Heights University Hospital

All Charges

Charge

Type

Setting

Price

CNS PSC-WF-URINE SCREEN

Facility

$578.00

Hospital Charge Code	94810085
Hospital Revenue Code	301
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

CNS PSC-WF-URINE SCREEN

Facility

$578.00

Hospital Charge Code	94810085
Hospital Revenue Code	301
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$289.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

CNS URINE CONFIRMATION

Facility

$375.00

Service Code	HCPCS 80102
Hospital Charge Code	94810005
Hospital Revenue Code	301
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

CNS URINE CONFIRMATION

Facility

$375.00

Service Code	HCPCS 80102
Hospital Charge Code	94810005
Hospital Revenue Code	301
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

CNS URINE DRUG SCREEN

Facility

$34.00

Service Code	HCPCS H0003HF
Hospital Charge Code	94810105
Hospital Revenue Code	300
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

CNS URINE DRUG SCREEN

Facility

$34.00

Service Code	HCPCS H0003HF
Hospital Charge Code	94810105
Hospital Revenue Code	300
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

CNTRL NASL HEMORRH ANT SIMPLE

Facility

$1,049.06

Service Code	HCPCS 30901
Hospital Charge Code	1600000348
Hospital Revenue Code	360
Min. Negotiated Rate	$157.36
Max. Negotiated Rate	$157.36
Rate for Payer: Qualcare PPO/HMO/WC	$157.36

CNTRL NASL HEMORRH ANT SIMPLE

Facility

$1,049.06

Service Code	HCPCS 30901
Hospital Charge Code	1600000348
Hospital Revenue Code	360
Min. Negotiated Rate	$136.38
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$314.72
Rate for Payer: Aetna Medicare Advantage	$314.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.51
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	$267.51
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.38
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.36
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CNTRL OROPHAR HEMORRH,REQ SURG

Facility

$40,491.68

Service Code	HCPCS 42962
Hospital Charge Code	1600000501
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,147.50
Rate for Payer: Aetna Commercial	$12,147.50
Rate for Payer: Aetna Medicare Advantage	$12,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,325.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,325.38
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	$10,325.38
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,263.92
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,073.75
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CNTRL OROPHAR HEMORRH,REQ SURG

Facility

$40,491.68

Service Code	HCPCS 42962
Hospital Charge Code	1600000501
Hospital Revenue Code	360
Min. Negotiated Rate	$6,073.75
Max. Negotiated Rate	$6,073.75
Rate for Payer: Qualcare PPO/HMO/WC	$6,073.75

CNTRL ORPHARYNG HEMORRAH,COMPL

Facility

$9,263.26

Service Code	HCPCS 42961
Hospital Charge Code	16000584
Hospital Revenue Code	360
Min. Negotiated Rate	$411.63
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$2,778.98
Rate for Payer: Aetna Medicare Advantage	$2,778.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,362.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,362.13
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	$2,362.13
Rate for Payer: Cigna Commercial	$411.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,204.22
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,389.49
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CNTRL ORPHARYNG HEMORRAH,COMPL

Facility

$9,263.26

Service Code	HCPCS 42961
Hospital Charge Code	16000584
Hospital Revenue Code	360
Min. Negotiated Rate	$1,389.49
Max. Negotiated Rate	$1,389.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,389.49

CNTRL VENOUS CATHTER STRPNG

Facility

$5,100.00

Service Code	HCPCS 75901
Hospital Charge Code	321075901
Hospital Revenue Code	320
Min. Negotiated Rate	$76.67
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CNTRL VENOUS CATHTER STRPNG

Facility

$5,100.00

Service Code	HCPCS 75901
Hospital Charge Code	2600057
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CNTRL VENOUS CATHTER STRPNG

Facility

$5,100.00

Service Code	HCPCS 75901
Hospital Charge Code	321075901
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CNTRL VENOUS CATHTER STRPNG

Facility

$5,100.00

Service Code	HCPCS 75901
Hospital Charge Code	2600057
Hospital Revenue Code	320
Min. Negotiated Rate	$76.67
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CNTRLZR DSTL VRSYS 9mm 7859-00

Facility

$401.20

Hospital Charge Code	270635650
Hospital Revenue Code	278
Min. Negotiated Rate	$60.18
Max. Negotiated Rate	$200.60
Rate for Payer: Aetna Commercial	$120.36
Rate for Payer: Aetna Medicare Advantage	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.31
Rate for Payer: Cigna Commercial	$200.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.09
Rate for Payer: Qualcare PPO/HMO/WC	$60.18

CNTRLZR DSTL VRSYS 9mm 7859-00

Facility

$401.20

Hospital Charge Code	270635650
Hospital Revenue Code	278
Min. Negotiated Rate	$60.18
Max. Negotiated Rate	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.09
Rate for Payer: Qualcare PPO/HMO/WC	$60.18

CNTRSNK 1.7STRYKR END 60-80117

Facility

$1,000.00

Hospital Charge Code	270655380
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CNTRSNK 1.7STRYKR END 60-80117

Facility

$1,000.00

Hospital Charge Code	270655380
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CO02 HE02 N2 E CYLINDER

Facility

$60.50

Hospital Charge Code	270658106
Hospital Revenue Code	270
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$30.25
Rate for Payer: Aetna Commercial	$18.15
Rate for Payer: Aetna Medicare Advantage	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.43
Rate for Payer: Cigna Commercial	$30.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.87
Rate for Payer: Oxford Commercial	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$9.07
Rate for Payer: UnitedHealthcare Commercial	$30.25

CO02 HE02 N2 E CYLINDER

Facility

$60.50

Hospital Charge Code	270658106
Hospital Revenue Code	270
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.07

CO2 CANISTER

Facility

$55.00

Hospital Charge Code	270665361
Hospital Revenue Code	270
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

CO2 CANISTER

Facility

$55.00

Hospital Charge Code	270665361
Hospital Revenue Code	270
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

CO2 SMART CAPNOLINE ADULT CO2

Facility

$70.40

Hospital Charge Code	270676818
Hospital Revenue Code	272
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$21.12
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$35.20

Know your out-of-pocket cost for care.

All Charges