Heights University Hospital

All Charges

Charge

Type

Setting

Price

CROMOLYN AEROSOL

Facility

$38.45

Hospital Charge Code	60628008
Hospital Revenue Code	259
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$5.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.77

CROMOLYN AEROSOL

Facility

$38.45

Hospital Charge Code	60628008
Hospital Revenue Code	259
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$19.23
Rate for Payer: Aetna Commercial	$11.54
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.80
Rate for Payer: Cigna Commercial	$19.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.00
Rate for Payer: Oxford Commercial	$19.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.77
Rate for Payer: UnitedHealthcare Commercial	$19.23

CROMOLYN SODIUM NAS SPRY 5.2MG

Facility

$65.65

Hospital Charge Code	60628964
Hospital Revenue Code	259
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

CROMOLYN SODIUM NAS SPRY 5.2MG

Facility

$65.65

Hospital Charge Code	60628964
Hospital Revenue Code	259
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$32.83
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$32.83

CROMOLYN SOD NSL SPR 5.2MG

Facility

$311.05

Hospital Charge Code	6001424
Hospital Revenue Code	259
Min. Negotiated Rate	$46.66
Max. Negotiated Rate	$46.66
Rate for Payer: Qualcare PPO/HMO/WC	$46.66

CROMOLYN SOD NSL SPR 5.2MG

Facility

$311.05

Hospital Charge Code	6001424
Hospital Revenue Code	259
Min. Negotiated Rate	$40.44
Max. Negotiated Rate	$155.53
Rate for Payer: Cigna Commercial	$155.53
Rate for Payer: Aetna Commercial	$93.31
Rate for Payer: Aetna Medicare Advantage	$93.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.44
Rate for Payer: Oxford Commercial	$155.53
Rate for Payer: Qualcare PPO/HMO/WC	$46.66
Rate for Payer: UnitedHealthcare Commercial	$155.53

CROMOLYN SOD RESP CAP 20MG

Facility

$165.80

Hospital Charge Code	6001432
Hospital Revenue Code	250
Min. Negotiated Rate	$21.55
Max. Negotiated Rate	$82.90
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: Aetna Medicare Advantage	$49.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$82.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.55
Rate for Payer: Oxford Commercial	$82.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.87
Rate for Payer: UnitedHealthcare Commercial	$82.90

CROMOLYN SOD RESP CAP 20MG

Facility

$165.80

Hospital Charge Code	6001432
Hospital Revenue Code	250
Min. Negotiated Rate	$24.87
Max. Negotiated Rate	$24.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.87

CROMOLYN SOL INH 20MG/2ML

Facility

$4.00

Hospital Charge Code	60628006
Hospital Revenue Code	259
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

CROMOLYN SOL INH 20MG/2ML

Facility

$4.00

Hospital Charge Code	60628006
Hospital Revenue Code	259
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CROMOLYN SPHT 4% 10 ML

Facility

$158.75

Hospital Charge Code	6001416
Hospital Revenue Code	259
Min. Negotiated Rate	$20.64
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$47.62
Rate for Payer: Aetna Medicare Advantage	$47.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.48
Rate for Payer: Cigna Commercial	$79.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.64
Rate for Payer: Oxford Commercial	$79.38
Rate for Payer: Qualcare PPO/HMO/WC	$23.81
Rate for Payer: UnitedHealthcare Commercial	$79.38

CROMOLYN SPHT 4% 10 ML

Facility

$158.75

Hospital Charge Code	6001416
Hospital Revenue Code	259
Min. Negotiated Rate	$23.81
Max. Negotiated Rate	$23.81
Rate for Payer: Qualcare PPO/HMO/WC	$23.81

CROSS CNTOR SPAN PLATE 2230550

Facility

$2,207.25

Hospital Charge Code	270632117
Hospital Revenue Code	278
Min. Negotiated Rate	$331.09
Max. Negotiated Rate	$534.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$441.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$534.15
Rate for Payer: Qualcare PPO/HMO/WC	$331.09

