Heights University Hospital

All Charges

Charge

Type

Setting

Price

AMBULANCE OTH FACIL W/RETURN

Facility

$896.00

Hospital Charge Code	1000020
Hospital Revenue Code	540
Min. Negotiated Rate	$134.40
Max. Negotiated Rate	$134.40
Rate for Payer: Qualcare PPO/HMO/WC	$134.40

AMBULANCE OTH FACIL W/RETURN

Facility

$896.00

Hospital Charge Code	1000020
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

AMBULATORY INFUSION PUMP***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400264
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
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	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

AMBULATORY INFUSION PUMP***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400264
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

AMCINONIDE OINT 0.1%

Facility

$195.85

Hospital Charge Code	60628368
Hospital Revenue Code	250
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$97.92
Rate for Payer: Aetna Commercial	$58.76
Rate for Payer: Aetna Medicare Advantage	$58.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.94
Rate for Payer: Cigna Commercial	$97.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.46
Rate for Payer: Oxford Commercial	$97.92
Rate for Payer: Qualcare PPO/HMO/WC	$29.38
Rate for Payer: UnitedHealthcare Commercial	$97.92

AMCINONIDE OINT 0.1%

Facility

$195.85

Hospital Charge Code	60628368
Hospital Revenue Code	250
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$29.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.38

AMEBIASIS ANTIBODIES

Facility

$336.00

Service Code	HCPCS 86753
Hospital Charge Code	3009992
Hospital Revenue Code	302
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.14
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.40
Rate for Payer: Cigna Commercial	$12.39
Rate for Payer: Cigna Medicare Advantage	$6.20
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.13
Rate for Payer: Wellcare Medicare Advantage	$12.39

AMEBIASIS ANTIBODIES

Facility

$336.00

Service Code	HCPCS 86753
Hospital Charge Code	3009992
Hospital Revenue Code	302
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

AMEBIC (E.HISTOLYTICA) ANTIBOD

Facility

$324.00

Service Code	HCPCS 86753
Hospital Charge Code	38476151
Hospital Revenue Code	302
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.14
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.40
Rate for Payer: Cigna Commercial	$12.39
Rate for Payer: Cigna Medicare Advantage	$6.20
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.13
Rate for Payer: Wellcare Medicare Advantage	$12.39

AMEBIC (E.HISTOLYTICA) ANTIBOD

Facility

$324.00

Service Code	HCPCS 86753
Hospital Charge Code	38476151
Hospital Revenue Code	302
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

A-METHAPRED/1000MG

Facility

$7.00

Hospital Charge Code	60632382
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

A-METHAPRED/1000MG

Facility

$7.00

Hospital Charge Code	60632382
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

A-METHAPRED/500MG

Facility

$193.00

Hospital Charge Code	60632381
Hospital Revenue Code	250
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$28.95
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

A-METHAPRED/500MG

Facility

$193.00

Hospital Charge Code	60632381
Hospital Revenue Code	250
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$96.50
Rate for Payer: Aetna Commercial	$57.90
Rate for Payer: Aetna Medicare Advantage	$57.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.22
Rate for Payer: Cigna Commercial	$96.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.09
Rate for Payer: Oxford Commercial	$96.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.95
Rate for Payer: UnitedHealthcare Commercial	$96.50

A-METHAPRED INJ/40MG/VIAL

Facility

$15.00

Hospital Charge Code	60634279
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

A-METHAPRED INJ/40MG/VIAL

Facility

$15.00

Hospital Charge Code	60634279
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

AMICA PROBE 14GX400MM

Facility

$12,000.00

Hospital Charge Code	270703724
Hospital Revenue Code	279
Min. Negotiated Rate	$1,560.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$6,000.00

AMICA PROBE 14GX400MM

Facility

$12,000.00

Hospital Charge Code	270703724
Hospital Revenue Code	279
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

AMICAR/500MG/TAB

Facility

$12.00

Hospital Charge Code	60632431
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

AMICAR/500MG/TAB

Facility

$12.00

Hospital Charge Code	60632431
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

AMID STAPLER

Facility

$1,475.00

Hospital Charge Code	270661559
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

AMID STAPLER

Facility

$1,475.00

Hospital Charge Code	270661559
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

AMIFOSTINE 500 MG INJ

Facility

$3,786.75

Hospital Charge Code	60628513
Hospital Revenue Code	636
Min. Negotiated Rate	$568.01
Max. Negotiated Rate	$1,893.38
Rate for Payer: Aetna Commercial	$1,136.03
Rate for Payer: Aetna Medicare Advantage	$1,136.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$965.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$965.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$965.62
Rate for Payer: Cigna Commercial	$1,893.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$916.39
Rate for Payer: Qualcare PPO/HMO/WC	$568.01

AMIFOSTINE 500 MG INJ

Facility

$3,786.75

Hospital Charge Code	60628513
Hospital Revenue Code	636
Min. Negotiated Rate	$568.01
Max. Negotiated Rate	$916.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$916.39
Rate for Payer: Qualcare PPO/HMO/WC	$568.01

AMIFOSTINE INJ 500MG

Facility

$1,731.20

Hospital Charge Code	6017099
Hospital Revenue Code	636
Min. Negotiated Rate	$259.68
Max. Negotiated Rate	$418.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.95
Rate for Payer: Qualcare PPO/HMO/WC	$259.68

Know your out-of-pocket cost for care.

All Charges