Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

COMFORT FORM WRIST/THUMB

Facility

$73.65

Hospital Charge Code	270653984
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$22.09
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Oxford Commercial	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$36.83

COMFORT FORM WRIST/THUMB

Facility

$73.65

Hospital Charge Code	270653984
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

COMM ANTEROPOSTEOR COLPORRHPHY

Facility

$46,649.25

Service Code	HCPCS 57260
Hospital Charge Code	1600000433
Hospital Revenue Code	360
Min. Negotiated Rate	$6,997.39
Max. Negotiated Rate	$6,997.39
Rate for Payer: Qualcare PPO/HMO/WC	$6,997.39

COMM ANTEROPOSTEOR COLPORRHPHY

Facility

$46,649.25

Service Code	HCPCS 57260
Hospital Charge Code	1600000433
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,994.77
Rate for Payer: Aetna Commercial	$13,994.77
Rate for Payer: Aetna Medicare Advantage	$13,994.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,895.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,895.56
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	$11,895.56
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,064.40
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,997.39
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GO
Hospital Charge Code	74203065
Hospital Revenue Code	430
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$48.30
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GO
Hospital Charge Code	74203065
Hospital Revenue Code	430
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

COMMUN WORK/REINT EA 15MIN CQ

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	409197537Q
Hospital Revenue Code	420
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$48.30
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

COMMUN WORK/REINT EA 15MIN CQ

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	409197537Q
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

COMP ARTICULAR 2.5MMX4.MM

Facility

$15,030.00

Service Code	HCPCS C1776
Hospital Charge Code	270692682
Hospital Revenue Code	278
Min. Negotiated Rate	$2,254.50
Max. Negotiated Rate	$7,515.00
Rate for Payer: Aetna Commercial	$4,509.00
Rate for Payer: Aetna Medicare Advantage	$4,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,832.65
Rate for Payer: Cigna Commercial	$7,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

COMP ARTICULAR 2.5MMX4.MM

Facility

$15,030.00

Service Code	HCPCS C1776
Hospital Charge Code	270692682
Hospital Revenue Code	278
Min. Negotiated Rate	$2,254.50
Max. Negotiated Rate	$3,637.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

COMPAZINE/10MG/CAP

Facility

$6.00

Hospital Charge Code	60632738
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

COMPAZINE/10MG/CAP

Facility

$6.00

Hospital Charge Code	60632738
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

COMPAZINE/10MG/TAB

Facility

$5.00

Hospital Charge Code	60632739
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

COMPAZINE/10MG/TAB

Facility

$5.00

Hospital Charge Code	60632739
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

COMPAZINE/15MG/CAP

Facility

$8.00

Hospital Charge Code	60632731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

COMPAZINE/15MG/CAP

Facility

$8.00

Hospital Charge Code	60632731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

COMPAZINE/25MG/EACH

Facility

$15.00

Hospital Charge Code	60632737
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

COMPAZINE/25MG/EACH

Facility

$15.00

Hospital Charge Code	60632737
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

COMPAZINE/2.5MG/EACH

Facility

$13.00

Hospital Charge Code	60632735
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

COMPAZINE/2.5MG/EACH

Facility

$13.00

Hospital Charge Code	60632735
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

COMPAZINE/5MG/1ML

Facility

$32.00

Hospital Charge Code	60632740
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

COMPAZINE/5MG/1ML

Facility

$32.00

Hospital Charge Code	60632740
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

COMPAZINE/5MG/5ML

Facility

$4.00

Service Code	NDC 440819012
Hospital Charge Code	60632732
Hospital Revenue Code	250
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

COMPAZINE/5MG/5ML

Facility

$4.00

Service Code	NDC 440819012
Hospital Charge Code	60632732
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges