Heights University Hospital

All Charges

Charge

Type

Setting

Price

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,035.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$834.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

17 ALPHA HYDROXYPROGESTERONE

Facility

$201.65

Service Code	HCPCS 83498
Hospital Charge Code	3000545
Hospital Revenue Code	301
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.55
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: Cigna Medicare Advantage	$13.59
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.80
Rate for Payer: Wellcare Medicare Advantage	$27.17

17 ALPHA HYDROXYPROGESTERONE

Facility

$201.65

Service Code	HCPCS 83498
Hospital Charge Code	3000545
Hospital Revenue Code	301
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$30.25

1.7 DRILL BIT

Facility

$395.00

Hospital Charge Code	270656153
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

1.7 DRILL BIT

Facility

$395.00

Hospital Charge Code	270656153
Hospital Revenue Code	272
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$118.50
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.35
Rate for Payer: Oxford Commercial	$197.50
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$197.50

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
Min. Negotiated Rate	$60.60
Max. Negotiated Rate	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$60.60

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
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	$23.56
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	$52.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.60
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

17 HYDROXY CORTICOSTEROIDS, U

Facility

$170.45

Service Code	HCPCS 83491
Hospital Charge Code	3001591
Hospital Revenue Code	301
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

17 HYDROXY CORTICOSTEROIDS, U

Facility

$170.45

Service Code	HCPCS 83491
Hospital Charge Code	3001591
Hospital Revenue Code	301
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	$23.56
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	$22.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
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

17 HYDROXY PREGNENOLONE

Facility

$205.65

Service Code	HCPCS 84143
Hospital Charge Code	3000544
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

17 HYDROXY PREGNENOLONE

Facility

$205.65

Service Code	HCPCS 84143
Hospital Charge Code	3000544
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Medicare Advantage	$11.40
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.58
Rate for Payer: Cigna Commercial	$22.81
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.18
Rate for Payer: Wellcare Medicare Advantage	$22.81

17 HYDROXYPREGNENOLONE***

Facility

$201.00

Hospital Charge Code	3010543
Hospital Revenue Code	301
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.30
Rate for Payer: Aetna Medicare Advantage	$60.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.26
Rate for Payer: Cigna Commercial	$100.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

17 HYDROXYPREGNENOLONE***

Facility

$201.00

Hospital Charge Code	3010543
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.58
Rate for Payer: Cigna Commercial	$22.81
Rate for Payer: Cigna Medicare Advantage	$11.40
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.18
Rate for Payer: Wellcare Medicare Advantage	$22.81

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.55
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: Cigna Medicare Advantage	$13.59
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
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	$27.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.80
Rate for Payer: Wellcare Medicare Advantage	$27.17

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.55
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: Cigna Medicare Advantage	$13.59
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.80
Rate for Payer: Wellcare Medicare Advantage	$27.17

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$109.35
Max. Negotiated Rate	$109.35
Rate for Payer: Qualcare PPO/HMO/WC	$109.35

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

17 KETOGENIC STEROIDS URINE

Facility

$179.25

Service Code	HCPCS 83582
Hospital Charge Code	3001724
Hospital Revenue Code	301
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

17 KETOGENIC STEROIDS URINE

Facility

$179.25

Service Code	HCPCS 83582
Hospital Charge Code	3001724
Hospital Revenue Code	301
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.12
Rate for Payer: Aetna Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.68
Rate for Payer: Cigna Commercial	$15.47
Rate for Payer: Cigna Medicare Advantage	$7.74
Rate for Payer: Clover Medicare Advantage	$14.70
Rate for Payer: EmblemHealth Commercial	$46.41
Rate for Payer: Humana Medicare Advantage	$15.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.40
Rate for Payer: Wellcare Medicare Advantage	$15.47

17 KETOSTEROIDS, URINE

Facility

$136.85

Service Code	HCPCS 83586
Hospital Charge Code	3001732
Hospital Revenue Code	301
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.47
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.90
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: Cigna Medicare Advantage	$6.40
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.57
Rate for Payer: Wellcare Medicare Advantage	$12.80

17 KETOSTEROIDS, URINE

Facility

$136.85

Service Code	HCPCS 83586
Hospital Charge Code	3001732
Hospital Revenue Code	301
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

17 KETOSTEROIDS,URINE

Facility

$390.00

Service Code	HCPCS 83586
Hospital Charge Code	38472383
Hospital Revenue Code	301
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.47
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.90
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: Cigna Medicare Advantage	$6.40
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
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	$12.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.57
Rate for Payer: Wellcare Medicare Advantage	$12.80

Know your out-of-pocket cost for care.

All Charges