Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309194780
Hospital Revenue Code	410
Min. Negotiated Rate	$24.24
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$55.94
Rate for Payer: Aetna Medicare Advantage	$55.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.54
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.24
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.97
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309094780
Hospital Revenue Code	410
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$27.97
Rate for Payer: Qualcare PPO/HMO/WC	$27.97

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309094780
Hospital Revenue Code	410
Min. Negotiated Rate	$24.24
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$55.94
Rate for Payer: Aetna Medicare Advantage	$55.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.54
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.24
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.97
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309194781
Hospital Revenue Code	410
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$27.97
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.12
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309094781
Hospital Revenue Code	410
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$27.97
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.12
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309294781
Hospital Revenue Code	410
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$27.97
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.12
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309094781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309194781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309294781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

CART COVER, CELAR VINLY, FRONT

Facility

$420.00

Hospital Charge Code	270665559
Hospital Revenue Code	270
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$126.00
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$210.00

CART COVER, CELAR VINLY, FRONT

Facility

$420.00

Hospital Charge Code	270665559
Hospital Revenue Code	270
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

Cart Cover for Model SP-30SL C

Facility

$580.00

Hospital Charge Code	270665973
Hospital Revenue Code	270
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$290.00
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: Aetna Commercial	$174.00
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Oxford Commercial	$290.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Commercial	$290.00

Cart Cover for Model SP-30SL C

Facility

$580.00

Hospital Charge Code	270665973
Hospital Revenue Code	270
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CARTDRIDGE NITROUS OXIDE

Facility

$300.00

Hospital Charge Code	270679447
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CARTDRIDGE NITROUS OXIDE

Facility

$300.00

Hospital Charge Code	270679447
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

CART FOR MODEL

Facility

$3,802.85

Hospital Charge Code	270658990
Hospital Revenue Code	272
Min. Negotiated Rate	$570.43
Max. Negotiated Rate	$570.43
Rate for Payer: Qualcare PPO/HMO/WC	$570.43

CART FOR MODEL

Facility

$3,802.85

Hospital Charge Code	270658990
Hospital Revenue Code	272
Min. Negotiated Rate	$494.37
Max. Negotiated Rate	$1,901.42
Rate for Payer: Aetna Commercial	$1,140.86
Rate for Payer: Aetna Medicare Advantage	$1,140.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$969.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$969.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$969.73
Rate for Payer: Cigna Commercial	$1,901.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.37
Rate for Payer: Oxford Commercial	$1,901.42
Rate for Payer: Qualcare PPO/HMO/WC	$570.43
Rate for Payer: UnitedHealthcare Commercial	$1,901.42

CARTICEL BIOPSY TRANSPORT KIT

Facility

$2,475.00

Hospital Charge Code	270657144
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

CARTICEL BIOPSY TRANSPORT KIT

Facility

$2,475.00

Hospital Charge Code	270657891
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CARTICEL BIOPSY TRANSPORT KIT

Facility

$2,475.00

Hospital Charge Code	270657891
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

CARTICEL BIOPSY TRANSPORT KIT

Facility

$2,475.00

Hospital Charge Code	270657144
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CARTICEL BIOPSY TRANSPT KIT

Facility

$2,475.00

Hospital Charge Code	270657145
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CARTICEL BIOPSY TRANSPT KIT

Facility

$2,475.00

Hospital Charge Code	270657145
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

CARTIFORM 10MM DISC

Facility

$16,050.00

Hospital Charge Code	270677959
Hospital Revenue Code	278
Min. Negotiated Rate	$2,407.50
Max. Negotiated Rate	$8,025.00
Rate for Payer: Aetna Commercial	$4,815.00
Rate for Payer: Aetna Medicare Advantage	$4,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,092.75
Rate for Payer: Cigna Commercial	$8,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50

CARTIFORM 10MM DISC

Facility

$16,050.00

Hospital Charge Code	270677959
Hospital Revenue Code	278
Min. Negotiated Rate	$2,407.50
Max. Negotiated Rate	$3,884.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50

Know your out-of-pocket cost for care.

All Charges