CROSS CNTOR SPAN PLATE 2230550

Facility

$2,207.25

Hospital Charge Code	270632117
Hospital Revenue Code	278
Min. Negotiated Rate	$331.09
Max. Negotiated Rate	$1,103.62
Rate for Payer: Aetna Commercial	$662.17
Rate for Payer: Aetna Medicare Advantage	$662.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$562.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$562.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$441.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$562.85
Rate for Payer: Cigna Commercial	$1,103.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$534.15
Rate for Payer: Qualcare PPO/HMO/WC	$331.09

CROSS CONCTOR HEX NUT 22301000

Facility

$446.45

Hospital Charge Code	270632116
Hospital Revenue Code	278
Min. Negotiated Rate	$66.97
Max. Negotiated Rate	$108.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.04
Rate for Payer: Qualcare PPO/HMO/WC	$66.97

CROSS CONCTOR HEX NUT 22301000

Facility

$446.45

Hospital Charge Code	270632116
Hospital Revenue Code	278
Min. Negotiated Rate	$66.97
Max. Negotiated Rate	$223.22
Rate for Payer: Aetna Commercial	$133.94
Rate for Payer: Aetna Medicare Advantage	$133.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.84
Rate for Payer: Cigna Commercial	$223.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.04
Rate for Payer: Qualcare PPO/HMO/WC	$66.97

CROSS CONEC SET SCREW 223005SS

Facility

$471.25

Hospital Charge Code	270632115
Hospital Revenue Code	278
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$114.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.04
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

CROSS CONEC SET SCREW 223005SS

Facility

$471.25

Hospital Charge Code	270632115
Hospital Revenue Code	278
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$235.62
Rate for Payer: Aetna Commercial	$141.38
Rate for Payer: Aetna Medicare Advantage	$141.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.17
Rate for Payer: Cigna Commercial	$235.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.04
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

CROSS CONNECTOR 48MM

Facility

$7,298.55

Service Code	HCPCS C1713
Hospital Charge Code	270704749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,094.78
Max. Negotiated Rate	$3,649.28
Rate for Payer: Aetna Commercial	$2,189.57
Rate for Payer: Aetna Medicare Advantage	$2,189.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,861.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,861.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,459.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,861.13
Rate for Payer: Cigna Commercial	$3,649.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,094.78

CROSS CONNECTOR 48MM

Facility

$7,298.55

Service Code	HCPCS C1713
Hospital Charge Code	270704749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,094.78
Max. Negotiated Rate	$1,766.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,459.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,094.78

CROSS CONNECTOR J-HOOK 2230635

Facility

$719.25

Hospital Charge Code	270632114
Hospital Revenue Code	278
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$215.78
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.06
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

CROSS CONNECTOR J-HOOK 2230635

Facility

$719.25

Hospital Charge Code	270632114
Hospital Revenue Code	278
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$174.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.06
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

CROSS CONNECT SYMP OCT30TO42

Facility

$5,892.00

Service Code	HCPCS C1713
Hospital Charge Code	270694400
Hospital Revenue Code	278
Min. Negotiated Rate	$883.80
Max. Negotiated Rate	$1,425.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,178.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.86
Rate for Payer: Qualcare PPO/HMO/WC	$883.80

CROSS CONNECT SYMP OCT30TO42

Facility

$5,892.00

Service Code	HCPCS C1713
Hospital Charge Code	270694400
Hospital Revenue Code	278
Min. Negotiated Rate	$883.80
Max. Negotiated Rate	$2,946.00
Rate for Payer: Aetna Commercial	$1,767.60
Rate for Payer: Aetna Medicare Advantage	$1,767.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,502.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,502.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,178.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,502.46
Rate for Payer: Cigna Commercial	$2,946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.86
Rate for Payer: Qualcare PPO/HMO/WC	$883.80

CROSS LINK 44-56 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	278703983
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

Know your out-of-pocket cost for care.

All Charges