Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAP END 10mm DC29259

Facility

$744.00

Hospital Charge Code	270635454
Hospital Revenue Code	272
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$111.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CAP END 15MM

Facility

$1,071.00

Hospital Charge Code	270659945
Hospital Revenue Code	278
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$535.50
Rate for Payer: Aetna Commercial	$321.30
Rate for Payer: Aetna Medicare Advantage	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.11
Rate for Payer: Cigna Commercial	$535.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

CAP END 15MM

Facility

$1,071.00

Hospital Charge Code	270659945
Hospital Revenue Code	278
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$259.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

CAP END DISTAL STERILE

Facility

$259.50

Hospital Charge Code	270695114
Hospital Revenue Code	272
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$38.92
Rate for Payer: Qualcare PPO/HMO/WC	$38.92

CAP END DISTAL STERILE

Facility

$259.50

Hospital Charge Code	270695114
Hospital Revenue Code	272
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$129.75
Rate for Payer: Aetna Commercial	$77.85
Rate for Payer: Aetna Medicare Advantage	$77.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$129.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.73
Rate for Payer: Oxford Commercial	$129.75
Rate for Payer: Qualcare PPO/HMO/WC	$38.92
Rate for Payer: UnitedHealthcare Commercial	$129.75

CAP F/11.0mm S.S TUBES & FIBER

Facility

$7.26

Hospital Charge Code	270639895
Hospital Revenue Code	278
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$3.63
Rate for Payer: Aetna Commercial	$2.18
Rate for Payer: Aetna Medicare Advantage	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

CAP F/11.0mm S.S TUBES & FIBER

Facility

$7.26

Hospital Charge Code	270639895
Hospital Revenue Code	278
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

CAP FLO CLEVER

Facility

$134.75

Hospital Charge Code	270678922
Hospital Revenue Code	272
Min. Negotiated Rate	$20.21
Max. Negotiated Rate	$20.21
Rate for Payer: Qualcare PPO/HMO/WC	$20.21

CAP FLO CLEVER

Facility

$134.75

Hospital Charge Code	270678922
Hospital Revenue Code	272
Min. Negotiated Rate	$17.52
Max. Negotiated Rate	$67.38
Rate for Payer: Aetna Commercial	$40.42
Rate for Payer: Aetna Medicare Advantage	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.36
Rate for Payer: Cigna Commercial	$67.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.52
Rate for Payer: Oxford Commercial	$67.38
Rate for Payer: Qualcare PPO/HMO/WC	$20.21
Rate for Payer: UnitedHealthcare Commercial	$67.38

CAP (FOR ADAPTOR)******

Facility

$18.00

Hospital Charge Code	8003055
Hospital Revenue Code	279
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

CAP (FOR ADAPTOR)******

Facility

$18.00

Hospital Charge Code	8003055
Hospital Revenue Code	279
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

CAP FOR TENKHOFF CATH****

Facility

$9.00

Hospital Charge Code	8002727
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

CAP FOR TENKHOFF CATH****

Facility

$9.00

Hospital Charge Code	8002727
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CAP GAS

Facility

$1,592.80

Hospital Charge Code	270683461
Hospital Revenue Code	272
Min. Negotiated Rate	$238.92
Max. Negotiated Rate	$238.92
Rate for Payer: Qualcare PPO/HMO/WC	$238.92

CAP GAS

Facility

$1,592.80

Hospital Charge Code	270683461
Hospital Revenue Code	272
Min. Negotiated Rate	$207.06
Max. Negotiated Rate	$796.40
Rate for Payer: Aetna Commercial	$477.84
Rate for Payer: Aetna Medicare Advantage	$477.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.16
Rate for Payer: Cigna Commercial	$796.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.06
Rate for Payer: Oxford Commercial	$796.40
Rate for Payer: Qualcare PPO/HMO/WC	$238.92
Rate for Payer: UnitedHealthcare Commercial	$796.40

CAP GREEN

Facility

$54.38

Hospital Charge Code	270662191
Hospital Revenue Code	272
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$27.19
Rate for Payer: Aetna Commercial	$16.31
Rate for Payer: Aetna Medicare Advantage	$16.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.87
Rate for Payer: Cigna Commercial	$27.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.07
Rate for Payer: Oxford Commercial	$27.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.16
Rate for Payer: UnitedHealthcare Commercial	$27.19

CAP GREEN

Facility

$54.38

Hospital Charge Code	270662191
Hospital Revenue Code	272
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$8.16
Rate for Payer: Qualcare PPO/HMO/WC	$8.16

CAP GROSHONG CONN & INJ (DB***

Facility

$30.25

Hospital Charge Code	8002891
Hospital Revenue Code	279
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$9.07
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$15.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$15.12

CAP GROSHONG CONN & INJ (DB***

Facility

$30.25

Hospital Charge Code	8002891
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG CONN & INJ (DBL**

Facility

$30.25

Hospital Charge Code	8002883
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG CONN & INJ (DBL**

Facility

$30.25

Hospital Charge Code	8002883
Hospital Revenue Code	279
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$9.07
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$15.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$15.12

CAP GROSHONG CONN & INJ SNGL**

Facility

$30.25

Hospital Charge Code	8002875
Hospital Revenue Code	279
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$9.07
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$15.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$15.12

CAP GROSHONG CONN & INJ SNGL**

Facility

$30.25

Hospital Charge Code	8002875
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG INJECTION***

Facility

$9.00

Hospital Charge Code	8002867
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CAP GROSHONG INJECTION***

Facility

$9.00

Hospital Charge Code	8002867
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

Know your out-of-pocket cost for care.

All Charges