Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALLOWRAP DS WET 2x4CM

Facility

$10,640.00

Hospital Charge Code	270678259
Hospital Revenue Code	636
Min. Negotiated Rate	$1,596.00
Max. Negotiated Rate	$2,574.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.00

ALLOWRAP DS WET 2x4CM

Facility

$10,640.00

Hospital Charge Code	270678259
Hospital Revenue Code	636
Min. Negotiated Rate	$1,596.00
Max. Negotiated Rate	$5,320.00
Rate for Payer: Aetna Commercial	$3,192.00
Rate for Payer: Aetna Medicare Advantage	$3,192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,713.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,713.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,713.20
Rate for Payer: Cigna Commercial	$5,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.00

ALLOWRAP DS WET 4x4CM

Facility

$7,700.00

Service Code	HCPCS Q4150
Hospital Charge Code	270681551
Hospital Revenue Code	278
Min. Negotiated Rate	$1,155.00
Max. Negotiated Rate	$1,863.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00

ALLOWRAP DS WET 4x4CM

Facility

$7,700.00

Service Code	HCPCS Q4150
Hospital Charge Code	270681551
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,310.00
Rate for Payer: Aetna Commercial	$2,310.00
Rate for Payer: Aetna Medicare Advantage	$2,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,963.50
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00

ALL POLY PAT VE 35MM DIA

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

ALL POLY PAT VE 35MM DIA

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
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) NJ Health	$1,200.00
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	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

ALL POLY PAY VE 35MM DIA

Facility

$5,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270690442
Hospital Revenue Code	278
Min. Negotiated Rate	$769.50
Max. Negotiated Rate	$1,241.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,026.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,241.46
Rate for Payer: Qualcare PPO/HMO/WC	$769.50

ALL POLY PAY VE 35MM DIA

Facility

$5,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270690442
Hospital Revenue Code	278
Min. Negotiated Rate	$769.50
Max. Negotiated Rate	$2,565.00
Rate for Payer: Aetna Commercial	$1,539.00
Rate for Payer: Aetna Medicare Advantage	$1,539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,308.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,308.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,308.15
Rate for Payer: Cigna Commercial	$2,565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,241.46
Rate for Payer: Qualcare PPO/HMO/WC	$769.50

ALL POLY STEMMED TIBIAL COMPON

Facility

$5,590.75

Service Code	HCPCS C1776
Hospital Charge Code	270706163
Hospital Revenue Code	278
Min. Negotiated Rate	$838.61
Max. Negotiated Rate	$2,795.38
Rate for Payer: Aetna Commercial	$1,677.22
Rate for Payer: Aetna Medicare Advantage	$1,677.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,425.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,425.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,425.64
Rate for Payer: Cigna Commercial	$2,795.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.96
Rate for Payer: Qualcare PPO/HMO/WC	$838.61

ALL POLY STEMMED TIBIAL COMPON

Facility

$5,590.75

Service Code	HCPCS C1776
Hospital Charge Code	270706163
Hospital Revenue Code	278
Min. Negotiated Rate	$838.61
Max. Negotiated Rate	$1,352.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.96
Rate for Payer: Qualcare PPO/HMO/WC	$838.61

ALL SUTURE ANCHOR 1.4MM

Facility

$1,755.00

Hospital Charge Code	270673196
Hospital Revenue Code	272
Min. Negotiated Rate	$228.15
Max. Negotiated Rate	$877.50
Rate for Payer: Aetna Commercial	$526.50
Rate for Payer: Aetna Medicare Advantage	$526.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.52
Rate for Payer: Cigna Commercial	$877.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.15
Rate for Payer: Oxford Commercial	$877.50
Rate for Payer: Qualcare PPO/HMO/WC	$263.25
Rate for Payer: UnitedHealthcare Commercial	$877.50

ALL SUTURE ANCHOR 1.4MM

Facility

$1,755.00

Hospital Charge Code	270673196
Hospital Revenue Code	272
Min. Negotiated Rate	$263.25
Max. Negotiated Rate	$263.25
Rate for Payer: Qualcare PPO/HMO/WC	$263.25

