Heights University Hospital

All Charges

Charge

Type

Setting

Price

DHT/0.4MG/TAB

Facility

$6.00

Hospital Charge Code	60632815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DIABETES

Facility

$7,672.12

Service Code	APR-DRG 4202
Min. Negotiated Rate	$5,103.99
Max. Negotiated Rate	$7,672.12
Rate for Payer: Aetna Better Health Medicaid	$7,521.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,672.12
Rate for Payer: Wellpoint Medicaid Managed Care	$5,103.99

DIABETES

Facility

$23,322.54

Service Code	APR-DRG 4204
Min. Negotiated Rate	$18,675.19
Max. Negotiated Rate	$23,322.54
Rate for Payer: Aetna Better Health Medicaid	$22,865.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,322.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18,675.19

DIABETES

Facility

$6,083.78

Service Code	APR-DRG 4201
Min. Negotiated Rate	$3,949.62
Max. Negotiated Rate	$6,083.78
Rate for Payer: Aetna Better Health Medicaid	$5,964.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,083.78
Rate for Payer: Wellpoint Medicaid Managed Care	$3,949.62

DIABETES

Facility

$11,406.42

Service Code	APR-DRG 4203
Min. Negotiated Rate	$7,659.07
Max. Negotiated Rate	$11,406.42
Rate for Payer: Aetna Better Health Medicaid	$11,182.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,406.42
Rate for Payer: Wellpoint Medicaid Managed Care	$7,659.07

DIABETES INPATIENT SERVICE

Facility

$112.00

Hospital Charge Code	9200051
Hospital Revenue Code	942
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$779.00
Rate for Payer: Aetna Commercial	$33.60
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$779.00

DIABETES INPATIENT SERVICE

Facility

$112.00

Hospital Charge Code	9200051
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

DIABETES WITH CC

Facility

$37,835.10

Service Code	MSDRG 638
Min. Negotiated Rate	$9,779.86
Max. Negotiated Rate	$37,835.10
Rate for Payer: Aetna Commercial	$30,219.77
Rate for Payer: Aetna Medicare Advantage	$9,779.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,810.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,810.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,611.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,810.30
Rate for Payer: Cigna Commercial	$19,287.12
Rate for Payer: Cigna Medicare Advantage	$12,611.70
Rate for Payer: Clover Medicare Advantage	$11,981.11
Rate for Payer: EmblemHealth Commercial	$37,835.10
Rate for Payer: Humana Medicare Advantage	$12,990.05
Rate for Payer: Oxford Commercial	$12,053.89
Rate for Payer: UnitedHealthcare Commercial	$13,682.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,611.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,368.40
Rate for Payer: Wellcare Medicare Advantage	$12,611.70

DIABETES WITH MCC

Facility

$53,523.51

Service Code	MSDRG 637
Min. Negotiated Rate	$15,678.11
Max. Negotiated Rate	$53,523.51
Rate for Payer: Aetna Commercial	$48,445.36
Rate for Payer: Aetna Medicare Advantage	$15,678.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,972.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,972.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,841.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,972.15
Rate for Payer: Cigna Commercial	$30,919.22
Rate for Payer: Cigna Medicare Advantage	$17,841.17
Rate for Payer: Clover Medicare Advantage	$16,949.11
Rate for Payer: EmblemHealth Commercial	$53,523.51
Rate for Payer: Humana Medicare Advantage	$18,376.41
Rate for Payer: Oxford Commercial	$19,323.62
Rate for Payer: UnitedHealthcare Commercial	$21,934.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,841.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,911.64
Rate for Payer: Wellcare Medicare Advantage	$17,841.17

DIABETES WITHOUT CC/MCC

Facility

$29,853.00

Service Code	MSDRG 639
Min. Negotiated Rate	$6,778.90
Max. Negotiated Rate	$29,853.00
Rate for Payer: Aetna Commercial	$20,946.80
Rate for Payer: Aetna Medicare Advantage	$6,778.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,091.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,091.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,091.54
Rate for Payer: Cigna Commercial	$13,368.85
Rate for Payer: Cigna Medicare Advantage	$9,951.00
Rate for Payer: Clover Medicare Advantage	$9,453.45
Rate for Payer: EmblemHealth Commercial	$29,853.00
Rate for Payer: Humana Medicare Advantage	$10,249.53
Rate for Payer: Oxford Commercial	$8,355.14
Rate for Payer: UnitedHealthcare Commercial	$9,483.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,951.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,548.06
Rate for Payer: Wellcare Medicare Advantage	$9,951.00

DIABETIC EGGNOG

Facility

$13.00

Hospital Charge Code	60634841
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

DIABETIC EGGNOG

Facility

$13.00

Hospital Charge Code	60634841
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DIABETIC PUDDING

Facility

$13.00

Hospital Charge Code	60634842
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DIABETIC PUDDING

Facility

$13.00

Hospital Charge Code	60634842
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

DIABETIC SELF MGMT COUNSEL GRP

Facility

$49.30

Hospital Charge Code	9200023
Hospital Revenue Code	942
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.39

DIABETIC SELF MGMT COUNSEL GRP

Facility

$49.30

Hospital Charge Code	9200023
Hospital Revenue Code	942
Min. Negotiated Rate	$6.41
Max. Negotiated Rate	$779.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.39
Rate for Payer: Aetna Commercial	$14.79
Rate for Payer: Aetna Medicare Advantage	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.57
Rate for Payer: Cigna Commercial	$24.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.41
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: UnitedHealthcare Commercial	$779.00

DIABETIC SELF MGMT COUNSEL IND

Facility

$89.60

Hospital Charge Code	9200015
Hospital Revenue Code	942
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$779.00
Rate for Payer: Aetna Commercial	$26.88
Rate for Payer: Aetna Medicare Advantage	$26.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.85
Rate for Payer: Cigna Commercial	$44.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.65
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.44
Rate for Payer: UnitedHealthcare Commercial	$779.00

DIABETIC SELF MGMT COUNSEL IND

Facility

$89.60

Hospital Charge Code	9200015
Hospital Revenue Code	942
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$13.44
Rate for Payer: Qualcare PPO/HMO/WC	$13.44

DIABINESE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60632817
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

DIABINESE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60632817
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DIABINESE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634219
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DIABINESE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634219
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

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$779.00

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB MGMT GESTATIONAL

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200029
Hospital Revenue Code	942
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$779.00
Rate for Payer: Aetna Commercial	$33.60
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$779.00

Know your out-of-pocket cost for care.

All Charges