Heights University Hospital

All Charges

Charge

Type

Setting

Price

DEPO-PROVERA 150MG SYRING

Facility

$186.00

Hospital Charge Code	60635270
Hospital Revenue Code	250
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$93.00

DEPO-PROVERA 400MG/ML

Facility

$654.00

Hospital Charge Code	60634752
Hospital Revenue Code	250
Min. Negotiated Rate	$98.10
Max. Negotiated Rate	$98.10
Rate for Payer: Qualcare PPO/HMO/WC	$98.10

DEPO-PROVERA 400MG/ML

Facility

$654.00

Hospital Charge Code	60634752
Hospital Revenue Code	250
Min. Negotiated Rate	$85.02
Max. Negotiated Rate	$327.00
Rate for Payer: Aetna Commercial	$196.20
Rate for Payer: Aetna Medicare Advantage	$196.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.77
Rate for Payer: Cigna Commercial	$327.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.02
Rate for Payer: Oxford Commercial	$327.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.10
Rate for Payer: UnitedHealthcare Commercial	$327.00

DEPRESSIVE DISORDERS

Facility

$5,016.45

Service Code	APR-DRG 7511
Min. Negotiated Rate	$3,543.62
Max. Negotiated Rate	$5,016.45
Rate for Payer: Aetna Better Health Medicaid	$4,918.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,016.45
Rate for Payer: Wellpoint Medicaid Managed Care	$3,543.62

DEPRESSIVE DISORDERS

Facility

$26,320.94

Service Code	APR-DRG 7514
Min. Negotiated Rate	$16,610.75
Max. Negotiated Rate	$26,320.94
Rate for Payer: Aetna Better Health Medicaid	$25,804.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,320.94
Rate for Payer: Wellpoint Medicaid Managed Care	$16,610.75

DEPRESSIVE DISORDERS

Facility

$6,715.72

Service Code	APR-DRG 7512
Min. Negotiated Rate	$4,912.94
Max. Negotiated Rate	$6,715.72
Rate for Payer: Aetna Better Health Medicaid	$6,584.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,715.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4,912.94

DEPRESSIVE DISORDERS

Facility

$11,984.99

Service Code	APR-DRG 7513
Min. Negotiated Rate	$8,556.32
Max. Negotiated Rate	$11,984.99
Rate for Payer: Aetna Better Health Medicaid	$11,749.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,984.99
Rate for Payer: Wellpoint Medicaid Managed Care	$8,556.32

DEPRESSIVE NEUROSES

Facility

$39,132.54

Service Code	MSDRG 881
Min. Negotiated Rate	$10,267.65
Max. Negotiated Rate	$39,132.54
Rate for Payer: Aetna Commercial	$31,727.04
Rate for Payer: Aetna Medicare Advantage	$10,267.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,044.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,085.97
Rate for Payer: Cigna Commercial	$20,249.11
Rate for Payer: Cigna Medicare Advantage	$13,044.18
Rate for Payer: Clover Medicare Advantage	$12,391.97
Rate for Payer: EmblemHealth Commercial	$39,132.54
Rate for Payer: Humana Medicare Advantage	$13,435.51
Rate for Payer: Oxford Commercial	$12,655.10
Rate for Payer: UnitedHealthcare Commercial	$14,364.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,044.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,826.83
Rate for Payer: Wellcare Medicare Advantage	$13,044.18

DEPRESSOR TONGUE ADULT STERILE

Facility

$0.16

Hospital Charge Code	270300380
Hospital Revenue Code	272
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.08
Rate for Payer: Aetna Commercial	$0.05
Rate for Payer: Aetna Medicare Advantage	$0.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.04
Rate for Payer: Cigna Commercial	$0.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.02
Rate for Payer: Oxford Commercial	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.02
Rate for Payer: UnitedHealthcare Commercial	$0.08

DEPRESSOR TONGUE ADULT STERILE

Facility

$0.16

Hospital Charge Code	270300380
Hospital Revenue Code	272
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.02

DEPROPROVERA MEDICATION*****

Facility

$24.17

Service Code	HCPCS J1055
Hospital Charge Code	9600023
Hospital Revenue Code	259
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$12.09
Rate for Payer: Aetna Commercial	$7.25
Rate for Payer: Aetna Medicare Advantage	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.16
Rate for Payer: Cigna Commercial	$12.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.14
Rate for Payer: Oxford Commercial	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$3.63
Rate for Payer: UnitedHealthcare Commercial	$12.09

DEPROPROVERA MEDICATION*****

Facility

$24.17

Service Code	HCPCS J1055
Hospital Charge Code	9600023
Hospital Revenue Code	259
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$3.63

