Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLOW CYTOMETRY TC 1 MARKER

Facility

$1,263.00

Service Code	HCPCS 88184
Hospital Charge Code	401088184A
Hospital Revenue Code	301
Min. Negotiated Rate	$189.45
Max. Negotiated Rate	$189.45
Rate for Payer: Qualcare PPO/HMO/WC	$189.45

FLOW CYTOMETRY TC ADD-ON X 22

Facility

$360.45

Service Code	HCPCS 88185
Hospital Charge Code	401030580B
Hospital Revenue Code	311
Min. Negotiated Rate	$54.07
Max. Negotiated Rate	$54.07
Rate for Payer: Qualcare PPO/HMO/WC	$54.07

FLOW CYTOMETRY TC ADD-ON X 22

Facility

$360.45

Service Code	HCPCS 88185
Hospital Charge Code	401030580B
Hospital Revenue Code	311
Min. Negotiated Rate	$13.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$108.14
Rate for Payer: Aetna Medicare Advantage	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.91
Rate for Payer: Cigna Commercial	$26.73
Rate for Payer: Cigna Medicare Advantage	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.07
Rate for Payer: UnitedHealthcare Commercial	$114.00

FLOWMETER 8LPM DISS NUT NIPPLE

Facility

$119.75

Hospital Charge Code	270669890
Hospital Revenue Code	272
Min. Negotiated Rate	$17.96
Max. Negotiated Rate	$17.96
Rate for Payer: Qualcare PPO/HMO/WC	$17.96

FLOWMETER 8LPM DISS NUT NIPPLE

Facility

$119.75

Hospital Charge Code	270669890
Hospital Revenue Code	272
Min. Negotiated Rate	$15.57
Max. Negotiated Rate	$59.88
Rate for Payer: Aetna Commercial	$35.92
Rate for Payer: Aetna Medicare Advantage	$35.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.54
Rate for Payer: Cigna Commercial	$59.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.57
Rate for Payer: Oxford Commercial	$59.88
Rate for Payer: Qualcare PPO/HMO/WC	$17.96
Rate for Payer: UnitedHealthcare Commercial	$59.88

FLOWMETER PEAK FLOW***

Facility

$93.50

Hospital Charge Code	9501115
Hospital Revenue Code	279
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$46.75
Rate for Payer: Aetna Commercial	$28.05
Rate for Payer: Aetna Medicare Advantage	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.84
Rate for Payer: Cigna Commercial	$46.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.15
Rate for Payer: Oxford Commercial	$46.75
Rate for Payer: Qualcare PPO/HMO/WC	$14.03
Rate for Payer: UnitedHealthcare Commercial	$46.75

FLOWMETER PEAK FLOW***

Facility

$93.50

Hospital Charge Code	9501115
Hospital Revenue Code	279
Min. Negotiated Rate	$14.03
Max. Negotiated Rate	$14.03
Rate for Payer: Qualcare PPO/HMO/WC	$14.03

FLOWMETER PERSONAL BEST

Facility

$131.25

Hospital Charge Code	270600658
Hospital Revenue Code	272
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$39.38
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$65.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$65.62

FLOWMETER PERSONAL BEST

Facility

$131.25

Hospital Charge Code	270600658
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

FLOWMETER TRUZONE PFM

Facility

$103.25

Hospital Charge Code	270600657
Hospital Revenue Code	272
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

FLOWMETER TRUZONE PFM

Facility

$103.25

Hospital Charge Code	270600657
Hospital Revenue Code	272
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$51.62
Rate for Payer: Aetna Commercial	$30.98
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.33
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.42
Rate for Payer: Oxford Commercial	$51.62
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$51.62

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$293.11
Max. Negotiated Rate	$293.11
Rate for Payer: Qualcare PPO/HMO/WC	$293.11

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$254.03
Max. Negotiated Rate	$977.02
Rate for Payer: Aetna Commercial	$586.22
Rate for Payer: Aetna Medicare Advantage	$586.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.28
Rate for Payer: Cigna Commercial	$977.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.03
Rate for Payer: Oxford Commercial	$977.02
Rate for Payer: Qualcare PPO/HMO/WC	$293.11
Rate for Payer: UnitedHealthcare Commercial	$977.02

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$16,500.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$16,500.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60632997
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60632997
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60634320
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60634320
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/300MG/TAB

Facility

$18.00

Hospital Charge Code	60634321
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FLOXIN/300MG/TAB

Facility

$18.00

Hospital Charge Code	60634321
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

FLOXIN/300MG/TAB

Facility

$13.00

Hospital Charge Code	60632998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

FLOXIN/300MG/TAB

Facility

$13.00

Hospital Charge Code	60632998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

Know your out-of-pocket cost for care.

All Charges