Heights University Hospital

All Charges

Charge

Type

Setting

Price

EPTIFIBATIDE 75 MG/100ML INJ

Facility

$2,923.81

Service Code	HCPCS J1327
Hospital Charge Code	60628969
Hospital Revenue Code	636
Min. Negotiated Rate	$438.57
Max. Negotiated Rate	$877.14
Rate for Payer: Aetna Commercial	$877.14
Rate for Payer: Aetna Medicare Advantage	$877.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.56
Rate for Payer: Qualcare PPO/HMO/WC	$438.57

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$158.16
Rate for Payer: Aetna Commercial	$94.89
Rate for Payer: Aetna Medicare Advantage	$94.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.66
Rate for Payer: Cigna Commercial	$158.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.12
Rate for Payer: Oxford Commercial	$158.16
Rate for Payer: Qualcare PPO/HMO/WC	$47.45
Rate for Payer: UnitedHealthcare Commercial	$158.16

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$47.45
Rate for Payer: Qualcare PPO/HMO/WC	$47.45

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$191.73
Max. Negotiated Rate	$737.42
Rate for Payer: Aetna Commercial	$442.45
Rate for Payer: Aetna Medicare Advantage	$442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.09
Rate for Payer: Cigna Commercial	$737.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.73
Rate for Payer: Oxford Commercial	$737.42
Rate for Payer: Qualcare PPO/HMO/WC	$221.23
Rate for Payer: UnitedHealthcare Commercial	$737.42

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$221.23
Max. Negotiated Rate	$221.23
Rate for Payer: Qualcare PPO/HMO/WC	$221.23

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$970.50
Max. Negotiated Rate	$1,565.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: Qualcare PPO/HMO/WC	$970.50

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$970.50
Max. Negotiated Rate	$3,235.00
Rate for Payer: Aetna Commercial	$1,941.00
Rate for Payer: Aetna Medicare Advantage	$1,941.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,649.85
Rate for Payer: Cigna Commercial	$3,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: Qualcare PPO/HMO/WC	$970.50

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$2,751.00
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$686.00
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) NJ Health	$90.00
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: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$686.00
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) NJ Health	$90.00
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: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

EQUIPMENT RENTAL FEE(PER CASE)

Facility

$3,750.00

Hospital Charge Code	2709007300
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$1,875.00

EQUIPMENT RENTAL FEE(PER CASE)

Facility

$3,750.00

Hospital Charge Code	2709007300
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$885.60
Max. Negotiated Rate	$885.60
Rate for Payer: Qualcare PPO/HMO/WC	$885.60

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$767.52
Max. Negotiated Rate	$2,159.89
Rate for Payer: Aetna Commercial	$1,771.20
Rate for Payer: Aetna Medicare Advantage	$1,771.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,505.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,505.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,505.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.52
Rate for Payer: Qualcare PPO/HMO/WC	$885.60

ER ABD PARACENRESIS W/IMAGING

Facility

$2,674.55

Service Code	HCPCS 49083
Hospital Charge Code	5701003
Hospital Revenue Code	450
Min. Negotiated Rate	$401.18
Max. Negotiated Rate	$401.18
Rate for Payer: Qualcare PPO/HMO/WC	$401.18

ER ABD PARACENRESIS W/IMAGING

Facility

$2,674.55

Service Code	HCPCS 49083
Hospital Charge Code	5701003
Hospital Revenue Code	450
Min. Negotiated Rate	$347.69
Max. Negotiated Rate	$2,159.89
Rate for Payer: Aetna Commercial	$802.37
Rate for Payer: Aetna Medicare Advantage	$802.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.01
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.69
Rate for Payer: Qualcare PPO/HMO/WC	$401.18

ER-ACCESSORY SINUSES

Facility

$343.00

Service Code	HCPCS 31299
Hospital Charge Code	5790075
Hospital Revenue Code	450
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$51.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

ER-ACCESSORY SINUSES

Facility

$343.00

Service Code	HCPCS 31299
Hospital Charge Code	5790075
Hospital Revenue Code	450
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$564.04
Rate for Payer: Aetna Commercial	$102.90
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.59
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

ER-A/C SEPARATN-DISLO-BIL

Facility

$612.00

Hospital Charge Code	5790330
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-A/C SEPARATN-DISLO-BIL

Facility

$612.00

Hospital Charge Code	5790330
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER ADMIN ANTIBIOTIC INJ IM

Facility

$161.26

Service Code	HCPCS 96372
Hospital Charge Code	5700250
Hospital Revenue Code	450
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: Aetna Medicare Advantage	$48.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.12
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.96
Rate for Payer: Qualcare PPO/HMO/WC	$24.19

ER ADMIN ANTIBIOTIC INJ IM

Facility

$161.26

Service Code	HCPCS 96372
Hospital Charge Code	5700250
Hospital Revenue Code	450
Min. Negotiated Rate	$24.19
Max. Negotiated Rate	$24.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.19

Know your out-of-pocket cost for care.

All Charges