Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA THREADED 5.5x55 214104

Facility

$128.00

Hospital Charge Code	270642289
Hospital Revenue Code	272
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$64.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$64.00

CANNULA THREADED 5.5x55 214104

Facility

$128.00

Hospital Charge Code	270642289
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CANNULA THREADED 5mm 214108

Facility

$625.00

Hospital Charge Code	270640104
Hospital Revenue Code	272
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.25
Rate for Payer: Oxford Commercial	$312.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$312.50

CANNULA THREADED 5mm 214108

Facility

$625.00

Hospital Charge Code	270640104
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CANNULA THREADED DISO 8.5X72MM

Facility

$156.50

Hospital Charge Code	270681096
Hospital Revenue Code	272
Min. Negotiated Rate	$23.48
Max. Negotiated Rate	$23.48
Rate for Payer: Qualcare PPO/HMO/WC	$23.48

CANNULA THREADED DISO 8.5X72MM

Facility

$156.50

Hospital Charge Code	270681096
Hospital Revenue Code	272
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$78.25
Rate for Payer: Aetna Commercial	$46.95
Rate for Payer: Aetna Medicare Advantage	$46.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.91
Rate for Payer: Cigna Commercial	$78.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.34
Rate for Payer: Oxford Commercial	$78.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.48
Rate for Payer: UnitedHealthcare Commercial	$78.25

CANNULATOME LL PC LUMEN SPH

Facility

$130.00

Hospital Charge Code	270325609
Hospital Revenue Code	272
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$39.00
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.90
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$65.00

CANNULATOME LL PC LUMEN SPH

Facility

$130.00

Hospital Charge Code	270325609
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

cannula transport 8mm

Facility

$821.95

Hospital Charge Code	270688489
Hospital Revenue Code	272
Min. Negotiated Rate	$123.29
Max. Negotiated Rate	$123.29
Rate for Payer: Qualcare PPO/HMO/WC	$123.29

cannula transport 8mm

Facility

$821.95

Hospital Charge Code	270688489
Hospital Revenue Code	272
Min. Negotiated Rate	$106.85
Max. Negotiated Rate	$410.98
Rate for Payer: Aetna Commercial	$246.59
Rate for Payer: Aetna Medicare Advantage	$246.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.60
Rate for Payer: Cigna Commercial	$410.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.85
Rate for Payer: Oxford Commercial	$410.98
Rate for Payer: Qualcare PPO/HMO/WC	$123.29
Rate for Payer: UnitedHealthcare Commercial	$410.98

CANNULA TRANSPORT 8MM 4-6

Facility

$473.55

Hospital Charge Code	270670488
Hospital Revenue Code	272
Min. Negotiated Rate	$61.56
Max. Negotiated Rate	$236.78
Rate for Payer: Aetna Commercial	$142.06
Rate for Payer: Aetna Medicare Advantage	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.76
Rate for Payer: Cigna Commercial	$236.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.56
Rate for Payer: Oxford Commercial	$236.78
Rate for Payer: Qualcare PPO/HMO/WC	$71.03
Rate for Payer: UnitedHealthcare Commercial	$236.78

CANNULA TRANSPORT 8MM 4-6

Facility

$473.55

Hospital Charge Code	270670488
Hospital Revenue Code	272
Min. Negotiated Rate	$71.03
Max. Negotiated Rate	$71.03
Rate for Payer: Qualcare PPO/HMO/WC	$71.03

CANNULA TWIST-IN 7MM

Facility

$125.00

Hospital Charge Code	270635387
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA TWIST-IN 7MM

Facility

$125.00

Hospital Charge Code	270635387
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: UnitedHealthcare Commercial	$62.50

CANNULA TWIST IN 8.25MMx9CM

Facility

$125.00

Hospital Charge Code	270672178
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA TWIST IN 8.25MMx9CM

Facility

$125.00

Hospital Charge Code	270672178
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CANNULA UNIV KIT 5X76MM 012405

Facility

$121.50

Hospital Charge Code	270612232
Hospital Revenue Code	272
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$60.75
Rate for Payer: Aetna Commercial	$36.45
Rate for Payer: Aetna Medicare Advantage	$36.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.98
Rate for Payer: Cigna Commercial	$60.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.79
Rate for Payer: Oxford Commercial	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.23
Rate for Payer: UnitedHealthcare Commercial	$60.75

CANNULA UNIV KIT 5X76MM 012405

Facility

$121.50

Hospital Charge Code	270612232
Hospital Revenue Code	272
Min. Negotiated Rate	$18.23
Max. Negotiated Rate	$18.23
Rate for Payer: Qualcare PPO/HMO/WC	$18.23

CANNULA UNIV KIT 7X76MM 012421

Facility

$1,433.65

Hospital Charge Code	270612233
Hospital Revenue Code	272
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$716.83
Rate for Payer: Aetna Commercial	$430.10
Rate for Payer: Aetna Medicare Advantage	$430.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.58
Rate for Payer: Cigna Commercial	$716.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.37
Rate for Payer: Oxford Commercial	$716.83
Rate for Payer: Qualcare PPO/HMO/WC	$215.05
Rate for Payer: UnitedHealthcare Commercial	$716.83

CANNULA UNIV KIT 7X76MM 012421

Facility

$1,433.65

Hospital Charge Code	270612233
Hospital Revenue Code	272
Min. Negotiated Rate	$215.05
Max. Negotiated Rate	$215.05
Rate for Payer: Qualcare PPO/HMO/WC	$215.05

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna Commercial	$13.41
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.81
Rate for Payer: Oxford Commercial	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Commercial	$22.35

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

CANNULA WITH OUTLET 8MM

Facility

$4,800.00

Hospital Charge Code	270663993
Hospital Revenue Code	270
Min. Negotiated Rate	$624.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,440.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$2,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$2,400.00

CANNULA WITH OUTLET 8MM

Facility

$4,800.00

Hospital Charge Code	270663993
Hospital Revenue Code	270
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

CANNULA W/OBTURATOR 8.4mmx75mm

Facility

$50.00

Hospital Charge Code	270639292
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

Know your out-of-pocket cost for care.

All Charges