Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLO SWITCH HP

Facility

$22.56

Hospital Charge Code	270623272S
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

FLOSWITCH HP

Facility

$76.00

Hospital Charge Code	2008100
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

FLOSWITCH HP

Facility

$76.00

Hospital Charge Code	2008100
Hospital Revenue Code	272
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$38.00

FLOTRAC SENSOR 84(213CM)

Facility

$1,802.50

Hospital Charge Code	270664027
Hospital Revenue Code	272
Min. Negotiated Rate	$234.32
Max. Negotiated Rate	$901.25
Rate for Payer: Aetna Commercial	$540.75
Rate for Payer: Aetna Medicare Advantage	$540.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.64
Rate for Payer: Cigna Commercial	$901.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.32
Rate for Payer: Oxford Commercial	$901.25
Rate for Payer: Qualcare PPO/HMO/WC	$270.38
Rate for Payer: UnitedHealthcare Commercial	$901.25

FLOTRAC SENSOR 84(213CM)

Facility

$1,802.50

Hospital Charge Code	270664027
Hospital Revenue Code	272
Min. Negotiated Rate	$270.38
Max. Negotiated Rate	$270.38
Rate for Payer: Qualcare PPO/HMO/WC	$270.38

FLOURESCENT TREPONEMAL AB

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	3001351
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FLOURESCENT TREPONEMAL AB

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	3001351
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
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	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

FLOUR,NON INF.AB SCREEN(1)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476257
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR,NON INF.AB SCREEN(1)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476257
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

FLOUR,NON INF.AB SCREEN(2)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476258
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

FLOUR,NON INF.AB SCREEN(2)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476258
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR.NON INF.AB SCREEN(3)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476259
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR.NON INF.AB SCREEN(3)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476259
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

FLOUR.NON INF.AB SCREEN(4)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476260
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR.NON INF.AB SCREEN(4)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476260
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

FLOUROSCOPY- 1 HR

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	84506085
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

FLOUROSCOPY- 1 HR

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	84506085
Hospital Revenue Code	320
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$909.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$773.26
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLOVENT 110MCG

Facility

$161.00

Hospital Charge Code	60635175
Hospital Revenue Code	250
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$80.50
Rate for Payer: Aetna Commercial	$48.30
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$80.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$80.50

FLOVENT 110MCG

Facility

$161.00

Hospital Charge Code	60635175
Hospital Revenue Code	250
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

FLOVENT 220MCG

Facility

$414.00

Hospital Charge Code	60635177
Hospital Revenue Code	250
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.57
Rate for Payer: Cigna Commercial	$207.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$207.00

FLOVENT 220MCG

Facility

$414.00

Hospital Charge Code	60635177
Hospital Revenue Code	250
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

FLOVENT 44MCG

Facility

$138.00

Hospital Charge Code	60635176
Hospital Revenue Code	250
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$41.40
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$69.00

FLOVENT 44MCG

Facility

$138.00

Hospital Charge Code	60635176
Hospital Revenue Code	250
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

FLOWABLE 10CC OAFL-10

Facility

$13,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270704064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,998.00
Max. Negotiated Rate	$3,223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,664.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,223.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,998.00

FLOWABLE 10CC OAFL-10

Facility

$13,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270704064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,998.00
Max. Negotiated Rate	$6,660.00
Rate for Payer: Aetna Commercial	$3,996.00
Rate for Payer: Aetna Medicare Advantage	$3,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,396.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,396.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,664.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,396.60
Rate for Payer: Cigna Commercial	$6,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,223.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,998.00

Know your out-of-pocket cost for care.

All Charges