Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALTEPLASE INJ 100MG

Facility

$18,581.80

Hospital Charge Code	6007041
Hospital Revenue Code	636
Min. Negotiated Rate	$2,787.27
Max. Negotiated Rate	$9,290.90
Rate for Payer: Aetna Commercial	$5,574.54
Rate for Payer: Aetna Medicare Advantage	$5,574.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,738.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,738.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,738.36
Rate for Payer: Cigna Commercial	$9,290.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,496.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,787.27

ALTEPLASE INJ 10MG OP

Facility

$1,686.40

Hospital Charge Code	60628991
Hospital Revenue Code	636
Min. Negotiated Rate	$252.96
Max. Negotiated Rate	$408.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.11
Rate for Payer: Qualcare PPO/HMO/WC	$252.96

ALTEPLASE INJ 10MG OP

Facility

$1,686.40

Hospital Charge Code	60628991
Hospital Revenue Code	636
Min. Negotiated Rate	$252.96
Max. Negotiated Rate	$843.20
Rate for Payer: Aetna Commercial	$505.92
Rate for Payer: Aetna Medicare Advantage	$505.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.03
Rate for Payer: Cigna Commercial	$843.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.11
Rate for Payer: Qualcare PPO/HMO/WC	$252.96

ALTEPLASE INJ 50MG

Facility

$12,325.80

Hospital Charge Code	6007371
Hospital Revenue Code	636
Min. Negotiated Rate	$1,848.87
Max. Negotiated Rate	$2,982.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,982.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,848.87

ALTEPLASE INJ 50MG

Facility

$12,325.80

Hospital Charge Code	6007371
Hospital Revenue Code	636
Min. Negotiated Rate	$1,848.87
Max. Negotiated Rate	$6,162.90
Rate for Payer: Aetna Commercial	$3,697.74
Rate for Payer: Aetna Medicare Advantage	$3,697.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,143.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,143.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,143.08
Rate for Payer: Cigna Commercial	$6,162.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,982.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,848.87

ALTERATION IN CONSCIOUSNESS

Facility

$9,221.15

Service Code	APR-DRG 0522
Min. Negotiated Rate	$6,349.47
Max. Negotiated Rate	$9,221.15
Rate for Payer: Aetna Better Health Medicaid	$9,040.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,221.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6,349.47

ALTERATION IN CONSCIOUSNESS

Facility

$25,430.57

Service Code	APR-DRG 0524
Min. Negotiated Rate	$21,911.84
Max. Negotiated Rate	$25,430.57
Rate for Payer: Aetna Better Health Medicaid	$24,931.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,430.57
Rate for Payer: Wellpoint Medicaid Managed Care	$21,911.84

ALTERATION IN CONSCIOUSNESS

Facility

$12,347.30

Service Code	APR-DRG 0523
Min. Negotiated Rate	$8,556.62
Max. Negotiated Rate	$12,347.30
Rate for Payer: Aetna Better Health Medicaid	$12,105.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,347.30
Rate for Payer: Wellpoint Medicaid Managed Care	$8,556.62

ALTERATION IN CONSCIOUSNESS

Facility

$7,814.01

Service Code	APR-DRG 0521
Min. Negotiated Rate	$5,424.75
Max. Negotiated Rate	$7,814.01
Rate for Payer: Aetna Better Health Medicaid	$7,660.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,814.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5,424.75

ALTERNAGEL/30ML

Facility

$3.00

Hospital Charge Code	60634606
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

ALTERNAGEL/30ML

Facility

$3.00

Hospital Charge Code	60634606
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ALTIPLY LYOPH AMNIO MEM 2X4CM

Facility

$9,987.50

Service Code	HCPCS C1762
Hospital Charge Code	270703810
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.12
Max. Negotiated Rate	$4,993.75
Rate for Payer: Aetna Commercial	$2,996.25
Rate for Payer: Aetna Medicare Advantage	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,546.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,546.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,546.81
Rate for Payer: Cigna Commercial	$4,993.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.12

ALTIPLY LYOPH AMNIO MEM 2X4CM

Facility

$9,987.50

Service Code	HCPCS C1762
Hospital Charge Code	270703810
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.12
Max. Negotiated Rate	$2,416.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.12

ALT - SGPT

Facility

$667.59

Service Code	HCPCS 84460
Hospital Charge Code	3002458
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

ALT - SGPT

Facility

$667.59

Service Code	HCPCS 84460
Hospital Charge Code	3002458
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALT/SGPT

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	8200352RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

ALT/SGPT

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	8200352RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

ALT - SGPT PANEL***

Facility

$21.00

Service Code	HCPCS 84460
Hospital Charge Code	3002458P
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

ALT - SGPT PANEL***

Facility

$21.00

Service Code	HCPCS 84460
Hospital Charge Code	3002458P
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

ALUM

Facility

$63.00

Hospital Charge Code	60635812
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

ALUM

Facility

$63.00

Hospital Charge Code	60635812
Hospital Revenue Code	250
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

ALUM 1% IRRIGATION

Facility

$32.00

Hospital Charge Code	60635135
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

ALUM 1% IRRIGATION

Facility

$32.00

Hospital Charge Code	60635135
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

ALUM 30 GRAMS

Facility

$2.00

Hospital Charge Code	60635627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

ALUM 30 GRAMS

Facility

$2.00

Hospital Charge Code	60635627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

Know your out-of-pocket cost for care.

All Charges