Heights University Hospital

All Charges

Charge

Type

Setting

Price

COCCIDIOIDES ANTIBODIES II

Facility

$108.00

Service Code	HCPCS 86635
Hospital Charge Code	3038099B
Hospital Revenue Code	302
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

COCCIDIOIDES ANTIBODIES II

Facility

$108.00

Service Code	HCPCS 86635
Hospital Charge Code	3038099B
Hospital Revenue Code	302
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.16
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.03
Rate for Payer: Cigna Commercial	$11.47
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$10.90
Rate for Payer: EmblemHealth Commercial	$34.41
Rate for Payer: Humana Medicare Advantage	$11.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.16
Rate for Payer: Wellcare Medicare Advantage	$11.47

COCCIDIOIDES ANTIBODY

Facility

$116.00

Service Code	HCPCS 86635
Hospital Charge Code	38473070
Hospital Revenue Code	302
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

COCCIDIOIDES ANTIBODY

Facility

$116.00

Service Code	HCPCS 86635
Hospital Charge Code	38473070
Hospital Revenue Code	302
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.16
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.03
Rate for Payer: Cigna Commercial	$11.47
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$10.90
Rate for Payer: EmblemHealth Commercial	$34.41
Rate for Payer: Humana Medicare Advantage	$11.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.16
Rate for Payer: Wellcare Medicare Advantage	$11.47

COCCYGECTOMY, PRIMARY

Facility

$30,595.00

Service Code	HCPCS 27080
Hospital Charge Code	16000867
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,178.50
Rate for Payer: Aetna Commercial	$9,178.50
Rate for Payer: Aetna Medicare Advantage	$9,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,801.73
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	$7,801.73
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,977.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

COCCYGECTOMY, PRIMARY

Facility

$30,595.00

Service Code	HCPCS 27080
Hospital Charge Code	16000867
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

COCK-UP 5TH TOE W PLSTC CLS-T9

Facility

$21,064.69

Service Code	HCPCS 28286
Hospital Charge Code	16000722
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.70
Max. Negotiated Rate	$3,159.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70

COCK-UP 5TH TOE W PLSTC CLS-T9

Facility

$21,064.69

Service Code	HCPCS 28286
Hospital Charge Code	16000722
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,319.41
Rate for Payer: Aetna Medicare Advantage	$6,319.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,371.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,371.50
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	$5,371.50
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.41
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CODE BLUE

Facility

$844.00

Service Code	HCPCS 92950
Hospital Charge Code	95090365
Hospital Revenue Code	480
Min. Negotiated Rate	$59.57
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$253.20
Rate for Payer: Aetna Medicare Advantage	$253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.22
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.72
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.60
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CODE BLUE

Facility

$844.00

Service Code	HCPCS 92950
Hospital Charge Code	95090365
Hospital Revenue Code	480
Min. Negotiated Rate	$126.60
Max. Negotiated Rate	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.60

CODE BLUE RESCUSCITATOR

Facility

$156.00

Hospital Charge Code	270332064
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

CODE BLUE RESCUSCITATOR

Facility

$156.00

Hospital Charge Code	270332064
Hospital Revenue Code	272
Min. Negotiated Rate	$20.28
Max. Negotiated Rate	$78.00
Rate for Payer: Aetna Commercial	$46.80
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.28
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$78.00

CODEINE

Facility

$137.79

Hospital Charge Code	38478105
Hospital Revenue Code	301
Min. Negotiated Rate	$17.91
Max. Negotiated Rate	$114.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: Aetna Commercial	$41.34
Rate for Payer: Aetna Medicare Advantage	$41.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.14
Rate for Payer: Cigna Commercial	$68.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.67

CODEINE

Facility

$137.79

Hospital Charge Code	38478105
Hospital Revenue Code	301
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$20.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.67

CODEINE

Facility

$323.00

Service Code	HCPCS 80361
Hospital Charge Code	38472215
Hospital Revenue Code	301
Min. Negotiated Rate	$41.99
Max. Negotiated Rate	$161.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.36
Rate for Payer: Cigna Commercial	$161.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.45
Rate for Payer: UnitedHealthcare Commercial	$114.00

CODEINE

Facility

$323.00

Service Code	HCPCS 80361
Hospital Charge Code	38472215
Hospital Revenue Code	301
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$48.45
Rate for Payer: Qualcare PPO/HMO/WC	$48.45

CODEINE 30MG/2ML INJ

Facility

$11.00

Hospital Charge Code	60635550
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

CODEINE 30MG/2ML INJ

Facility

$11.00

Hospital Charge Code	60635550
Hospital Revenue Code	250
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

CODEINE 60 MG/ 2 ML INJECTION

Facility

$3.95

Hospital Charge Code	60629825
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$0.59
Rate for Payer: Qualcare PPO/HMO/WC	$0.59

CODEINE 60 MG/ 2 ML INJECTION

Facility

$3.95

Hospital Charge Code	60629825
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$1.98
Rate for Payer: Aetna Commercial	$1.19
Rate for Payer: Aetna Medicare Advantage	$1.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.01
Rate for Payer: Cigna Commercial	$1.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.59
Rate for Payer: UnitedHealthcare Commercial	$1.98

CODEINE CARPUJECT 2ML/15M

Facility

$5.00

Hospital Charge Code	60632723
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

CODEINE CARPUJECT 2ML/15M

Facility

$5.00

Hospital Charge Code	60632723
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

CODEINE PHOSPHATE 30MG/ML SYRI

Facility

$10.45

Hospital Charge Code	60627703
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$5.22

CODEINE PHOSPHATE 30MG/ML SYRI

Facility

$10.45

Hospital Charge Code	60627703
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

CODEINE,QUANTITATIVE URINE

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3007631
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges