Heights University Hospital

All Charges

Charge

Type

Setting

Price

FULL RING LRF CARBON 155MM

Facility

$11,410.05

Service Code	HCPCS C1713
Hospital Charge Code	270699597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,711.51
Max. Negotiated Rate	$5,705.02
Rate for Payer: Aetna Commercial	$3,423.01
Rate for Payer: Aetna Medicare Advantage	$3,423.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,909.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,909.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,282.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,909.56
Rate for Payer: Cigna Commercial	$5,705.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,761.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,711.51

FULL RING LRF CARBON 155MM

Facility

$11,410.05

Service Code	HCPCS C1713
Hospital Charge Code	270699597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,711.51
Max. Negotiated Rate	$2,761.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,282.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,761.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,711.51

FULL TERM NEONATE WITH MAJOR PROBLEMS

Facility

$140,598.43

Service Code	MSDRG 793
Min. Negotiated Rate	$3,533.00
Max. Negotiated Rate	$140,598.43
Rate for Payer: Aetna Commercial	$140,598.43
Rate for Payer: Aetna Medicare Advantage	$45,501.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116,057.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116,057.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44,282.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116,057.07
Rate for Payer: Cigna Commercial	$89,733.96
Rate for Payer: Cigna Medicare Advantage	$44,282.65
Rate for Payer: Clover Medicare Advantage	$42,068.52
Rate for Payer: EmblemHealth Commercial	$132,847.95
Rate for Payer: Humana Medicare Advantage	$45,611.13
Rate for Payer: Oxford Commercial	$3,533.00
Rate for Payer: UnitedHealthcare Commercial	$4,009.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$44,282.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$46,939.61
Rate for Payer: Wellcare Medicare Advantage	$44,282.65

FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY

Facility

$75,986.52

Service Code	MSDRG 934
Min. Negotiated Rate	$24,062.40
Max. Negotiated Rate	$75,986.52
Rate for Payer: Aetna Commercial	$74,541.18
Rate for Payer: Aetna Medicare Advantage	$24,123.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,328.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57,615.03
Rate for Payer: Cigna Commercial	$47,574.32
Rate for Payer: Cigna Medicare Advantage	$25,328.84
Rate for Payer: Clover Medicare Advantage	$24,062.40
Rate for Payer: EmblemHealth Commercial	$75,986.52
Rate for Payer: Humana Medicare Advantage	$26,088.71
Rate for Payer: Oxford Commercial	$29,732.57
Rate for Payer: UnitedHealthcare Commercial	$33,749.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,328.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26,848.57
Rate for Payer: Wellcare Medicare Advantage	$25,328.84

FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC

Facility

$241,862.58

Service Code	MSDRG 928
Min. Negotiated Rate	$69,671.46
Max. Negotiated Rate	$241,862.58
Rate for Payer: Aetna Commercial	$241,862.58
Rate for Payer: Aetna Medicare Advantage	$78,272.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190,763.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190,763.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73,338.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190,763.64
Rate for Payer: Cigna Commercial	$154,363.68
Rate for Payer: Cigna Medicare Advantage	$73,338.38
Rate for Payer: Clover Medicare Advantage	$69,671.46
Rate for Payer: EmblemHealth Commercial	$220,015.14
Rate for Payer: Humana Medicare Advantage	$75,538.53
Rate for Payer: Oxford Commercial	$96,472.82
Rate for Payer: UnitedHealthcare Commercial	$109,505.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$73,338.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$77,738.68
Rate for Payer: Wellcare Medicare Advantage	$73,338.38

FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC

Facility

$108,605.00

Service Code	MSDRG 929
Min. Negotiated Rate	$33,347.63
Max. Negotiated Rate	$108,605.00
Rate for Payer: Cigna Commercial	$69,314.84
Rate for Payer: Aetna Commercial	$108,605.00
Rate for Payer: Aetna Medicare Advantage	$35,147.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88,765.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88,765.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35,102.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88,765.74
Rate for Payer: Cigna Medicare Advantage	$35,102.77
Rate for Payer: Clover Medicare Advantage	$33,347.63
Rate for Payer: EmblemHealth Commercial	$105,308.31
Rate for Payer: Humana Medicare Advantage	$36,155.85
Rate for Payer: Oxford Commercial	$43,319.76
Rate for Payer: UnitedHealthcare Commercial	$49,171.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$35,102.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37,208.94
Rate for Payer: Wellcare Medicare Advantage	$35,102.77

FULVESTRANT 50 MG/ML INJ

Facility

$963.30

Hospital Charge Code	60628648
Hospital Revenue Code	636
Min. Negotiated Rate	$144.50
Max. Negotiated Rate	$233.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.12
Rate for Payer: Qualcare PPO/HMO/WC	$144.50

