Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLOSURE NEEDLE-EXCEL DPC610***

Facility

$125.00

Hospital Charge Code	1606094
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CLOSURE PRELUDE 24CM 10

Facility

$175.00

Hospital Charge Code	270689933S
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CLOSURE PRELUDE 24CM 10

Facility

$175.00

Hospital Charge Code	270689933S
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

CLOSURE PRELUDE 24 CM 10 ML

Facility

$175.00

Hospital Charge Code	270689933
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

CLOSURE PRELUDE 24 CM 10 ML

Facility

$175.00

Hospital Charge Code	270689933
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CLOSURE SUR FIT TAIL 1756-35

Facility

$3.49

Hospital Charge Code	270649374
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.75
Rate for Payer: Aetna Commercial	$1.05
Rate for Payer: Aetna Medicare Advantage	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.89
Rate for Payer: Cigna Commercial	$1.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.45
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.52
Rate for Payer: UnitedHealthcare Commercial	$1.75

CLOSURE SUR FIT TAIL 1756-35

Facility

$3.49

Hospital Charge Code	270649374
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$0.52
Rate for Payer: Qualcare PPO/HMO/WC	$0.52

CLOSURE SYSTEM WECK EFX

Facility

$525.00

Service Code	HCPCS C1760
Hospital Charge Code	270693986
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CLOSURE SYSTEM WECK EFX

Facility

$525.00

Service Code	HCPCS C1760
Hospital Charge Code	270693986
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CLOSURE TOP

Facility

$393.00

Hospital Charge Code	270339053
Hospital Revenue Code	272
Min. Negotiated Rate	$51.09
Max. Negotiated Rate	$196.50
Rate for Payer: Aetna Commercial	$117.90
Rate for Payer: Aetna Medicare Advantage	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.22
Rate for Payer: Cigna Commercial	$196.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.09
Rate for Payer: Oxford Commercial	$196.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.95
Rate for Payer: UnitedHealthcare Commercial	$196.50

CLOSURE TOP

Facility

$393.00

Hospital Charge Code	270339053
Hospital Revenue Code	272
Min. Negotiated Rate	$58.95
Max. Negotiated Rate	$58.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.95

CLOTALYST STD SOLUTION 60ML

Facility

$5,750.00

Hospital Charge Code	270663732
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

CLOTALYST STD SOLUTION 60ML

Facility

$5,750.00

Hospital Charge Code	270663732
Hospital Revenue Code	272
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

CLO TEST*****

Facility

$188.00

Service Code	HCPCS 87072
Hospital Charge Code	2300697
Hospital Revenue Code	306
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

CLO TEST*****

Facility

$188.00

Service Code	HCPCS 87072
Hospital Charge Code	2300697
Hospital Revenue Code	306
Min. Negotiated Rate	$24.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$56.40
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

CLOTEST RAPID UREASE TEST

Facility

$51.05

Hospital Charge Code	270658250
Hospital Revenue Code	270
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$25.52
Rate for Payer: Aetna Commercial	$15.31
Rate for Payer: Aetna Medicare Advantage	$15.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.02
Rate for Payer: Cigna Commercial	$25.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.64
Rate for Payer: Oxford Commercial	$25.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.66
Rate for Payer: UnitedHealthcare Commercial	$25.52

CLOTEST RAPID UREASE TEST

Facility

$51.05

Hospital Charge Code	270658250
Hospital Revenue Code	270
Min. Negotiated Rate	$7.66
Max. Negotiated Rate	$7.66
Rate for Payer: Qualcare PPO/HMO/WC	$7.66

CLO TESTS, ENDO AEROBIC ISOL

Facility

$389.24

Service Code	HCPCS 87077
Hospital Charge Code	3009356
Hospital Revenue Code	309
Min. Negotiated Rate	$58.39
Max. Negotiated Rate	$58.39
Rate for Payer: Qualcare PPO/HMO/WC	$58.39

CLO TESTS, ENDO AEROBIC ISOL

Facility

$389.24

Service Code	HCPCS 87077
Hospital Charge Code	3009356
Hospital Revenue Code	309
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.18
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.61
Rate for Payer: Cigna Commercial	$8.08
Rate for Payer: Cigna Medicare Advantage	$4.04
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.56
Rate for Payer: Wellcare Medicare Advantage	$8.08

CLO TESTS, ENDO ANAEROBIC ISOL

Facility

$244.85

Service Code	HCPCS 87076
Hospital Charge Code	3009355
Hospital Revenue Code	309
Min. Negotiated Rate	$36.73
Max. Negotiated Rate	$36.73
Rate for Payer: Qualcare PPO/HMO/WC	$36.73

CLO TESTS, ENDO ANAEROBIC ISOL

Facility

$244.85

Service Code	HCPCS 87076
Hospital Charge Code	3009355
Hospital Revenue Code	309
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.18
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.61
Rate for Payer: Cigna Commercial	$8.08
Rate for Payer: Cigna Medicare Advantage	$4.04
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.56
Rate for Payer: Wellcare Medicare Advantage	$8.08

CLO TESTS, ENDO CLO TEST

Facility

$306.00

Service Code	HCPCS 87072
Hospital Charge Code	3009354
Hospital Revenue Code	306
Min. Negotiated Rate	$39.78
Max. Negotiated Rate	$153.00
Rate for Payer: Aetna Commercial	$91.80
Rate for Payer: Aetna Medicare Advantage	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.03
Rate for Payer: Cigna Commercial	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.90
Rate for Payer: UnitedHealthcare Commercial	$114.00

CLO TESTS, ENDO CLO TEST

Facility

$306.00

Service Code	HCPCS 87072
Hospital Charge Code	3009354
Hospital Revenue Code	306
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Qualcare PPO/HMO/WC	$45.90

CLOT FACTOR VIII AHG 1 STAGE

Facility

$390.00

Service Code	HCPCS 85240
Hospital Charge Code	401085240
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CLOT FACTOR VIII AHG 1 STAGE

Facility

$390.00

Service Code	HCPCS 85240
Hospital Charge Code	401085240
Hospital Revenue Code	305
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.00
Rate for Payer: Aetna Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.59
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: Cigna Medicare Advantage	$8.95
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

Know your out-of-pocket cost for care.

All Charges