Heights University Hospital

All Charges

Charge

Type

Setting

Price

ECHOVIRUS AB (4,7,9,11,30 V

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990038E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ECHOVIRUS ANTIBODIES

Facility

$261.00

Service Code	HCPCS 86658
Hospital Charge Code	38476150
Hospital Revenue Code	302
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.22
Rate for Payer: Aetna Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.74
Rate for Payer: Cigna Commercial	$13.03
Rate for Payer: Cigna Medicare Advantage	$6.51
Rate for Payer: Clover Medicare Advantage	$12.38
Rate for Payer: EmblemHealth Commercial	$39.09
Rate for Payer: Humana Medicare Advantage	$13.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.81
Rate for Payer: Wellcare Medicare Advantage	$13.03

ECHOVIRUS ANTIBODIES

Facility

$261.00

Service Code	HCPCS 86658
Hospital Charge Code	38476150
Hospital Revenue Code	302
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$39.15
Rate for Payer: Qualcare PPO/HMO/WC	$39.15

ECLIPSE FILTER SYSTEM

Facility

$6,000.00

Hospital Charge Code	270659487
Hospital Revenue Code	270
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

ECLIPSE FILTER SYSTEM

Facility

$6,000.00

Hospital Charge Code	270659487
Hospital Revenue Code	270
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.00
Rate for Payer: Oxford Commercial	$3,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$3,000.00

ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES

Facility

$715,711.21

Service Code	MSDRG 003
Min. Negotiated Rate	$198,834.80
Max. Negotiated Rate	$715,711.21
Rate for Payer: Aetna Commercial	$715,711.21
Rate for Payer: Aetna Medicare Advantage	$231,621.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$587,728.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$587,728.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$209,299.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$587,728.44
Rate for Payer: Cigna Medicare Advantage	$209,299.79
Rate for Payer: Clover Medicare Advantage	$198,834.80
Rate for Payer: EmblemHealth Commercial	$627,899.37
Rate for Payer: Humana Medicare Advantage	$215,578.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$209,299.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$221,857.78
Rate for Payer: Wellcare Medicare Advantage	$209,299.79

ECNMY ULTRASND GEL 5 LTRE CUBE

Facility

$62.75

Hospital Charge Code	270663149
Hospital Revenue Code	270
Min. Negotiated Rate	$9.41
Max. Negotiated Rate	$9.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.41

ECNMY ULTRASND GEL 5 LTRE CUBE

Facility

$62.75

Hospital Charge Code	270663149
Hospital Revenue Code	270
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$31.38
Rate for Payer: Aetna Commercial	$18.82
Rate for Payer: Aetna Medicare Advantage	$18.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.00
Rate for Payer: Cigna Commercial	$31.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.16
Rate for Payer: Oxford Commercial	$31.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.41
Rate for Payer: UnitedHealthcare Commercial	$31.38

ECONOPRED 1/8%/5ML

Facility

$61.00

Hospital Charge Code	60634561
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

ECONOPRED 1/8%/5ML

Facility

$61.00

Hospital Charge Code	60634561
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

ECONOZOLE NITRATE CREAM 1% 30G

Facility

$163.20

Hospital Charge Code	6008551
Hospital Revenue Code	252
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

ECONOZOLE NITRATE CREAM 1% 30G

Facility

$163.20

Hospital Charge Code	6008551
Hospital Revenue Code	252
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.22
Rate for Payer: Oxford Commercial	$81.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$81.60

ECOTRIN/325MG/TAB

Facility

$1.00

Hospital Charge Code	60632924
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ECOTRIN/325MG/TAB

Facility

$1.00

Hospital Charge Code	60632924
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

ECT SINGLE SEIZURE

Facility

$6,615.00

Service Code	HCPCS 90870
Hospital Charge Code	1600540
Hospital Revenue Code	901
Min. Negotiated Rate	$138.27
Max. Negotiated Rate	$2,044.99
Rate for Payer: Aetna Commercial	$1,984.50
Rate for Payer: Aetna Medicare Advantage	$1,984.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,686.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,686.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,686.83
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.95
Rate for Payer: Qualcare PPO/HMO/WC	$992.25

ECT SINGLE SEIZURE

Facility

$2,404.25

Service Code	HCPCS 90870
Hospital Charge Code	7500069
Hospital Revenue Code	901
Min. Negotiated Rate	$138.27
Max. Negotiated Rate	$2,044.99
Rate for Payer: Aetna Commercial	$721.27
Rate for Payer: Aetna Medicare Advantage	$721.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.08
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.55
Rate for Payer: Qualcare PPO/HMO/WC	$360.64

ECT SINGLE SEIZURE

Facility

$2,404.25

Service Code	HCPCS 90870
Hospital Charge Code	7500069
Hospital Revenue Code	901
Min. Negotiated Rate	$360.64
Max. Negotiated Rate	$360.64
Rate for Payer: Qualcare PPO/HMO/WC	$360.64

ECT SINGLE SEIZURE

Facility

$6,615.00

Service Code	HCPCS 90870
Hospital Charge Code	1600540
Hospital Revenue Code	901
Min. Negotiated Rate	$992.25
Max. Negotiated Rate	$992.25
Rate for Payer: Qualcare PPO/HMO/WC	$992.25

EDECRIN SODIUM/50MG

Facility

$101.00

Hospital Charge Code	60632925
Hospital Revenue Code	250
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$30.30
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$50.50

EDECRIN SODIUM/50MG

Facility

$101.00

Hospital Charge Code	60632925
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

EDETATE INJ 200MG/1ML 5ML

Facility

$228.00

Hospital Charge Code	60628178A
Hospital Revenue Code	636
Min. Negotiated Rate	$34.20
Max. Negotiated Rate	$55.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.20

EDETATE INJ 200MG/1ML 5ML

Facility

$228.00

Hospital Charge Code	60628178A
Hospital Revenue Code	636
Min. Negotiated Rate	$34.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.14
Rate for Payer: Cigna Commercial	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.20

ED-INSERT SUPRA CATH

Facility

$7,721.00

Service Code	HCPCS 51040
Hospital Charge Code	5790165
Hospital Revenue Code	450
Min. Negotiated Rate	$1,158.15
Max. Negotiated Rate	$1,158.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.15

ED-INSERT SUPRA CATH

Facility

$7,721.00

Service Code	HCPCS 51040
Hospital Charge Code	5790165
Hospital Revenue Code	450
Min. Negotiated Rate	$278.30
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,316.30
Rate for Payer: Aetna Medicare Advantage	$2,316.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,968.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,968.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,968.86
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,003.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.15

EDMS III BECKER

Facility

$981.00

Hospital Charge Code	270670474
Hospital Revenue Code	272
Min. Negotiated Rate	$127.53
Max. Negotiated Rate	$490.50
Rate for Payer: Aetna Commercial	$294.30
Rate for Payer: Aetna Medicare Advantage	$294.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.16
Rate for Payer: Cigna Commercial	$490.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.53
Rate for Payer: Oxford Commercial	$490.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.15
Rate for Payer: UnitedHealthcare Commercial	$490.50

Know your out-of-pocket cost for care.

All Charges