Heights University Hospital

All Charges

Charge

Type

Setting

Price

EYE CONFORMER SMALL HOLE

Facility

$315.00

Hospital Charge Code	270688506
Hospital Revenue Code	278
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$76.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

EYE CONFORMER SMALL HOLE

Facility

$315.00

Hospital Charge Code	270688506
Hospital Revenue Code	278
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$94.50
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$24,427.81

Service Code	APR-DRG 0824
Min. Negotiated Rate	$15,974.85
Max. Negotiated Rate	$24,427.81
Rate for Payer: Aetna Better Health Medicaid	$23,948.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,427.81
Rate for Payer: Wellpoint Medicaid Managed Care	$15,974.85

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$13,299.47

Service Code	APR-DRG 0823
Min. Negotiated Rate	$8,848.29
Max. Negotiated Rate	$13,299.47
Rate for Payer: Aetna Better Health Medicaid	$13,038.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,299.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8,848.29

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$9,128.48

Service Code	APR-DRG 0822
Min. Negotiated Rate	$6,150.73
Max. Negotiated Rate	$9,128.48
Rate for Payer: Aetna Better Health Medicaid	$8,949.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,128.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6,150.73

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$7,461.44

Service Code	APR-DRG 0821
Min. Negotiated Rate	$4,914.63
Max. Negotiated Rate	$7,461.44
Rate for Payer: Aetna Better Health Medicaid	$7,315.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,461.44
Rate for Payer: Wellpoint Medicaid Managed Care	$4,914.63

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$9.78
Rate for Payer: Aetna Commercial	$5.87
Rate for Payer: Aetna Medicare Advantage	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.99
Rate for Payer: Cigna Commercial	$9.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$9.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.93
Rate for Payer: UnitedHealthcare Commercial	$9.78

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$2.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.93

EYE RX

Facility

$81.00

Hospital Charge Code	60634916
Hospital Revenue Code	250
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

EYE RX

Facility

$81.00

Hospital Charge Code	60634916
Hospital Revenue Code	250
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$24.30
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$40.50

EYESHIELD PHOTOTHERAPY NEWBORN

Facility

$15.25

Hospital Charge Code	270654356
Hospital Revenue Code	270
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$4.58
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$7.62

EYESHIELD PHOTOTHERAPY NEWBORN

Facility

$15.25

Hospital Charge Code	270654356
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$85.20
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.46

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

EZETIMIBE 10 MG TAB

Facility

$57.69

Service Code	NDC 66582041431
Hospital Charge Code	60629852
Hospital Revenue Code	250
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

EZETIMIBE 10 MG TAB

Facility

$57.69

Service Code	NDC 66582041431
Hospital Charge Code	60629852
Hospital Revenue Code	250
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$28.84
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.71
Rate for Payer: Cigna Commercial	$28.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$28.84
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$28.84

EZETIMIBE-VASTATIN 10-20MG TAB

Facility

$14.80

Hospital Charge Code	60629940
Hospital Revenue Code	250
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.22

Know your out-of-pocket cost for care.

All Charges