Heights University Hospital

All Charges

Charge

Type

Setting

Price

CONICAL SUBTALAR IMPLANT 9MM

Facility

$6,475.00

Hospital Charge Code	270656735
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

CONICAL SUBTALAR IMPLANT 9MM

Facility

$6,475.00

Hospital Charge Code	270656735
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$1,942.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

CONIVAPTAN 5MG/ML INJ

Facility

$3,918.46

Hospital Charge Code	606350917
Hospital Revenue Code	250
Min. Negotiated Rate	$509.40
Max. Negotiated Rate	$1,959.23
Rate for Payer: Aetna Commercial	$1,175.54
Rate for Payer: Aetna Medicare Advantage	$1,175.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$999.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$999.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$999.21
Rate for Payer: Cigna Commercial	$1,959.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$509.40
Rate for Payer: Oxford Commercial	$1,959.23
Rate for Payer: Qualcare PPO/HMO/WC	$587.77
Rate for Payer: UnitedHealthcare Commercial	$1,959.23

CONIVAPTAN 5MG/ML INJ

Facility

$3,918.46

Hospital Charge Code	606350917
Hospital Revenue Code	250
Min. Negotiated Rate	$587.77
Max. Negotiated Rate	$587.77
Rate for Payer: Qualcare PPO/HMO/WC	$587.77

CONIZATION OF CERVIX

Facility

$29,961.70

Service Code	HCPCS 57520
Hospital Charge Code	1600000654
Hospital Revenue Code	360
Min. Negotiated Rate	$4,494.26
Max. Negotiated Rate	$4,494.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26

CONIZATION OF CERVIX

Facility

$29,961.70

Service Code	HCPCS 57520
Hospital Charge Code	1600000654
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,988.51
Rate for Payer: Aetna Commercial	$8,988.51
Rate for Payer: Aetna Medicare Advantage	$8,988.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,640.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,640.23
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	$7,640.23
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,895.02
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000217
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$7,326.67
Rate for Payer: Aetna Medicare Advantage	$7,326.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,227.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,227.67
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	$6,227.67
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,174.89
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000188
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000217
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000188
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$7,326.67
Rate for Payer: Aetna Medicare Advantage	$7,326.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,227.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,227.67
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	$6,227.67
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,174.89
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$242.26
Max. Negotiated Rate	$390.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$242.26
Max. Negotiated Rate	$484.53
Rate for Payer: Aetna Commercial	$484.53
Rate for Payer: Aetna Medicare Advantage	$484.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: Oxford Commercial	$4.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$4.12

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$3.55
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.92
Rate for Payer: Oxford Commercial	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$3.55

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$2.57
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$4.29

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$356.54
Max. Negotiated Rate	$1,371.33
Rate for Payer: Aetna Commercial	$822.79
Rate for Payer: Aetna Medicare Advantage	$822.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.38
Rate for Payer: Cigna Commercial	$1,371.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.54
Rate for Payer: Oxford Commercial	$1,371.33
Rate for Payer: Qualcare PPO/HMO/WC	$411.40
Rate for Payer: UnitedHealthcare Commercial	$1,371.33

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$411.40
Max. Negotiated Rate	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$411.40

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

CONNECTING SCREW

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270686084
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CONNECTING SCREW

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270686084
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$156.00
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CONNECTION ROD LONG

Facility

$51.75

Service Code	HCPCS C1713
Hospital Charge Code	270678087
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

Know your out-of-pocket cost for care.

All Charges