospital Charge Code	270660887
Hospital Revenue Code	272
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

CANNULA GEMINI SR8 ARTHREX

Facility

$160.00

Hospital Charge Code	270660887
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CANNULA II WITH OBTURATOR

Facility

$1,975.00

Hospital Charge Code	270673922
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CANNULA II WITH OBTURATOR

Facility

$1,975.00

Hospital Charge Code	270673922
Hospital Revenue Code	272
Min. Negotiated Rate	$256.75
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.75
Rate for Payer: Oxford Commercial	$987.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$987.50

CANNULA INFANT

Facility

$6.98

Hospital Charge Code	270635034
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.49
Rate for Payer: Aetna Commercial	$2.09
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.49

CANNULA INFANT

Facility

$6.98

Hospital Charge Code	270635034
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CANNULA INNER 6.0 XLT 77100060

Facility

$19.90

Hospital Charge Code	270633235
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$9.95
Rate for Payer: Aetna Commercial	$5.97
Rate for Payer: Aetna Medicare Advantage	$5.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.07
Rate for Payer: Cigna Commercial	$9.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$9.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$9.95

CANNULA INNER 6.0 XLT 77100060

Facility

$19.90

Hospital Charge Code	270633235
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

CANNULA INNER 7.0 XLT 70XLTIN

Facility

$31.70

Hospital Charge Code	270642877
Hospital Revenue Code	272
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

CANNULA INNER 7.0 XLT 70XLTIN

Facility

$31.70

Hospital Charge Code	270642877
Hospital Revenue Code	272
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$15.85
Rate for Payer: Aetna Commercial	$9.51
Rate for Payer: Aetna Medicare Advantage	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.08
Rate for Payer: Cigna Commercial	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.12
Rate for Payer: Oxford Commercial	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$15.85

CANNULA INNER DISP 8.0XLT

Facility

$27.09

Hospital Charge Code	270632703
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$13.54
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.91
Rate for Payer: Cigna Commercial	$13.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Oxford Commercial	$13.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.06
Rate for Payer: UnitedHealthcare Commercial	$13.54

CANNULA INNER DISP 8.0XLT

Facility

$27.09

Hospital Charge Code	270632703
Hospital Revenue Code	272
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$4.06

CANNULA INNER FENESTRD #6

Facility

$18.00

Hospital Charge Code	270643740
Hospital Revenue Code	270
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

CANNULA INNER FENESTRD #6

Facility

$18.00

Hospital Charge Code	270643740
Hospital Revenue Code	270
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

CANNULA INNER TRACH #4

Facility

$39.25

Hospital Charge Code	270600033
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$19.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$19.62

CANNULA INNER TRACH #4

Facility

$39.25

Hospital Charge Code	270600033
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CANNULA INNER TRACH #6

Facility

$39.25

Hospital Charge Code	270600035
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$19.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$19.62

CANNULA INNER TRACH #6

Facility

$39.25

Hospital Charge Code	270600035
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CANNULA INNER TRACH #8

Facility

$39.25

Hospital Charge Code	270600036
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$19.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$19.62

CANNULA INNER TRACH #8

Facility

$39.25

Hospital Charge Code	270600036
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CANNULA INNER TRACH DISP 4-8**

Facility

$17.00

Hospital Charge Code	8004327
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

CANNULA INNER TRACH DISP 4-8**

Facility

$17.00

Hospital Charge Code	8004327
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969R
Hospital Revenue Code	272
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$19.64
Rate for Payer: Qualcare PPO/HMO/WC	$19.64

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969
Hospital Revenue Code	272
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$19.64
Rate for Payer: Qualcare PPO/HMO/WC	$19.64

CANNULA JABCZENSKI DUCTOGRAM

Facility

$130.90

Hospital Charge Code	270678969
Hospital Revenue Code	272
Min. Negotiated Rate	$17.02
Max. Negotiated Rate	$65.45
Rate for Payer: Aetna Commercial	$39.27
Rate for Payer: Aetna Medicare Advantage	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.38
Rate for Payer: Cigna Commercial	$65.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.02
Rate for Payer: Oxford Commercial	$65.45
Rate for Payer: Qualcare PPO/HMO/WC	$19.64
Rate for Payer: UnitedHealthcare Commercial	$65.45

Know your out-of-pocket cost for care.

All Charges