DEPTH GAUGE FOR NAIL SYSTEM MU

Facility

$4,462.65

Hospital Charge Code	270688274
Hospital Revenue Code	272
Min. Negotiated Rate	$669.40
Max. Negotiated Rate	$669.40
Rate for Payer: Qualcare PPO/HMO/WC	$669.40

DEPTH GAUGE FOR NAIL SYSTEM MU

Facility

$4,462.65

Hospital Charge Code	270688274
Hospital Revenue Code	272
Min. Negotiated Rate	$580.14
Max. Negotiated Rate	$2,231.32
Rate for Payer: Aetna Commercial	$1,338.80
Rate for Payer: Aetna Medicare Advantage	$1,338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.98
Rate for Payer: Cigna Commercial	$2,231.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.14
Rate for Payer: Oxford Commercial	$2,231.32
Rate for Payer: Qualcare PPO/HMO/WC	$669.40
Rate for Payer: UnitedHealthcare Commercial	$2,231.32

DEPTH GAUGE FOR SMALL SCREW

Facility

$1,845.00

Hospital Charge Code	270656229
Hospital Revenue Code	272
Min. Negotiated Rate	$239.85
Max. Negotiated Rate	$922.50
Rate for Payer: Aetna Commercial	$553.50
Rate for Payer: Aetna Medicare Advantage	$553.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$470.48
Rate for Payer: Cigna Commercial	$922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.85
Rate for Payer: Oxford Commercial	$922.50
Rate for Payer: Qualcare PPO/HMO/WC	$276.75
Rate for Payer: UnitedHealthcare Commercial	$922.50

DEPTH GAUGE FOR SMALL SCREW

Facility

$1,845.00

Hospital Charge Code	270656229
Hospital Revenue Code	272
Min. Negotiated Rate	$276.75
Max. Negotiated Rate	$276.75
Rate for Payer: Qualcare PPO/HMO/WC	$276.75

DEPTH GAUGE SML FRAG SET 2.7MM

Facility

$1,779.10

Hospital Charge Code	270643522
Hospital Revenue Code	272
Min. Negotiated Rate	$231.28
Max. Negotiated Rate	$889.55
Rate for Payer: Aetna Commercial	$533.73
Rate for Payer: Aetna Medicare Advantage	$533.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.67
Rate for Payer: Cigna Commercial	$889.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.28
Rate for Payer: Oxford Commercial	$889.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.87
Rate for Payer: UnitedHealthcare Commercial	$889.55

DEPTH GAUGE SML FRAG SET 2.7MM

Facility

$1,779.10

Hospital Charge Code	270643522
Hospital Revenue Code	272
Min. Negotiated Rate	$266.87
Max. Negotiated Rate	$266.87
Rate for Payer: Qualcare PPO/HMO/WC	$266.87

DEPTH GUAGE

Facility

$2,385.00

Hospital Charge Code	270659777
Hospital Revenue Code	272
Min. Negotiated Rate	$310.05
Max. Negotiated Rate	$1,192.50
Rate for Payer: Aetna Commercial	$715.50
Rate for Payer: Aetna Medicare Advantage	$715.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$608.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$608.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$608.17
Rate for Payer: Cigna Commercial	$1,192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.05
Rate for Payer: Oxford Commercial	$1,192.50
Rate for Payer: Qualcare PPO/HMO/WC	$357.75
Rate for Payer: UnitedHealthcare Commercial	$1,192.50

DEPTH GUAGE

Facility

$2,385.00

Hospital Charge Code	270659777
Hospital Revenue Code	272
Min. Negotiated Rate	$357.75
Max. Negotiated Rate	$357.75
Rate for Payer: Qualcare PPO/HMO/WC	$357.75

DEPTH REAMER 2.0MM STERILE

Facility

$1,000.00

Hospital Charge Code	270665478
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

DEPTH REAMER 2.0MM STERILE

Facility

$1,000.00

Hospital Charge Code	270665478
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

DERMABOND

Facility

$129.00

Hospital Charge Code	60635298
Hospital Revenue Code	250
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$64.50

DERMABOND

Facility

$129.00

Hospital Charge Code	60635298
Hospital Revenue Code	250
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

DERMABOND

Facility

$221.00

Hospital Charge Code	5792185
Hospital Revenue Code	250
Min. Negotiated Rate	$28.73
Max. Negotiated Rate	$110.50
Rate for Payer: Aetna Commercial	$66.30
Rate for Payer: Aetna Medicare Advantage	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.35
Rate for Payer: Cigna Commercial	$110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.73
Rate for Payer: Oxford Commercial	$110.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.15
Rate for Payer: UnitedHealthcare Commercial	$110.50

Know your out-of-pocket cost for care.

All Charges