Heights University Hospital

All Charges

Charge

Type

Setting

Price

COLY-MYCIN S OTIC/10ML

Facility

$101.00

Hospital Charge Code	60632728
Hospital Revenue Code	250
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$30.30
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$50.50

COLY-MYCIN S OTIC/5ML

Facility

$61.00

Hospital Charge Code	60632727
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

COLY-MYCIN S OTIC/5ML

Facility

$61.00

Hospital Charge Code	60632727
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

COLYTE/3785ML

Facility

$84.00

Hospital Charge Code	60632730
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

COLYTE/3785ML

Facility

$84.00

Hospital Charge Code	60632730
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

COLYTE/4000ML

Facility

$90.00

Hospital Charge Code	60632729
Hospital Revenue Code	250
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

COLYTE/4000ML

Facility

$90.00

Hospital Charge Code	60632729
Hospital Revenue Code	250
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

COMB 5 BLACK

Facility

$4.00

Hospital Charge Code	270300665
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

COMB 5 BLACK

Facility

$4.00

Hospital Charge Code	270300665
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC

Facility

$303,802.65

Service Code	MSDRG 429
Min. Negotiated Rate	$86,555.30
Max. Negotiated Rate	$303,802.65
Rate for Payer: Aetna Commercial	$303,802.65
Rate for Payer: Aetna Medicare Advantage	$98,318.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91,110.84
Rate for Payer: Cigna Commercial	$193,895.60
Rate for Payer: Cigna Medicare Advantage	$91,110.84
Rate for Payer: Clover Medicare Advantage	$86,555.30
Rate for Payer: EmblemHealth Commercial	$273,332.52
Rate for Payer: Humana Medicare Advantage	$93,844.17
Rate for Payer: Oxford Commercial	$121,179.12
Rate for Payer: UnitedHealthcare Commercial	$137,549.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$91,110.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$96,577.49
Rate for Payer: Wellcare Medicare Advantage	$91,110.84

COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC

Facility

$194,465.94

Service Code	MSDRG 430
Min. Negotiated Rate	$56,751.92
Max. Negotiated Rate	$194,465.94
Rate for Payer: Aetna Commercial	$194,465.94
Rate for Payer: Aetna Medicare Advantage	$62,933.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$59,738.86
Rate for Payer: Cigna Commercial	$124,113.76
Rate for Payer: Cigna Medicare Advantage	$59,738.86
Rate for Payer: Clover Medicare Advantage	$56,751.92
Rate for Payer: EmblemHealth Commercial	$179,216.58
Rate for Payer: Humana Medicare Advantage	$61,531.03
Rate for Payer: Oxford Commercial	$77,567.49
Rate for Payer: UnitedHealthcare Commercial	$88,046.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$59,738.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$63,323.19
Rate for Payer: Wellcare Medicare Advantage	$59,738.86

COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC

Facility

$168,710.04

Service Code	MSDRG 454
Min. Negotiated Rate	$168,710.04
Max. Negotiated Rate	$168,710.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168,710.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168,710.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168,710.04

COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC

Facility

$244,243.62

Service Code	MSDRG 453
Min. Negotiated Rate	$244,243.62
Max. Negotiated Rate	$244,243.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244,243.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244,243.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244,243.62

COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC

Facility

$127,083.87

Service Code	MSDRG 455
Min. Negotiated Rate	$127,083.87
Max. Negotiated Rate	$127,083.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127,083.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127,083.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127,083.87

COMBIVENT RESPIMAT 4GM

Facility

$1,155.85

Hospital Charge Code	60630190
Hospital Revenue Code	250
Min. Negotiated Rate	$150.26
Max. Negotiated Rate	$577.92
Rate for Payer: Aetna Commercial	$346.75
Rate for Payer: Aetna Medicare Advantage	$346.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.74
Rate for Payer: Cigna Commercial	$577.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.26
Rate for Payer: Oxford Commercial	$577.92
Rate for Payer: Qualcare PPO/HMO/WC	$173.38
Rate for Payer: UnitedHealthcare Commercial	$577.92

COMBIVENT RESPIMAT 4GM

Facility

$1,155.85

Hospital Charge Code	60630190
Hospital Revenue Code	250
Min. Negotiated Rate	$173.38
Max. Negotiated Rate	$173.38
Rate for Payer: Qualcare PPO/HMO/WC	$173.38

COMBIVIR 150/300 TAB

Facility

$60.00

Hospital Charge Code	60635200
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

COMBIVIR 150/300 TAB

Facility

$60.00

Hospital Charge Code	60635200
Hospital Revenue Code	250
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

COMB RHC + LHC

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	366893460
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

COMB RHC + LHC

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	7411241
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

COMB RHC + LHC

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	366893460
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COMB RHC + LHC

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	7411241
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COMET II PRESSURE GUIDEWIRE

Facility

$6,375.00

Hospital Charge Code	270703404
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

COMET II PRESSURE GUIDEWIRE

Facility

$6,375.00

Hospital Charge Code	270703404
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$1,912.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

COMFORT DISCS LARGE

Facility

$66.67

Hospital Charge Code	2709002551
Hospital Revenue Code	272
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$33.34
Rate for Payer: Aetna Commercial	$20.00
Rate for Payer: Aetna Medicare Advantage	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.00
Rate for Payer: Cigna Commercial	$33.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.67
Rate for Payer: Oxford Commercial	$33.34
Rate for Payer: Qualcare PPO/HMO/WC	$10.00
Rate for Payer: UnitedHealthcare Commercial	$33.34

Know your out-of-pocket cost for care.

All Charges