ALL SUTURE ANCHOR 2.2MM

Facility

$1,755.00

Hospital Charge Code	270673195
Hospital Revenue Code	272
Min. Negotiated Rate	$263.25
Max. Negotiated Rate	$263.25
Rate for Payer: Qualcare PPO/HMO/WC	$263.25

ALL SUTURE ANCHOR 2.2MM

Facility

$1,755.00

Hospital Charge Code	270673195
Hospital Revenue Code	272
Min. Negotiated Rate	$228.15
Max. Negotiated Rate	$877.50
Rate for Payer: Aetna Commercial	$526.50
Rate for Payer: Aetna Medicare Advantage	$526.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.52
Rate for Payer: Cigna Commercial	$877.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.15
Rate for Payer: Oxford Commercial	$877.50
Rate for Payer: Qualcare PPO/HMO/WC	$263.25
Rate for Payer: UnitedHealthcare Commercial	$877.50

ALL-TIME FAVORITES GAMES

Facility

$739.95

Hospital Charge Code	270662668
Hospital Revenue Code	270
Min. Negotiated Rate	$110.99
Max. Negotiated Rate	$110.99
Rate for Payer: Qualcare PPO/HMO/WC	$110.99

ALL-TIME FAVORITES GAMES

Facility

$739.95

Hospital Charge Code	270662668
Hospital Revenue Code	270
Min. Negotiated Rate	$96.19
Max. Negotiated Rate	$369.98
Rate for Payer: Aetna Commercial	$221.99
Rate for Payer: Aetna Medicare Advantage	$221.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.69
Rate for Payer: Cigna Commercial	$369.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Oxford Commercial	$369.98
Rate for Payer: Qualcare PPO/HMO/WC	$110.99
Rate for Payer: UnitedHealthcare Commercial	$369.98

ALMOND (F20) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900357
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALMOND (F20) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900357
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

ALMOTRIPTAN 12.5 MG TAB

Facility

$58.45

Hospital Charge Code	60629139
Hospital Revenue Code	250
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$8.77
Rate for Payer: Qualcare PPO/HMO/WC	$8.77

ALMOTRIPTAN 12.5 MG TAB

Facility

$58.45

Hospital Charge Code	60629139
Hospital Revenue Code	250
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$29.23
Rate for Payer: Aetna Commercial	$17.54
Rate for Payer: Aetna Medicare Advantage	$17.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.90
Rate for Payer: Cigna Commercial	$29.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.60
Rate for Payer: Oxford Commercial	$29.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.77
Rate for Payer: UnitedHealthcare Commercial	$29.23

ALOSETRON 1MG TABLET

Facility

$15.40

Hospital Charge Code	60629072
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

ALOSETRON 1MG TABLET

Facility

$15.40

Hospital Charge Code	60629072
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

ALO VERA GEL (CARRASYN H-GEL)

Facility

$69.15

Hospital Charge Code	60628805
Hospital Revenue Code	250
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$10.37
Rate for Payer: Qualcare PPO/HMO/WC	$10.37

ALO VERA GEL (CARRASYN H-GEL)

Facility

$69.15

Hospital Charge Code	60628805
Hospital Revenue Code	250
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$34.58
Rate for Payer: Aetna Commercial	$20.75
Rate for Payer: Aetna Medicare Advantage	$20.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.63
Rate for Payer: Cigna Commercial	$34.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.99
Rate for Payer: Oxford Commercial	$34.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.37
Rate for Payer: UnitedHealthcare Commercial	$34.58

ALO VERA GEL SPRAY 16OZ

Facility

$32.65

Hospital Charge Code	60628806
Hospital Revenue Code	250
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$16.32
Rate for Payer: Aetna Commercial	$9.79
Rate for Payer: Aetna Medicare Advantage	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.33
Rate for Payer: Cigna Commercial	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.24
Rate for Payer: Oxford Commercial	$16.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Commercial	$16.32

Know your out-of-pocket cost for care.

All Charges