Heights University Hospital

All Charges

Charge

Type

Setting

Price

COT FINGER 3-1/2 12203

Facility

$49.10

Hospital Charge Code	270650448
Hospital Revenue Code	270
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

COT FINGER 3-1/2 12203

Facility

$49.10

Hospital Charge Code	270650448
Hospital Revenue Code	270
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$24.55
Rate for Payer: Aetna Commercial	$14.73
Rate for Payer: Aetna Medicare Advantage	$14.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.52
Rate for Payer: Cigna Commercial	$24.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.38
Rate for Payer: Oxford Commercial	$24.55
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$24.55

COTININE, URINE

Facility

$333.00

Service Code	HCPCS 86022
Hospital Charge Code	38473083
Hospital Revenue Code	302
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.52
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.31
Rate for Payer: Cigna Commercial	$18.37
Rate for Payer: Cigna Medicare Advantage	$9.19
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.47
Rate for Payer: Wellcare Medicare Advantage	$18.37

COTININE, URINE

Facility

$333.00

Service Code	HCPCS 86022
Hospital Charge Code	38473083
Hospital Revenue Code	302
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

COTRIMOXAZOLE INJ

Facility

$70.40

Hospital Charge Code	6001390
Hospital Revenue Code	250
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

COTRIMOXAZOLE INJ

Facility

$70.40

Hospital Charge Code	6001390
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$21.12
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$35.20

COTRIMOXAZOLE TAB 800MG/160MG

Facility

$1.95

Hospital Charge Code	6022370
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

COTRIMOXAZOLE TAB 800MG/160MG

Facility

$1.95

Hospital Charge Code	6022370
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

COTTON ALLOG WEDGE 6X24X14MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270671557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

COTTON ALLOG WEDGE 6X24X14MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270671557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

COTTON BALLS STER

Facility

$2.40

Hospital Charge Code	270649384
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$1.20
Rate for Payer: Aetna Commercial	$0.72
Rate for Payer: Aetna Medicare Advantage	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.61
Rate for Payer: Cigna Commercial	$1.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.31
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.36
Rate for Payer: UnitedHealthcare Commercial	$1.20

COTTON BALLS STER

Facility

$2.40

Hospital Charge Code	270649384
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Qualcare PPO/HMO/WC	$0.36

COTTON FLAT PLATE

Facility

$4,290.00

Hospital Charge Code	270656500
Hospital Revenue Code	278
Min. Negotiated Rate	$643.50
Max. Negotiated Rate	$1,038.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$858.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,038.18
Rate for Payer: Qualcare PPO/HMO/WC	$643.50

COTTON FLAT PLATE

Facility

$4,290.00

Hospital Charge Code	270656500
Hospital Revenue Code	278
Min. Negotiated Rate	$643.50
Max. Negotiated Rate	$2,145.00
Rate for Payer: Aetna Commercial	$1,287.00
Rate for Payer: Aetna Medicare Advantage	$1,287.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,093.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,093.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,093.95
Rate for Payer: Cigna Commercial	$2,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,038.18
Rate for Payer: Qualcare PPO/HMO/WC	$643.50

COTTON-LEUNG STENT ONLY 7FR

Facility

$253.00

Hospital Charge Code	270332242
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

COTTON-LEUNG STENT ONLY 7FR

Facility

$253.00

Hospital Charge Code	270332242
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

COTTON WEDGE 15X20X8MM

Facility

$14,490.00

Hospital Charge Code	270700419
Hospital Revenue Code	278
Min. Negotiated Rate	$2,173.50
Max. Negotiated Rate	$7,245.00
Rate for Payer: Cigna Commercial	$7,245.00
Rate for Payer: Aetna Commercial	$4,347.00
Rate for Payer: Aetna Medicare Advantage	$4,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,694.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,694.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,898.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,694.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,506.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,173.50

COTTON WEDGE 15X20X8MM

Facility

$14,490.00

Hospital Charge Code	270700419
Hospital Revenue Code	278
Min. Negotiated Rate	$2,173.50
Max. Negotiated Rate	$3,506.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,898.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,506.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,173.50

COTTON WEDGE 8MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270674212
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$1,195.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

COTTON WEDGE 8MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270674212
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,470.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.70
Rate for Payer: Cigna Commercial	$2,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

COTTON WEDGE BIO 20X14X10X6.5

Facility

$10,136.50

Service Code	HCPCS C1716
Hospital Charge Code	270702334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,520.47
Max. Negotiated Rate	$2,453.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,027.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,453.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,520.47

COTTON WEDGE BIO 20X14X10X6.5

Facility

$10,136.50

Service Code	HCPCS C1716
Hospital Charge Code	270702334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,197.08
Max. Negotiated Rate	$3,040.95
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Aetna Commercial	$3,040.95
Rate for Payer: Aetna Medicare Advantage	$3,040.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,584.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,584.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,027.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,584.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,453.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,520.47

COUMADIN/10MG/TAB

Facility

$4.00

Hospital Charge Code	60632756
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

COUMADIN/10MG/TAB

Facility

$4.00

Hospital Charge Code	60632756
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

COUMADIN/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60632757
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges