Heights University Hospital

All Charges

Charge

Type

Setting

Price

AMBICOR PENILE PROTHESIS

Facility

$69,625.00

Service Code	HCPCS C1813
Hospital Charge Code	270687019
Hospital Revenue Code	278
Min. Negotiated Rate	$10,443.75
Max. Negotiated Rate	$16,849.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,849.25
Rate for Payer: Qualcare PPO/HMO/WC	$10,443.75

AMBIENT HIPVAC 50IFS

Facility

$1,975.00

Hospital Charge Code	270679418
Hospital Revenue Code	272
Min. Negotiated Rate	$256.75
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.75
Rate for Payer: Oxford Commercial	$987.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$987.50

AMBIENT HIPVAC 50IFS

Facility

$1,975.00

Hospital Charge Code	270679418
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

AMBIEN (ZOLPIDEM)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035146
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

AMBIEN (ZOLPIDEM)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035146
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

AMBIODISK AMNIOT MEMBRANE 15MM

Facility

$3,100.00

Service Code	HCPCS C1762
Hospital Charge Code	270665138
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$750.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

AMBIODISK AMNIOT MEMBRANE 15MM

Facility

$3,100.00

Service Code	HCPCS C1762
Hospital Charge Code	270665138
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$930.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

AMBIO DRY 2

Facility

$2,975.00

Hospital Charge Code	270655881
Hospital Revenue Code	272
Min. Negotiated Rate	$386.75
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.75
Rate for Payer: Oxford Commercial	$1,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$1,487.50

AMBIO DRY 2

Facility

$2,975.00

Hospital Charge Code	270655881
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

AMBISOME 50MG INJECTION

Facility

$1,391.66

Service Code	HCPCS J0289
Hospital Charge Code	606350938
Hospital Revenue Code	636
Min. Negotiated Rate	$208.75
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$417.50
Rate for Payer: Aetna Medicare Advantage	$417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.78
Rate for Payer: Qualcare PPO/HMO/WC	$208.75

AMBISOME 50MG INJECTION

Facility

$1,391.66

Service Code	HCPCS J0289
Hospital Charge Code	606350938
Hospital Revenue Code	636
Min. Negotiated Rate	$208.75
Max. Negotiated Rate	$336.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.78
Rate for Payer: Qualcare PPO/HMO/WC	$208.75

AMBISONE 50MG/VIAL

Facility

$704.00

Hospital Charge Code	60635353
Hospital Revenue Code	636
Min. Negotiated Rate	$105.60
Max. Negotiated Rate	$352.00
Rate for Payer: Aetna Commercial	$211.20
Rate for Payer: Aetna Medicare Advantage	$211.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.52
Rate for Payer: Cigna Commercial	$352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.37
Rate for Payer: Qualcare PPO/HMO/WC	$105.60

AMBISONE 50MG/VIAL

Facility

$704.00

Hospital Charge Code	60635353
Hospital Revenue Code	636
Min. Negotiated Rate	$105.60
Max. Negotiated Rate	$170.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.37
Rate for Payer: Qualcare PPO/HMO/WC	$105.60

AMB RESP AND TRMT NO TRANSPORT

Facility

$300.00

Hospital Charge Code	26000515
Hospital Revenue Code	540
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

AMB RESP AND TRMT NO TRANSPORT

Facility

$300.00

Hospital Charge Code	26000515
Hospital Revenue Code	540
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

AMBU AURA GAIN SZ 4

Facility

$75.00

Hospital Charge Code	270684105
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

AMBU AURA GAIN SZ 4

Facility

$75.00

Hospital Charge Code	270684105
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

AMBULANCE BAYONNE

Facility

$577.30

Hospital Charge Code	1000017
Hospital Revenue Code	540
Min. Negotiated Rate	$75.05
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$173.19
Rate for Payer: Aetna Medicare Advantage	$173.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.21
Rate for Payer: Cigna Commercial	$288.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.05
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.59
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

AMBULANCE BAYONNE

Facility

$577.30

Hospital Charge Code	1000017
Hospital Revenue Code	540
Min. Negotiated Rate	$86.59
Max. Negotiated Rate	$86.59
Rate for Payer: Qualcare PPO/HMO/WC	$86.59

AMBULANCE JERSEY CITY

Facility

$698.90

Hospital Charge Code	1000025
Hospital Revenue Code	540
Min. Negotiated Rate	$90.86
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$209.67
Rate for Payer: Aetna Medicare Advantage	$209.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.22
Rate for Payer: Cigna Commercial	$349.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.86
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.83
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

AMBULANCE JERSEY CITY

Facility

$698.90

Hospital Charge Code	1000025
Hospital Revenue Code	540
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$104.83
Rate for Payer: Qualcare PPO/HMO/WC	$104.83

AMBULANCE NEWARK

Facility

$896.00

Hospital Charge Code	1000041
Hospital Revenue Code	540
Min. Negotiated Rate	$116.48
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$268.80
Rate for Payer: Aetna Medicare Advantage	$268.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.48
Rate for Payer: Cigna Commercial	$448.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.48
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.40
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

AMBULANCE NEWARK

Facility

$896.00

Hospital Charge Code	1000041
Hospital Revenue Code	540
Min. Negotiated Rate	$134.40
Max. Negotiated Rate	$134.40
Rate for Payer: Qualcare PPO/HMO/WC	$134.40

AMBULANCE OTHER

Facility

$1,430.40

Hospital Charge Code	1009992
Hospital Revenue Code	540
Min. Negotiated Rate	$214.56
Max. Negotiated Rate	$214.56
Rate for Payer: Qualcare PPO/HMO/WC	$214.56

AMBULANCE OTHER

Facility

$1,430.40

Hospital Charge Code	1009992
Hospital Revenue Code	540
Min. Negotiated Rate	$185.95
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$429.12
Rate for Payer: Aetna Medicare Advantage	$429.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.75
Rate for Payer: Cigna Commercial	$715.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.95
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.56
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

Know your out-of-pocket cost for care.

All Charges