Heights University Hospital

All Charges

Charge

Type

Setting

Price

GEMCITABINE 1000 MG INJ

Facility

$1,125.60

Service Code	HCPCS J9201
Hospital Charge Code	60627386
Hospital Revenue Code	636
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$337.68
Rate for Payer: Aetna Commercial	$337.68
Rate for Payer: Aetna Medicare Advantage	$337.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.03
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.84

GEMCITABINE 1000 MG INJ

Facility

$1,125.60

Service Code	HCPCS J9201
Hospital Charge Code	60627386
Hospital Revenue Code	636
Min. Negotiated Rate	$168.84
Max. Negotiated Rate	$272.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.84

GEMCITABINE 200 MG INJ

Facility

$1,127.01

Service Code	HCPCS J9201
Hospital Charge Code	60627385
Hospital Revenue Code	636
Min. Negotiated Rate	$169.05
Max. Negotiated Rate	$272.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.74
Rate for Payer: Qualcare PPO/HMO/WC	$169.05

GEMCITABINE 200 MG INJ

Facility

$1,127.01

Service Code	HCPCS J9201
Hospital Charge Code	60627385
Hospital Revenue Code	636
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$338.10
Rate for Payer: Aetna Commercial	$338.10
Rate for Payer: Aetna Medicare Advantage	$338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.39
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.74
Rate for Payer: Qualcare PPO/HMO/WC	$169.05

GEMCITABINE INJ 200MG

Facility

$272.65

Hospital Charge Code	6016497
Hospital Revenue Code	636
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$136.32
Rate for Payer: Aetna Commercial	$81.80
Rate for Payer: Aetna Medicare Advantage	$81.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.53
Rate for Payer: Cigna Commercial	$136.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.98
Rate for Payer: Qualcare PPO/HMO/WC	$40.90

GEMCITABINE INJ 200MG

Facility

$272.65

Hospital Charge Code	6016497
Hospital Revenue Code	636
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$65.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.98
Rate for Payer: Qualcare PPO/HMO/WC	$40.90

GEMCITABINE INJ LG

Facility

$1,361.95

Hospital Charge Code	6016406
Hospital Revenue Code	636
Min. Negotiated Rate	$204.29
Max. Negotiated Rate	$680.98
Rate for Payer: Aetna Commercial	$408.58
Rate for Payer: Aetna Medicare Advantage	$408.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.30
Rate for Payer: Cigna Commercial	$680.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.59
Rate for Payer: Qualcare PPO/HMO/WC	$204.29

GEMCITABINE INJ LG

Facility

$1,361.95

Hospital Charge Code	6016406
Hospital Revenue Code	636
Min. Negotiated Rate	$204.29
Max. Negotiated Rate	$329.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.59
Rate for Payer: Qualcare PPO/HMO/WC	$204.29

GEMFIBROZIL 600 MG TAB

Facility

$7.64

Service Code	NDC 71073720
Hospital Charge Code	60627620
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$3.82
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Oxford Commercial	$3.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$3.82

GEMFIBROZIL 600 MG TAB

Facility

$7.64

Service Code	NDC 71073720
Hospital Charge Code	60627620
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

GEMTUZUMAB 5 MG INJ

Facility

$14,415.50

Hospital Charge Code	60628992
Hospital Revenue Code	636
Min. Negotiated Rate	$2,162.32
Max. Negotiated Rate	$3,488.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,488.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,162.32

GEMTUZUMAB 5 MG INJ

Facility

$14,415.50

Hospital Charge Code	60628992
Hospital Revenue Code	636
Min. Negotiated Rate	$2,162.32
Max. Negotiated Rate	$7,207.75
Rate for Payer: Aetna Commercial	$4,324.65
Rate for Payer: Aetna Medicare Advantage	$4,324.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,675.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,675.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,675.95
Rate for Payer: Cigna Commercial	$7,207.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,488.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,162.32

GEN.CYT. FILTER METHOD ONLY

Facility

$259.00

Service Code	HCPCS 88106
Hospital Charge Code	38474085
Hospital Revenue Code	311
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$38.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

GEN.CYT. FILTER METHOD ONLY

Facility

$259.00

Service Code	HCPCS 88106
Hospital Charge Code	38474085
Hospital Revenue Code	311
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

GENDER PFJ FEM COMP SIZE 2-RT

Facility

$25,560.00

Service Code	HCPCS C1776
Hospital Charge Code	270681300
Hospital Revenue Code	278
Min. Negotiated Rate	$3,834.00
Max. Negotiated Rate	$12,780.00
Rate for Payer: Aetna Commercial	$7,668.00
Rate for Payer: Aetna Medicare Advantage	$7,668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,517.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,517.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,517.80
Rate for Payer: Cigna Commercial	$12,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,185.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,834.00

GENDER PFJ FEM COMP SIZE 2-RT

Facility

$25,560.00

Service Code	HCPCS C1776
Hospital Charge Code	270681300
Hospital Revenue Code	278
Min. Negotiated Rate	$3,834.00
Max. Negotiated Rate	$6,185.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,185.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,834.00

GENDER PFJ MILL BURR STANDARD

Facility

$720.00

Hospital Charge Code	270681303
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

GENDER PFJ MILL BURR STANDARD

Facility

$720.00

Hospital Charge Code	270681303
Hospital Revenue Code	272
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.60
Rate for Payer: Oxford Commercial	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$360.00

GENDER RELATED PROCEDURES

Facility

$37,595.29

Service Code	APR-DRG 8513
Min. Negotiated Rate	$36,858.13
Max. Negotiated Rate	$37,595.29
Rate for Payer: Aetna Better Health Medicaid	$36,858.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$37,595.29
Rate for Payer: Wellpoint Medicaid Managed Care	$36,858.13

GENDER RELATED PROCEDURES

Facility

$25,545.66

Service Code	APR-DRG 8512
Min. Negotiated Rate	$25,044.76
Max. Negotiated Rate	$25,545.66
Rate for Payer: Aetna Better Health Medicaid	$25,044.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,545.66

GENDER RELATED PROCEDURES

Facility

$22,183.57

Service Code	APR-DRG 8511
Min. Negotiated Rate	$21,748.60
Max. Negotiated Rate	$22,183.57
Rate for Payer: Aetna Better Health Medicaid	$21,748.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,183.57

GENDER RELATED PROCEDURES

Facility

$115,746.29

Service Code	APR-DRG 8514
Min. Negotiated Rate	$113,476.75
Max. Negotiated Rate	$115,746.29
Rate for Payer: Aetna Better Health Medicaid	$113,476.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$115,746.29
Rate for Payer: Wellpoint Medicaid Managed Care	$113,476.75

GENERAL ANESTHESIA GAS

Facility

$164.50

Hospital Charge Code	6027056
Hospital Revenue Code	250
Min. Negotiated Rate	$21.39
Max. Negotiated Rate	$82.25
Rate for Payer: Aetna Commercial	$49.35
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.39
Rate for Payer: Oxford Commercial	$82.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$82.25

GENERAL ANESTHESIA GAS

Facility

$164.50

Hospital Charge Code	6027056
Hospital Revenue Code	250
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

GENERAL ANESTHESIA GAS

Facility

$213.80

Hospital Charge Code	6065064
Hospital Revenue Code	250
Min. Negotiated Rate	$27.79
Max. Negotiated Rate	$106.90
Rate for Payer: Aetna Commercial	$64.14
Rate for Payer: Aetna Medicare Advantage	$64.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.52
Rate for Payer: Cigna Commercial	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Oxford Commercial	$106.90
Rate for Payer: Qualcare PPO/HMO/WC	$32.07
Rate for Payer: UnitedHealthcare Commercial	$106.90

Know your out-of-pocket cost for care.

All Charges