Heights University Hospital

All Charges

Charge

Type

Setting

Price

GERI PSYCH SEMI-PRIVATE

Facility

$18,000.00

Hospital Charge Code	100826
Hospital Revenue Code	124
Min. Negotiated Rate	$1,109.00
Max. Negotiated Rate	$3,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

GERITOL PER ML

Facility

$4.00

Service Code	NDC 46017001112
Hospital Charge Code	606390439
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

GERITOL PER ML

Facility

$4.00

Service Code	NDC 46017001112
Hospital Charge Code	606390439
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

GERM CELL I

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	3038091A
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

GERM CELL I

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	3038091A
Hospital Revenue Code	301
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

GERM CELL II

Facility

$233.00

Service Code	HCPCS 82105
Hospital Charge Code	3038091B
Hospital Revenue Code	301
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$34.95

GERM CELL II

Facility

$233.00

Service Code	HCPCS 82105
Hospital Charge Code	3038091B
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

GEWIRE 035D 260x7cm TFE 256899

Facility

$312.50

Hospital Charge Code	270633916
Hospital Revenue Code	272
Min. Negotiated Rate	$40.62
Max. Negotiated Rate	$156.25
Rate for Payer: Aetna Commercial	$93.75
Rate for Payer: Aetna Medicare Advantage	$93.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.69
Rate for Payer: Cigna Commercial	$156.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.62
Rate for Payer: Oxford Commercial	$156.25
Rate for Payer: Qualcare PPO/HMO/WC	$46.88
Rate for Payer: UnitedHealthcare Commercial	$156.25

GEWIRE 035D 260x7cm TFE 256899

Facility

$312.50

Hospital Charge Code	270633916
Hospital Revenue Code	272
Min. Negotiated Rate	$46.88
Max. Negotiated Rate	$46.88
Rate for Payer: Qualcare PPO/HMO/WC	$46.88

GFRAFT GOR 14MMX40CM SBT1401

Facility

$4,310.25

Hospital Charge Code	270634308
Hospital Revenue Code	278
Min. Negotiated Rate	$646.54
Max. Negotiated Rate	$2,155.12
Rate for Payer: Aetna Commercial	$1,293.08
Rate for Payer: Aetna Medicare Advantage	$1,293.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,099.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,099.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,099.11
Rate for Payer: Cigna Commercial	$2,155.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,043.08
Rate for Payer: Qualcare PPO/HMO/WC	$646.54

GFRAFT GOR 14MMX40CM SBT1401

Facility

$4,310.25

Hospital Charge Code	270634308
Hospital Revenue Code	278
Min. Negotiated Rate	$646.54
Max. Negotiated Rate	$1,043.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,043.08
Rate for Payer: Qualcare PPO/HMO/WC	$646.54

GFRG AUTOL FAT LIPO EA ADDL

Facility

$8,265.00

Service Code	HCPCS 15774
Hospital Charge Code	1600000627
Hospital Revenue Code	360
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$2,479.50
Rate for Payer: Aetna Commercial	$2,479.50
Rate for Payer: Aetna Medicare Advantage	$2,479.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,107.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,107.57
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	$2,107.57
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.45
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,239.75
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

GFRG AUTOL FAT LIPO EA ADDL

Facility

$8,265.00

Service Code	HCPCS 15774
Hospital Charge Code	1600000627
Hospital Revenue Code	360
Min. Negotiated Rate	$1,239.75
Max. Negotiated Rate	$1,239.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,239.75

GGTP GAMMA GLUTAMYLTRANSFERAS

Facility

$667.59

Service Code	HCPCS 82977
Hospital Charge Code	3030293
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

GGTP GAMMA GLUTAMYLTRANSFERAS

Facility

$667.59

Service Code	HCPCS 82977
Hospital Charge Code	3030293
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.33
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.38
Rate for Payer: Cigna Commercial	$7.20
Rate for Payer: Cigna Medicare Advantage	$3.60
Rate for Payer: Clover Medicare Advantage	$6.84
Rate for Payer: EmblemHealth Commercial	$21.60
Rate for Payer: Humana Medicare Advantage	$7.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.63
Rate for Payer: Wellcare Medicare Advantage	$7.20

G,H 10MM, 7-10, POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657028
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

G,H 10MM, 7-10, POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657028
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

GIA-50 LOAD UNIT****

Facility

$158.00

Hospital Charge Code	1601038
Hospital Revenue Code	272
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$47.40
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$79.00

GIA-50 LOAD UNIT****

Facility

$158.00

Hospital Charge Code	1601038
Hospital Revenue Code	272
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

GIA-50 STAPLE****

Facility

$321.00

Hospital Charge Code	1601020
Hospital Revenue Code	272
Min. Negotiated Rate	$41.73
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$96.30
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.73
Rate for Payer: Oxford Commercial	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$160.50

GIA-50 STAPLE****

Facility

$321.00

Hospital Charge Code	1601020
Hospital Revenue Code	272
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

GIARDIA AG EIA,STOOL

Facility

$178.00

Service Code	HCPCS 87328
Hospital Charge Code	38479086
Hospital Revenue Code	306
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$26.70
Rate for Payer: Qualcare PPO/HMO/WC	$26.70

GIARDIA AG EIA,STOOL

Facility

$178.00

Service Code	HCPCS 87328
Hospital Charge Code	38479086
Hospital Revenue Code	306
Min. Negotiated Rate	$6.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.78
Rate for Payer: Aetna Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.64
Rate for Payer: Cigna Commercial	$13.82
Rate for Payer: Cigna Medicare Advantage	$6.91
Rate for Payer: Clover Medicare Advantage	$13.13
Rate for Payer: EmblemHealth Commercial	$41.46
Rate for Payer: Humana Medicare Advantage	$14.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.65
Rate for Payer: Wellcare Medicare Advantage	$13.82

GIARDIA AG,EIA,STOOL

Facility

$390.00

Service Code	HCPCS 87329
Hospital Charge Code	39990054EX
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GIARDIA AG,EIA,STOOL

Facility

$390.00

Service Code	HCPCS 87329
Hospital Charge Code	39990054EX
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
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	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

Know your out-of-pocket cost for care.

All Charges