Heights University Hospital

All Charges

Charge

Type

Setting

Price

CESSJ THERAPY CATH REMOVAL

Facility

$6,404.20

Service Code	HCPCS 37214
Hospital Charge Code	5600232
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

CESSJ THERAPY CATH REMOVAL

Facility

$10,333.93

Service Code	HCPCS 37214
Hospital Charge Code	7411507
Hospital Revenue Code	361
Min. Negotiated Rate	$1,550.09
Max. Negotiated Rate	$1,550.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.09

CETACAINE/56ML

Facility

$123.00

Hospital Charge Code	60632671
Hospital Revenue Code	250
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

CETACAINE/56ML

Facility

$123.00

Hospital Charge Code	60632671
Hospital Revenue Code	250
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$61.50
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$61.50

CETACAINE SPRAY 56 G

Facility

$209.15

Hospital Charge Code	60628409W
Hospital Revenue Code	250
Min. Negotiated Rate	$27.19
Max. Negotiated Rate	$104.58
Rate for Payer: Aetna Commercial	$62.74
Rate for Payer: Aetna Medicare Advantage	$62.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.33
Rate for Payer: Cigna Commercial	$104.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.19
Rate for Payer: Oxford Commercial	$104.58
Rate for Payer: Qualcare PPO/HMO/WC	$31.37
Rate for Payer: UnitedHealthcare Commercial	$104.58

CETACAINE SPRAY 56 G

Facility

$209.15

Hospital Charge Code	60628409W
Hospital Revenue Code	250
Min. Negotiated Rate	$31.37
Max. Negotiated Rate	$31.37
Rate for Payer: Qualcare PPO/HMO/WC	$31.37

CETACAINE SPRAY 56 GM

Facility

$185.00

Hospital Charge Code	6014021
Hospital Revenue Code	251
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

CETACAINE SPRAY 56 GM

Facility

$185.00

Hospital Charge Code	6014021
Hospital Revenue Code	251
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$92.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$92.50

CETAPHIL/240ML

Facility

$28.00

Hospital Charge Code	60632672
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

CETAPHIL/240ML

Facility

$28.00

Hospital Charge Code	60632672
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

CETIRIZINE HCL TAB 10MG

Facility

$13.45

Hospital Charge Code	6027130
Hospital Revenue Code	252
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$4.04
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$6.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$6.72

CETIRIZINE HCL TAB 10MG

Facility

$13.45

Hospital Charge Code	6027130
Hospital Revenue Code	252
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

CETUXIMAB 100 MG/50 ML

Facility

$3,216.00

Service Code	HCPCS J9055
Hospital Charge Code	60629340
Hospital Revenue Code	636
Min. Negotiated Rate	$482.40
Max. Negotiated Rate	$778.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.27
Rate for Payer: Qualcare PPO/HMO/WC	$482.40

CETUXIMAB 100 MG/50 ML

Facility

$3,216.00

Service Code	HCPCS J9055
Hospital Charge Code	60629340
Hospital Revenue Code	636
Min. Negotiated Rate	$482.40
Max. Negotiated Rate	$964.80
Rate for Payer: Aetna Commercial	$964.80
Rate for Payer: Aetna Medicare Advantage	$964.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.27
Rate for Payer: Qualcare PPO/HMO/WC	$482.40

CEVALIN/500MG/1ML

Facility

$13.00

Hospital Charge Code	60632673
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

CEVALIN/500MG/1ML

Facility

$13.00

Hospital Charge Code	60632673
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

CF,CARRIER SCREEN

Facility

$395.00

Service Code	HCPCS 81220
Hospital Charge Code	39900014
Hospital Revenue Code	310
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$2,039.38
Rate for Payer: Aetna Commercial	$1,803.38
Rate for Payer: Aetna Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,039.38
Rate for Payer: Cigna Commercial	$556.60
Rate for Payer: Cigna Medicare Advantage	$278.30
Rate for Payer: Clover Medicare Advantage	$528.77
Rate for Payer: EmblemHealth Commercial	$1,669.80
Rate for Payer: Humana Medicare Advantage	$573.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$556.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$590.00
Rate for Payer: Wellcare Medicare Advantage	$556.60

CF,CARRIER SCREEN

Facility

$395.00

Service Code	HCPCS 81220
Hospital Charge Code	39900014
Hospital Revenue Code	310
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

CFH ACETAMINOPHEN 160MG

Facility

$4.00

Hospital Charge Code	83652675
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

CFH ACETAMINOPHEN 160MG

Facility

$4.00

Hospital Charge Code	83652675
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CFH ANOSCOPY

Facility

$274.00

Service Code	HCPCS 46600
Hospital Charge Code	83652105
Hospital Revenue Code	361
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

CFH ANOSCOPY

Facility

$274.00

Service Code	HCPCS 46600
Hospital Charge Code	83652105
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$82.20
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.87
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	83652141
Hospital Revenue Code	361
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

CFH COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	83652141
Hospital Revenue Code	361
Min. Negotiated Rate	$192.40
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$444.00
Rate for Payer: Aetna Medicare Advantage	$444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.40
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH CRYOCAUTERY OF CERVIX

Facility

$669.00

Service Code	HCPCS 57511
Hospital Charge Code	83652149
Hospital Revenue Code	361
Min. Negotiated Rate	$86.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.59
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges