Heights University Hospital

All Charges

Charge

Type

Setting

Price

CANNULA W/OBTURATOR 8.4mmx75mm

Facility

$50.00

Hospital Charge Code	270639292
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 XL 7fr-5.5fr RX 4582

Facility

$391.90

Hospital Charge Code	270627939
Hospital Revenue Code	272
Min. Negotiated Rate	$50.95
Max. Negotiated Rate	$195.95
Rate for Payer: Aetna Commercial	$117.57
Rate for Payer: Aetna Medicare Advantage	$117.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.93
Rate for Payer: Cigna Commercial	$195.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.95
Rate for Payer: Oxford Commercial	$195.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.78
Rate for Payer: UnitedHealthcare Commercial	$195.95

CANNULA XL 7fr-5.5fr RX 4582

Facility

$391.90

Hospital Charge Code	270627939
Hospital Revenue Code	272
Min. Negotiated Rate	$58.78
Max. Negotiated Rate	$58.78
Rate for Payer: Qualcare PPO/HMO/WC	$58.78

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$36.10
Max. Negotiated Rate	$36.10
Rate for Payer: Qualcare PPO/HMO/WC	$36.10

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$31.29
Max. Negotiated Rate	$120.35
Rate for Payer: Aetna Commercial	$72.21
Rate for Payer: Aetna Medicare Advantage	$72.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.38
Rate for Payer: Cigna Commercial	$120.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.29
Rate for Payer: Oxford Commercial	$120.35
Rate for Payer: Qualcare PPO/HMO/WC	$36.10
Rate for Payer: UnitedHealthcare Commercial	$120.35

CANNULLA RF 18G 10X100MM

Facility

$2,665.00

Hospital Charge Code	270691392
Hospital Revenue Code	279
Min. Negotiated Rate	$399.75
Max. Negotiated Rate	$399.75
Rate for Payer: Qualcare PPO/HMO/WC	$399.75

CANNULLA RF 18G 10X100MM

Facility

$2,665.00

Hospital Charge Code	270691392
Hospital Revenue Code	279
Min. Negotiated Rate	$346.45
Max. Negotiated Rate	$1,332.50
Rate for Payer: Aetna Commercial	$799.50
Rate for Payer: Aetna Medicare Advantage	$799.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$679.58
Rate for Payer: Cigna Commercial	$1,332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.45
Rate for Payer: Oxford Commercial	$1,332.50
Rate for Payer: Qualcare PPO/HMO/WC	$399.75
Rate for Payer: UnitedHealthcare Commercial	$1,332.50

CANOPY RESP 2342

Facility

$63.25

Hospital Charge Code	270200060
Hospital Revenue Code	270
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

CANOPY RESP 2342

Facility

$63.25

Hospital Charge Code	270200060
Hospital Revenue Code	270
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$18.98
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$31.62

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$52.50

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

CAN USE

Facility

$65.00

Hospital Charge Code	6501290
Hospital Revenue Code	410
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAN USE

Facility

$65.00

Hospital Charge Code	6501290
Hospital Revenue Code	410
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CAN USE -ERROR

Facility

$116.48

Hospital Charge Code	2700400
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

CAN USE -ERROR

Facility

$116.48

Hospital Charge Code	2700400
Hospital Revenue Code	260
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$34.94
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$802.00

CAN USE INCORRECT MM NUMBER

Facility

$850.00

Hospital Charge Code	270945239
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CAN USE INCORRECT MM NUMBER

Facility

$850.00

Hospital Charge Code	270945239
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700996
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700996
Hospital Revenue Code	260
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$34.94
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$802.00

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700998
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700998
Hospital Revenue Code	260
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$34.94
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$802.00

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges