Heights University Hospital

All Charges

Charge

Type

Setting

Price

CFH FP VARICELLA VIRUS VACCINE

Facility

$91.00

Service Code	HCPCS 90716
Hospital Charge Code	83652331
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$22.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

CFH FP VARICELLA VIRUS VACCINE

Facility

$91.00

Service Code	HCPCS 90716
Hospital Charge Code	83652331
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$95.20
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

CFH FUROSEMIDE 20MG LASIX TAB

Facility

$2.00

Hospital Charge Code	83652680
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

CFH FUROSEMIDE 20MG LASIX TAB

Facility

$2.00

Hospital Charge Code	83652680
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

CFH GLUCOSE 5GM TAB

Facility

$2.00

Hospital Charge Code	83652685
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

CFH GLUCOSE 5GM TAB

Facility

$2.00

Hospital Charge Code	83652685
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

CFH HSTART POST PARTUM

Facility

$139.00

Service Code	HCPCS 9924152
Hospital Charge Code	83652517
Hospital Revenue Code	514
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$69.50
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CFH HSTART POST PARTUM

Facility

$139.00

Service Code	HCPCS 9924152
Hospital Charge Code	83652517
Hospital Revenue Code	514
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CFH IBUPROFEN 100MG

Facility

$3.00

Hospital Charge Code	83652690
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

CFH IBUPROFEN 100MG

Facility

$3.00

Hospital Charge Code	83652690
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CFH IBUPROFEN 400MG

Facility

$2.00

Hospital Charge Code	83652695
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

CFH IBUPROFEN 400MG

Facility

$2.00

Hospital Charge Code	83652695
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652063
Hospital Revenue Code	761
Min. Negotiated Rate	$92.95
Max. Negotiated Rate	$361.89
Rate for Payer: Aetna Better Health Medicaid	$354.79
Rate for Payer: Aetna Commercial	$214.50
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.95
Rate for Payer: Oxford Commercial	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Commercial	$357.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652635
Hospital Revenue Code	761
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$107.25
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652063
Hospital Revenue Code	761
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$107.25
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652635
Hospital Revenue Code	761
Min. Negotiated Rate	$92.95
Max. Negotiated Rate	$361.89
Rate for Payer: Aetna Better Health Medicaid	$354.79
Rate for Payer: Aetna Commercial	$214.50
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.95
Rate for Payer: Oxford Commercial	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Commercial	$357.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89

CFH IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	83652065
Hospital Revenue Code	761
Min. Negotiated Rate	$270.53
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$624.30
Rate for Payer: Aetna Medicare Advantage	$624.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.65
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.53
Rate for Payer: Oxford Commercial	$1,040.50
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$1,040.50

CFH IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	83652065
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

CFH INR STRIP

Facility

$176.40

Service Code	HCPCS 85610
Hospital Charge Code	83652281
Hospital Revenue Code	305
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.90
Rate for Payer: Aetna Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.46
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.55
Rate for Payer: Wellcare Medicare Advantage	$4.29

CFH INR STRIP

Facility

$176.40

Service Code	HCPCS 85610
Hospital Charge Code	83652281
Hospital Revenue Code	305
Min. Negotiated Rate	$26.46
Max. Negotiated Rate	$26.46
Rate for Payer: Qualcare PPO/HMO/WC	$26.46

CFH MIRENA IUD

Facility

$284.00

Hospital Charge Code	83652650
Hospital Revenue Code	636
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

CFH MIRENA IUD

Facility

$284.00

Hospital Charge Code	83652650
Hospital Revenue Code	636
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$85.20
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

CFH NITRO SL 0.4MG TAB

Facility

$2.00

Hospital Charge Code	83652670
Hospital Revenue Code	637
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

CFH NITRO SL 0.4MG TAB

Facility

$2.00

Hospital Charge Code	83652670
Hospital Revenue Code	637
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

CFH PAP SMEAR

Facility

$35.00

Service Code	HCPCS 88142
Hospital Charge Code	83652289
Hospital Revenue Code	311
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

Know your out-of-pocket cost for care.

All Charges