Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA RF NEEDLE 100MM 22G

Facility

$205.75

Hospital Charge Code	270654885
Hospital Revenue Code	272
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$102.88
Rate for Payer: Aetna Commercial	$61.73
Rate for Payer: Aetna Medicare Advantage	$61.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.47
Rate for Payer: Cigna Commercial	$102.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.75
Rate for Payer: Oxford Commercial	$102.88
Rate for Payer: Qualcare PPO/HMO/WC	$30.86
Rate for Payer: UnitedHealthcare Commercial	$102.88

CANNULA RX ERCP BALL TIP 210CM

Facility

$569.35

Hospital Charge Code	270698334
Hospital Revenue Code	272
Min. Negotiated Rate	$74.02
Max. Negotiated Rate	$284.68
Rate for Payer: Aetna Commercial	$170.81
Rate for Payer: Aetna Medicare Advantage	$170.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.18
Rate for Payer: Cigna Commercial	$284.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.02
Rate for Payer: Oxford Commercial	$284.68
Rate for Payer: Qualcare PPO/HMO/WC	$85.40
Rate for Payer: UnitedHealthcare Commercial	$284.68

CANNULA RX ERCP BALL TIP 210CM

Facility

$569.35

Hospital Charge Code	270698334
Hospital Revenue Code	272
Min. Negotiated Rate	$85.40
Max. Negotiated Rate	$85.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.40

CANNULA RX ERCP STD TIP 210CM

Facility

$363.90

Hospital Charge Code	270673012
Hospital Revenue Code	272
Min. Negotiated Rate	$47.31
Max. Negotiated Rate	$181.95
Rate for Payer: Aetna Commercial	$109.17
Rate for Payer: Aetna Medicare Advantage	$109.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.79
Rate for Payer: Cigna Commercial	$181.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.31
Rate for Payer: Oxford Commercial	$181.95
Rate for Payer: Qualcare PPO/HMO/WC	$54.59
Rate for Payer: UnitedHealthcare Commercial	$181.95

CANNULA RX ERCP STD TIP 210CM

Facility

$363.90

Hospital Charge Code	270673012
Hospital Revenue Code	272
Min. Negotiated Rate	$54.59
Max. Negotiated Rate	$54.59
Rate for Payer: Qualcare PPO/HMO/WC	$54.59

CANNULA RX ERCP TAPR TIP 210CM

Facility

$569.35

Hospital Charge Code	270698323
Hospital Revenue Code	272
Min. Negotiated Rate	$74.02
Max. Negotiated Rate	$284.68
Rate for Payer: Aetna Commercial	$170.81
Rate for Payer: Aetna Medicare Advantage	$170.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.18
Rate for Payer: Cigna Commercial	$284.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.02
Rate for Payer: Oxford Commercial	$284.68
Rate for Payer: Qualcare PPO/HMO/WC	$85.40
Rate for Payer: UnitedHealthcare Commercial	$284.68

CANNULA RX ERCP TAPR TIP 210CM

Facility

$569.35

Hospital Charge Code	270698323
Hospital Revenue Code	272
Min. Negotiated Rate	$85.40
Max. Negotiated Rate	$85.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.40

CANNULA RX STANDARD TIP

Facility

$342.50

Hospital Charge Code	270654333
Hospital Revenue Code	272
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$51.38
Rate for Payer: Qualcare PPO/HMO/WC	$51.38

CANNULA RX STANDARD TIP

Facility

$342.50

Hospital Charge Code	270654333
Hospital Revenue Code	272
Min. Negotiated Rate	$44.52
Max. Negotiated Rate	$171.25
Rate for Payer: Aetna Commercial	$102.75
Rate for Payer: Aetna Medicare Advantage	$102.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.34
Rate for Payer: Cigna Commercial	$171.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.52
Rate for Payer: Oxford Commercial	$171.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.38
Rate for Payer: UnitedHealthcare Commercial	$171.25

CANNULA SEAL 5 MM

Facility

$1,750.00

Hospital Charge Code	270666139
Hospital Revenue Code	270
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CANNULA SEAL 5 MM

Facility

$1,750.00

Hospital Charge Code	270666139
Hospital Revenue Code	270
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CANNULA SET 6x75mm DISPOSABLE

Facility

$50.00

Hospital Charge Code	270639291
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 SET 6x75mm DISPOSABLE

Facility

$50.00

Hospital Charge Code	270639291
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CANNULA SET 8.4x90mm DISPOSAB-

Facility

$50.00

Hospital Charge Code	270639293
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CANNULA SET 8.4x90mm DISPOSAB-

Facility

$50.00

Hospital Charge Code	270639293
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 SHILEY INNER

Facility

$17.35

Service Code	HCPCS A4623
Hospital Charge Code	270699949
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.60

CANNULA SHILEY INNER

Facility

$17.35

Service Code	HCPCS A4623
Hospital Charge Code	270699949
Hospital Revenue Code	272
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$9.34
Rate for Payer: Aetna Commercial	$5.21
Rate for Payer: Aetna Medicare Advantage	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.42
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: Cigna Medicare Advantage	$5.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.26
Rate for Payer: Oxford Commercial	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.60
Rate for Payer: UnitedHealthcare Commercial	$8.68

CANNULA SILICONE TIP 27GA

Facility

$19.07

Hospital Charge Code	270657592
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

CANNULA SILICONE TIP 27GA

Facility

$19.07

Hospital Charge Code	270657592
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$9.54
Rate for Payer: Aetna Commercial	$5.72
Rate for Payer: Aetna Medicare Advantage	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.48
Rate for Payer: Oxford Commercial	$9.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$9.54

CANNULA SIZE 10 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690819
Hospital Revenue Code	272
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$145.43
Rate for Payer: Aetna Commercial	$87.25
Rate for Payer: Aetna Medicare Advantage	$87.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.17
Rate for Payer: Cigna Commercial	$145.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.81
Rate for Payer: Oxford Commercial	$145.43
Rate for Payer: Qualcare PPO/HMO/WC	$43.63
Rate for Payer: UnitedHealthcare Commercial	$145.43

CANNULA SIZE 10 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690819
Hospital Revenue Code	272
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$43.63
Rate for Payer: Qualcare PPO/HMO/WC	$43.63

CANNULA SIZE 7.5 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690815
Hospital Revenue Code	272
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$145.43
Rate for Payer: Aetna Commercial	$87.25
Rate for Payer: Aetna Medicare Advantage	$87.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.17
Rate for Payer: Cigna Commercial	$145.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.81
Rate for Payer: Oxford Commercial	$145.43
Rate for Payer: Qualcare PPO/HMO/WC	$43.63
Rate for Payer: UnitedHealthcare Commercial	$145.43

CANNULA SIZE 7.5 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690815
Hospital Revenue Code	272
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$43.63
Rate for Payer: Qualcare PPO/HMO/WC	$43.63

CANNULA SIZE 7 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690814
Hospital Revenue Code	272
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$145.43
Rate for Payer: Aetna Commercial	$87.25
Rate for Payer: Aetna Medicare Advantage	$87.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.17
Rate for Payer: Cigna Commercial	$145.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.81
Rate for Payer: Oxford Commercial	$145.43
Rate for Payer: Qualcare PPO/HMO/WC	$43.63
Rate for Payer: UnitedHealthcare Commercial	$145.43

CANNULA SIZE 7 INNER NON FEN

Facility

$290.85

Hospital Charge Code	270690814
Hospital Revenue Code	272
Min. Negotiated Rate	$43.63
Max. Negotiated Rate	$43.63
Rate for Payer: Qualcare PPO/HMO/WC	$43.63

Know your out-of-pocket cost for care.

All Charges