Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRSG REST ALGT 1X12 3158529969

Facility

$39.63

Hospital Charge Code	270641732W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$19.82
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.11
Rate for Payer: Cigna Commercial	$19.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.15
Rate for Payer: Oxford Commercial	$19.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.94
Rate for Payer: UnitedHealthcare Commercial	$19.82

DRSG REST CONT 6X8 3158509342

Facility

$168.50

Hospital Charge Code	270641731W
Hospital Revenue Code	272
Min. Negotiated Rate	$21.91
Max. Negotiated Rate	$84.25
Rate for Payer: Aetna Commercial	$50.55
Rate for Payer: Aetna Medicare Advantage	$50.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.97
Rate for Payer: Cigna Commercial	$84.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.91
Rate for Payer: Oxford Commercial	$84.25
Rate for Payer: Qualcare PPO/HMO/WC	$25.27
Rate for Payer: UnitedHealthcare Commercial	$84.25

DRSG REST CONT 6X8 3158509342

Facility

$168.50

Hospital Charge Code	270641731W
Hospital Revenue Code	272
Min. Negotiated Rate	$25.27
Max. Negotiated Rate	$25.27
Rate for Payer: Qualcare PPO/HMO/WC	$25.27

DRSG SIL CON LYR4x5 3158509341

Facility

$42.97

Hospital Charge Code	270641730W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.48
Rate for Payer: Aetna Commercial	$12.89
Rate for Payer: Aetna Medicare Advantage	$12.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.48
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.48

DRSG SIL CON LYR4x5 3158509341

Facility

$42.97

Hospital Charge Code	270641730W
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

DRSG SYS THREEFLEX MSC4300

Facility

$48.58

Service Code	HCPCS A6449
Hospital Charge Code	270639039
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$24.29
Rate for Payer: Aetna Commercial	$14.57
Rate for Payer: Aetna Medicare Advantage	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.39
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: Cigna Medicare Advantage	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.32
Rate for Payer: Oxford Commercial	$24.29
Rate for Payer: Qualcare PPO/HMO/WC	$7.29
Rate for Payer: UnitedHealthcare Commercial	$24.29

DRSG SYS THREEFLEX MSC4300

Facility

$48.58

Service Code	HCPCS A6449
Hospital Charge Code	270639039
Hospital Revenue Code	272
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$7.29
Rate for Payer: Qualcare PPO/HMO/WC	$7.29

DRSG TEGADRM FOAM SQ 2x2 90610

Facility

$12.24

Hospital Charge Code	270641295W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$6.12
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.12
Rate for Payer: Cigna Commercial	$6.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.59
Rate for Payer: Oxford Commercial	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.84
Rate for Payer: UnitedHealthcare Commercial	$6.12

DRSG TEGADRM FOAM SQ 2x2 90610

Facility

$12.24

Hospital Charge Code	270641295W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.84

DRSG TEGADRM FOAM SQ 4x4 90612

Facility

$20.00

Hospital Charge Code	270641297W
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

DRSG TEGADRM FOAM SQ 4x4 90612

Facility

$20.00

Hospital Charge Code	270641297W
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

DRS HEEL GENT BORDER 668000506

Facility

$57.71

Hospital Charge Code	270665240
Hospital Revenue Code	271
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

DRS HEEL GENT BORDER 668000506

Facility

$57.71

Hospital Charge Code	270665240
Hospital Revenue Code	271
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$28.86
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.72
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$28.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$28.86

DRSING MEROGL NASAL 4x4 157002

Facility

$280.25

Hospital Charge Code	270622521
Hospital Revenue Code	272
Min. Negotiated Rate	$36.43
Max. Negotiated Rate	$140.12
Rate for Payer: Aetna Commercial	$84.08
Rate for Payer: Aetna Medicare Advantage	$84.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.46
Rate for Payer: Cigna Commercial	$140.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.43
Rate for Payer: Oxford Commercial	$140.12
Rate for Payer: Qualcare PPO/HMO/WC	$42.04
Rate for Payer: UnitedHealthcare Commercial	$140.12

DRSING MEROGL NASAL 4x4 157002

Facility

$280.25

Hospital Charge Code	270622521
Hospital Revenue Code	272
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$42.04
Rate for Payer: Qualcare PPO/HMO/WC	$42.04

DRSNG ABSORB ACTOCOAT AG ROPE

Facility

$38.46

Hospital Charge Code	270650151
Hospital Revenue Code	270
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	$9.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.81
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

DRSNG ABSORB ACTOCOAT AG ROPE

Facility

$38.46

Hospital Charge Code	270650151
Hospital Revenue Code	270
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$5.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.77

DRUG ABUSE PANEL 9,SERUM VI

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001F
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM VI

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001F
Hospital Revenue Code	301
Min. Negotiated Rate	$64.97
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$149.93
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$114.00

DRUG ADMIN & HEMODYNMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93463
Hospital Charge Code	411093463
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

DRUG ADMIN & HEMODYNMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93463
Hospital Charge Code	411093463
Hospital Revenue Code	481
Min. Negotiated Rate	$89.34
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$89.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$8,284.48

Service Code	APR-DRG 7703
Min. Negotiated Rate	$6,107.54
Max. Negotiated Rate	$8,284.48
Rate for Payer: Aetna Better Health Medicaid	$8,122.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,284.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6,107.54

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$5,307.12

Service Code	APR-DRG 7702
Min. Negotiated Rate	$2,958.24
Max. Negotiated Rate	$5,307.12
Rate for Payer: Aetna Better Health Medicaid	$5,203.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,307.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2,958.24

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$18,248.01

Service Code	APR-DRG 7704
Min. Negotiated Rate	$17,444.64
Max. Negotiated Rate	$18,248.01
Rate for Payer: Aetna Better Health Medicaid	$17,444.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,793.53
Rate for Payer: Wellpoint Medicaid Managed Care	$18,248.01

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$3,550.26

Service Code	APR-DRG 7701
Min. Negotiated Rate	$2,256.28
Max. Negotiated Rate	$3,550.26
Rate for Payer: Aetna Better Health Medicaid	$3,480.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,550.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2,256.28

Know your out-of-pocket cost for care.

All Charges