Heights University Hospital

All Charges

Charge

Type

Setting

Price

FREE HGBU (HEMOGLOBIN,FREE,URI

Facility

$43.25

Service Code	HCPCS 83069
Hospital Charge Code	3009065
Hospital Revenue Code	301
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

FREE HGBU (HEMOGLOBIN,FREE,URI

Facility

$43.25

Service Code	HCPCS 83069
Hospital Charge Code	3009065
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

FREEING OF BOWEL ADHESION

Facility

$15,014.00

Service Code	HCPCS 44005
Hospital Charge Code	16000162
Hospital Revenue Code	360
Min. Negotiated Rate	$2,252.10
Max. Negotiated Rate	$2,252.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,252.10

FREEING OF BOWEL ADHESION

Facility

$15,014.00

Service Code	HCPCS 44005
Hospital Charge Code	16000162
Hospital Revenue Code	360
Min. Negotiated Rate	$1,111.39
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,504.20
Rate for Payer: Aetna Medicare Advantage	$4,504.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,828.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,828.57
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	$3,828.57
Rate for Payer: Cigna Commercial	$1,111.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,951.82
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,252.10
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

FREE KAPPA/LAMBDA,RANDOM URINE

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3035137B
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

FREE KAPPA/LAMBDA,RANDOM URINE

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3035137A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

FREE KAPPA/LAMBDA,RANDOM URINE

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3035137A
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

FREE KAPPA/LAMBDA,RANDOM URINE

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3035137B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

FREE KAPPA/LAMBDA RND UR I

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990014A
Hospital Revenue Code	301
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.04
Rate for Payer: Aetna Medicare Advantage	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.83
Rate for Payer: Cigna Commercial	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.02
Rate for Payer: UnitedHealthcare Commercial	$114.00

FREE KAPPA/LAMBDA RND UR I

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990014A
Hospital Revenue Code	301
Min. Negotiated Rate	$14.02
Max. Negotiated Rate	$14.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.02

FREE KAPPA/LAMBDA RND UR II

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990014B
Hospital Revenue Code	301
Min. Negotiated Rate	$14.02
Max. Negotiated Rate	$14.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.02

FREE KAPPA/LAMBDA RND UR II

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990014B
Hospital Revenue Code	301
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.04
Rate for Payer: Aetna Medicare Advantage	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.83
Rate for Payer: Cigna Commercial	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.02
Rate for Payer: UnitedHealthcare Commercial	$114.00

FREE KAPPA & LAMBDA W/ RA I

Facility

$390.00

Service Code	HCPCS 8388391
Hospital Charge Code	39990013A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FREE KAPPA & LAMBDA W/ RA I

Facility

$390.00

Service Code	HCPCS 8388391
Hospital Charge Code	39990013A
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

FREE KAPPA & LAMBDA W/ RA II

Facility

$390.00

Service Code	HCPCS 8388391
Hospital Charge Code	39990013B
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

FREE KAPPA & LAMBDA W/ RA II

Facility

$390.00

Service Code	HCPCS 8388391
Hospital Charge Code	39990013B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FREELINK REMOTE CONTROL KIT

Facility

$6,750.00

Service Code	HCPCS C1787
Hospital Charge Code	270696218
Hospital Revenue Code	271
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,012.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FREELINK REMOTE CONTROL KIT

Facility

$6,750.00

Service Code	HCPCS C1787
Hospital Charge Code	270696218
Hospital Revenue Code	271
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.50
Rate for Payer: Oxford Commercial	$3,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Commercial	$3,375.00

FREE T3

Facility

$390.00

Service Code	HCPCS 84481
Hospital Charge Code	39900506
Hospital Revenue Code	301
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$16.94
Rate for Payer: Cigna Medicare Advantage	$8.47
Rate for Payer: Aetna Commercial	$54.89
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
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	$16.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.96
Rate for Payer: Wellcare Medicare Advantage	$16.94

FREE T3

Facility

$390.00

Service Code	HCPCS 84481
Hospital Charge Code	39900506
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FREE THYROXINE INDEX***

Facility

$48.00

Service Code	HCPCS 84439
Hospital Charge Code	3031689
Hospital Revenue Code	312
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

FREE THYROXINE INDEX***

Facility

$48.00

Service Code	HCPCS 84439
Hospital Charge Code	3031689
Hospital Revenue Code	312
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$29.22
Rate for Payer: Aetna Medicare Advantage	$9.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.05
Rate for Payer: Cigna Commercial	$9.02
Rate for Payer: Cigna Medicare Advantage	$4.51
Rate for Payer: Clover Medicare Advantage	$8.57
Rate for Payer: EmblemHealth Commercial	$27.06
Rate for Payer: Humana Medicare Advantage	$9.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.56
Rate for Payer: Wellcare Medicare Advantage	$9.02

FRENOPLASTY

Facility

$42,339.20

Service Code	HCPCS 41520
Hospital Charge Code	1600000631
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

FRENOPLASTY

Facility

$42,339.20

Service Code	HCPCS 41520
Hospital Charge Code	1600000631
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,701.76
Rate for Payer: Aetna Commercial	$12,701.76
Rate for Payer: Aetna Medicare Advantage	$12,701.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,796.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,796.50
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	$10,796.50
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,504.10
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

FRENULOTOMY OF PENIS

Facility

$12,062.25

Service Code	HCPCS 54164
Hospital Charge Code	1600000595
Hospital Revenue Code	360
Min. Negotiated Rate	$1,568.09
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$3,618.68
Rate for Payer: Aetna Medicare Advantage	$3,618.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,075.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,075.87
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	$3,075.87
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Know your out-of-pocket cost for care.

All Charges