Heights University Hospital

All Charges

Charge

Type

Setting

Price

FOLATE SERUM

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	8200311RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.66
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE SERUM

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	8200311RS
Hospital Revenue Code	301
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$40.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.66

FOLATE,SERUM

Facility

$101.05

Service Code	HCPCS 82746
Hospital Charge Code	39900080
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.16
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE,SERUM

Facility

$101.05

Service Code	HCPCS 82746
Hospital Charge Code	39900080
Hospital Revenue Code	301
Min. Negotiated Rate	$15.16
Max. Negotiated Rate	$15.16
Rate for Payer: Qualcare PPO/HMO/WC	$15.16

FOLEY 605698****

Facility

$26.75

Hospital Charge Code	270605698
Hospital Revenue Code	272
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$8.03
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.48
Rate for Payer: Oxford Commercial	$13.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$13.38

FOLEY 605698****

Facility

$26.75

Hospital Charge Code	270605698
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

FOLEY CATH 18F TRAY LF 900118A

Facility

$72.77

Hospital Charge Code	270639932
Hospital Revenue Code	272
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.92

FOLEY CATH 18F TRAY LF 900118A

Facility

$72.77

Hospital Charge Code	270639932
Hospital Revenue Code	272
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$36.38
Rate for Payer: Aetna Commercial	$21.83
Rate for Payer: Aetna Medicare Advantage	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.56
Rate for Payer: Cigna Commercial	$36.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.46
Rate for Payer: Oxford Commercial	$36.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.92
Rate for Payer: UnitedHealthcare Commercial	$36.38

FOLEY CATHETER 24FR 30CC 2WAY

Facility

$416.00

Hospital Charge Code	270332269
Hospital Revenue Code	272
Min. Negotiated Rate	$54.08
Max. Negotiated Rate	$208.00
Rate for Payer: Aetna Commercial	$124.80
Rate for Payer: Aetna Medicare Advantage	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.08
Rate for Payer: Cigna Commercial	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.08
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.40
Rate for Payer: UnitedHealthcare Commercial	$208.00

FOLEY CATHETER 24FR 30CC 2WAY

Facility

$416.00

Hospital Charge Code	270332269
Hospital Revenue Code	272
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$62.40

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	366851702
Hospital Revenue Code	361
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

FOLEY CATH INSERTION

Facility

$499.90

Service Code	HCPCS 51702
Hospital Charge Code	1001196
Hospital Revenue Code	361
Min. Negotiated Rate	$74.98
Max. Negotiated Rate	$74.98
Rate for Payer: Qualcare PPO/HMO/WC	$74.98

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	366851702
Hospital Revenue Code	361
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$47.70
Rate for Payer: Aetna Medicare Advantage	$47.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.67
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	7411145
Hospital Revenue Code	361
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$47.70
Rate for Payer: Aetna Medicare Advantage	$47.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.67
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	7411145
Hospital Revenue Code	361
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

FOLEY CATH INSERTION

Facility

$499.90

Service Code	HCPCS 51702
Hospital Charge Code	1001196
Hospital Revenue Code	361
Min. Negotiated Rate	$64.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$149.97
Rate for Payer: Aetna Medicare Advantage	$149.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.47
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.99
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.98
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FOLEY CONE TIP URETERAL 8FR

Facility

$631.00

Hospital Charge Code	270331018
Hospital Revenue Code	272
Min. Negotiated Rate	$94.65
Max. Negotiated Rate	$94.65
Rate for Payer: Qualcare PPO/HMO/WC	$94.65

FOLEY CONE TIP URETERAL 8FR

Facility

$631.00

Hospital Charge Code	270331018
Hospital Revenue Code	272
Min. Negotiated Rate	$82.03
Max. Negotiated Rate	$315.50
Rate for Payer: Aetna Commercial	$189.30
Rate for Payer: Aetna Medicare Advantage	$189.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.91
Rate for Payer: Cigna Commercial	$315.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.03
Rate for Payer: Oxford Commercial	$315.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.65
Rate for Payer: UnitedHealthcare Commercial	$315.50

FOLIC ACID 1 MG TAB

Facility

$4.00

Service Code	NDC 63739053710
Hospital Charge Code	60628482
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

FOLIC ACID 1 MG TAB

Facility

$4.00

Service Code	NDC 63739053710
Hospital Charge Code	60628482
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

FOLIC ACID 5 MG/ML INJ

Facility

$21.44

Service Code	NDC 63323018410
Hospital Charge Code	6002513
Hospital Revenue Code	250
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$10.72
Rate for Payer: Aetna Commercial	$6.43
Rate for Payer: Aetna Medicare Advantage	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.47
Rate for Payer: Cigna Commercial	$10.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.79
Rate for Payer: Oxford Commercial	$10.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.22
Rate for Payer: UnitedHealthcare Commercial	$10.72

Know your out-of-pocket cost for care.

All Charges