Heights University Hospital

All Charges

Charge

Type

Setting

Price

END TIDAL CO2

Facility

$2,476.94

Service Code	HCPCS 94770
Hospital Charge Code	411094770
Hospital Revenue Code	460
Min. Negotiated Rate	$322.00
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$743.08
Rate for Payer: Aetna Medicare Advantage	$743.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.62
Rate for Payer: Cigna Commercial	$1,238.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.54
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

END TIDAL CO2

Facility

$2,476.94

Service Code	HCPCS 94770
Hospital Charge Code	411094770
Hospital Revenue Code	460
Min. Negotiated Rate	$371.54
Max. Negotiated Rate	$371.54
Rate for Payer: Qualcare PPO/HMO/WC	$371.54

END TIDAL CO2

Facility

$10,357.02

Service Code	HCPCS 94770
Hospital Charge Code	9501295
Hospital Revenue Code	460
Min. Negotiated Rate	$1,346.41
Max. Negotiated Rate	$5,178.51
Rate for Payer: Aetna Commercial	$3,107.11
Rate for Payer: Aetna Medicare Advantage	$3,107.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,641.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,641.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,641.04
Rate for Payer: Cigna Commercial	$5,178.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.41
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

END TIDAL CO2

Facility

$10,357.02

Service Code	HCPCS 94770
Hospital Charge Code	9501295
Hospital Revenue Code	460
Min. Negotiated Rate	$1,553.55
Max. Negotiated Rate	$1,553.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55

ENDURONYL/TAB

Facility

$3.00

Hospital Charge Code	60634222
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ENDURONYL/TAB

Facility

$3.00

Hospital Charge Code	60634222
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

ENEMA SET DISP

Facility

$7.18

Hospital Charge Code	270649734
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$3.59
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$3.59

ENEMA SET DISP

Facility

$7.18

Hospital Charge Code	270649734
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

ENFAMIL

Facility

$34.60

Hospital Charge Code	6008239
Hospital Revenue Code	252
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

ENFAMIL

Facility

$34.60

Hospital Charge Code	6008239
Hospital Revenue Code	252
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

ENFAMIL INFANT FORMUL LOW IRON

Facility

$104.00

Hospital Charge Code	60628776
Hospital Revenue Code	270
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

ENFAMIL INFANT FORMUL LOW IRON

Facility

$104.00

Hospital Charge Code	60628776
Hospital Revenue Code	270
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$52.00

ENFLURANE 100% GAS

Facility

$1,276.85

Hospital Charge Code	60627667
Hospital Revenue Code	250
Min. Negotiated Rate	$191.53
Max. Negotiated Rate	$191.53
Rate for Payer: Qualcare PPO/HMO/WC	$191.53

ENFLURANE 100% GAS

Facility

$1,276.85

Hospital Charge Code	60627667
Hospital Revenue Code	250
Min. Negotiated Rate	$165.99
Max. Negotiated Rate	$638.42
Rate for Payer: Aetna Commercial	$383.06
Rate for Payer: Aetna Medicare Advantage	$383.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.60
Rate for Payer: Cigna Commercial	$638.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.99
Rate for Payer: Oxford Commercial	$638.42
Rate for Payer: Qualcare PPO/HMO/WC	$191.53
Rate for Payer: UnitedHealthcare Commercial	$638.42

ENFLURANE INH 125ML

Facility

$985.60

Hospital Charge Code	6002166
Hospital Revenue Code	251
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$492.80
Rate for Payer: Aetna Commercial	$295.68
Rate for Payer: Aetna Medicare Advantage	$295.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.33
Rate for Payer: Cigna Commercial	$492.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.13
Rate for Payer: Oxford Commercial	$492.80
Rate for Payer: Qualcare PPO/HMO/WC	$147.84
Rate for Payer: UnitedHealthcare Commercial	$492.80

ENFLURANE INH 125ML

Facility

$985.60

Hospital Charge Code	6002166
Hospital Revenue Code	251
Min. Negotiated Rate	$147.84
Max. Negotiated Rate	$147.84
Rate for Payer: Qualcare PPO/HMO/WC	$147.84

ENGERIX-B PEDIATRIC

Facility

$162.00

Service Code	HCPCS 90743
Hospital Charge Code	60634776
Hospital Revenue Code	636
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$39.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

ENGERIX-B PEDIATRIC

Facility

$162.00

Service Code	HCPCS 90743
Hospital Charge Code	60634776
Hospital Revenue Code	636
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$75.15
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$75.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

ENHANCE COUNSELING WHC*****

Facility

$60.00

Service Code	HCPCS Y7633WF
Hospital Charge Code	9600013
Hospital Revenue Code	519
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ENHANCE COUNSELING WHC*****

Facility

$60.00

Service Code	HCPCS Y7633WF
Hospital Charge Code	9600013
Hospital Revenue Code	519
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ENHANCED LIVER FIBROSIS (ELF)

Facility

$340.00

Service Code	HCPCS 81517
Hospital Charge Code	397080022
Hospital Revenue Code	310
Min. Negotiated Rate	$44.20
Max. Negotiated Rate	$645.56
Rate for Payer: Aetna Commercial	$570.86
Rate for Payer: Aetna Medicare Advantage	$176.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$176.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.56
Rate for Payer: Cigna Commercial	$176.19
Rate for Payer: Cigna Medicare Advantage	$88.09
Rate for Payer: Clover Medicare Advantage	$167.38
Rate for Payer: EmblemHealth Commercial	$528.57
Rate for Payer: Humana Medicare Advantage	$181.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$176.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$186.76
Rate for Payer: Wellcare Medicare Advantage	$176.19

ENHANCED LIVER FIBROSIS (ELF)

Facility

$340.00

Service Code	HCPCS 81517
Hospital Charge Code	397080022
Hospital Revenue Code	310
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

ENISYL/500MG/TAB

Facility

$4.00

Service Code	NDC 536673101
Hospital Charge Code	60632936
Hospital Revenue Code	250
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

ENISYL/500MG/TAB

Facility

$4.00

Service Code	NDC 536673101
Hospital Charge Code	60632936
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ENOXAPARIN 100 MG SYRINGE

Facility

$605.08

Service Code	HCPCS J1650
Hospital Charge Code	60628902
Hospital Revenue Code	636
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$181.52
Rate for Payer: Aetna Commercial	$181.52
Rate for Payer: Aetna Medicare Advantage	$181.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.30
Rate for Payer: Cigna Commercial	$0.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.43
Rate for Payer: Qualcare PPO/HMO/WC	$90.76

Know your out-of-pocket cost for care.

All Charges