FULVESTRANT 50 MG/ML INJ

Facility

$963.30

Hospital Charge Code	60628648
Hospital Revenue Code	636
Min. Negotiated Rate	$144.50
Max. Negotiated Rate	$481.65
Rate for Payer: Aetna Commercial	$288.99
Rate for Payer: Aetna Medicare Advantage	$288.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.64
Rate for Payer: Cigna Commercial	$481.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.12
Rate for Payer: Qualcare PPO/HMO/WC	$144.50

FULVESTRANT(FASLODEX)50MG/ML

Facility

$8,525.80

Hospital Charge Code	60630123
Hospital Revenue Code	636
Min. Negotiated Rate	$1,278.87
Max. Negotiated Rate	$4,262.90
Rate for Payer: Aetna Commercial	$2,557.74
Rate for Payer: Aetna Medicare Advantage	$2,557.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,174.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,174.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,174.08
Rate for Payer: Cigna Commercial	$4,262.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,063.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,278.87

FULVESTRANT(FASLODEX)50MG/ML

Facility

$8,525.80

Hospital Charge Code	60630123
Hospital Revenue Code	636
Min. Negotiated Rate	$1,278.87
Max. Negotiated Rate	$2,063.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,063.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,278.87

FULVESTRANT INJ 25MG

Facility

$1,933.45

Hospital Charge Code	60629243
Hospital Revenue Code	636
Min. Negotiated Rate	$290.02
Max. Negotiated Rate	$467.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.89
Rate for Payer: Qualcare PPO/HMO/WC	$290.02

FULVESTRANT INJ 25MG

Facility

$1,933.45

Hospital Charge Code	60629243
Hospital Revenue Code	636
Min. Negotiated Rate	$290.02
Max. Negotiated Rate	$966.73
Rate for Payer: Aetna Commercial	$580.03
Rate for Payer: Aetna Medicare Advantage	$580.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$493.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$493.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$493.03
Rate for Payer: Cigna Commercial	$966.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.89
Rate for Payer: Qualcare PPO/HMO/WC	$290.02

FULVICIN/500MG

Facility

$3.00

Hospital Charge Code	60634959
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

FULVICIN/500MG

Facility

$3.00

Hospital Charge Code	60634959
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FULVICIN P/G/250MG/TAB

Facility

$6.00

Hospital Charge Code	60633017
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

FULVICIN P/G/250MG/TAB

Facility

$6.00

Hospital Charge Code	60633017
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

FULVICIN P/G/330MG/TAB

Facility

$6.00

Hospital Charge Code	60633016
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

FULVICIN P/G/330MG/TAB

Facility

$6.00

Hospital Charge Code	60633016
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

FUNCT ACT @ COMPLMT/COMPONENT

Facility

$85.50

Service Code	HCPCS 86161
Hospital Charge Code	38478079
Hospital Revenue Code	300
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.88
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.97
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.82
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.72
Rate for Payer: Wellcare Medicare Advantage	$12.00

FUNCT ACT @ COMPLMT/COMPONENT

Facility

$85.50

Service Code	HCPCS 86161
Hospital Charge Code	38478079
Hospital Revenue Code	300
Min. Negotiated Rate	$12.82
Max. Negotiated Rate	$12.82
Rate for Payer: Qualcare PPO/HMO/WC	$12.82

FUNGAL ANTIBODIES

Facility

$339.00

Service Code	HCPCS 86671
Hospital Charge Code	38476190
Hospital Revenue Code	302
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

FUNGAL ANTIBODIES

Facility

$339.00

Service Code	HCPCS 86671
Hospital Charge Code	38476190
Hospital Revenue Code	302
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.69
Rate for Payer: Aetna Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: Cigna Medicare Advantage	$6.12
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.98
Rate for Payer: Wellcare Medicare Advantage	$12.25

FUNGAL ID

Facility

$390.00

Service Code	HCPCS 87106
Hospital Charge Code	39900488
Hospital Revenue Code	309
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.81
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
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	$10.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.94
Rate for Payer: Wellcare Medicare Advantage	$10.32

FUNGAL ID

Facility

$390.00

Service Code	HCPCS 87106
Hospital Charge Code	39900488
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FUNGAL ISOLATED IDENTIFICATION

Facility

$183.60

Service Code	HCPCS 87107
Hospital Charge Code	397080010
Hospital Revenue Code	309
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.81
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.94
Rate for Payer: Wellcare Medicare Advantage	$10.32

Know your out-of-pocket cost for care.

All Charges