Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANAFRANIL/25MG/CAP

Facility

$6.00

Hospital Charge Code	60632456
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

ANAFRANIL/25MG/CAP

Facility

$6.00

Hospital Charge Code	60632455
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ANAFRANIL/50MG/CAP

Facility

$6.00

Hospital Charge Code	60632457
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

ANAFRANIL/50MG/CAP

Facility

$6.00

Hospital Charge Code	60632457
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ANAFRANIL (CLOMIPRAMINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009073
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ANAFRANIL (CLOMIPRAMINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009073
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

ANAGRELIDE HCL CAP 0.5MG

Facility

$30.10

Hospital Charge Code	6017974
Hospital Revenue Code	250
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.91
Rate for Payer: Oxford Commercial	$15.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$15.05

ANAGRELIDE HCL CAP 0.5MG

Facility

$30.10

Hospital Charge Code	6017974
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

ANAL AND PERINEAL PROCEDURES

Facility

$10,645.18

Service Code	APR-DRG 2261
Min. Negotiated Rate	$6,465.02
Max. Negotiated Rate	$10,645.18
Rate for Payer: Aetna Better Health Medicaid	$10,436.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,645.18
Rate for Payer: Wellpoint Medicaid Managed Care	$6,465.02

ANAL AND PERINEAL PROCEDURES

Facility

$36,512.53

Service Code	APR-DRG 2264
Min. Negotiated Rate	$29,203.09
Max. Negotiated Rate	$36,512.53
Rate for Payer: Aetna Better Health Medicaid	$35,796.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,512.53
Rate for Payer: Wellpoint Medicaid Managed Care	$29,203.09

ANAL AND PERINEAL PROCEDURES

Facility

$13,423.08

Service Code	APR-DRG 2262
Min. Negotiated Rate	$8,753.73
Max. Negotiated Rate	$13,423.08
Rate for Payer: Aetna Better Health Medicaid	$13,159.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,423.08
Rate for Payer: Wellpoint Medicaid Managed Care	$8,753.73

ANAL AND PERINEAL PROCEDURES

Facility

$20,207.67

Service Code	APR-DRG 2263
Min. Negotiated Rate	$14,269.47
Max. Negotiated Rate	$20,207.67
Rate for Payer: Aetna Better Health Medicaid	$19,811.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,207.67
Rate for Payer: Wellpoint Medicaid Managed Care	$14,269.47

ANAL AND STOMAL PROCEDURES WITH CC

Facility

$49,811.10

Service Code	MSDRG 348
Min. Negotiated Rate	$14,282.39
Max. Negotiated Rate	$49,811.10
Rate for Payer: Aetna Commercial	$44,132.59
Rate for Payer: Aetna Medicare Advantage	$14,282.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,837.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,837.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,603.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,837.10
Rate for Payer: Cigna Commercial	$28,166.68
Rate for Payer: Cigna Medicare Advantage	$16,603.70
Rate for Payer: Clover Medicare Advantage	$15,773.51
Rate for Payer: EmblemHealth Commercial	$49,811.10
Rate for Payer: Humana Medicare Advantage	$17,101.81
Rate for Payer: Oxford Commercial	$17,603.36
Rate for Payer: UnitedHealthcare Commercial	$19,981.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,603.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,599.92
Rate for Payer: Wellcare Medicare Advantage	$16,603.70

ANAL AND STOMAL PROCEDURES WITH MCC

Facility

$78,453.72

Service Code	MSDRG 347
Min. Negotiated Rate	$24,843.68
Max. Negotiated Rate	$78,453.72
Rate for Payer: Aetna Commercial	$77,407.37
Rate for Payer: Aetna Medicare Advantage	$25,050.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70,295.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70,295.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,151.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70,295.85
Rate for Payer: Cigna Commercial	$49,403.61
Rate for Payer: Cigna Medicare Advantage	$26,151.24
Rate for Payer: Clover Medicare Advantage	$24,843.68
Rate for Payer: EmblemHealth Commercial	$78,453.72
Rate for Payer: Humana Medicare Advantage	$26,935.78
Rate for Payer: Oxford Commercial	$30,875.82
Rate for Payer: UnitedHealthcare Commercial	$35,046.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,151.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27,720.31
Rate for Payer: Wellcare Medicare Advantage	$26,151.24

ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC

Facility

$37,092.03

Service Code	MSDRG 349
Min. Negotiated Rate	$9,500.49
Max. Negotiated Rate	$37,092.03
Rate for Payer: Aetna Commercial	$29,356.51
Rate for Payer: Aetna Medicare Advantage	$9,500.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,015.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,015.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,364.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,015.66
Rate for Payer: Cigna Commercial	$18,736.18
Rate for Payer: Cigna Medicare Advantage	$12,364.01
Rate for Payer: Clover Medicare Advantage	$11,745.81
Rate for Payer: EmblemHealth Commercial	$37,092.03
Rate for Payer: Humana Medicare Advantage	$12,734.93
Rate for Payer: Oxford Commercial	$11,709.57
Rate for Payer: UnitedHealthcare Commercial	$13,291.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,364.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,105.85
Rate for Payer: Wellcare Medicare Advantage	$12,364.01

ANAL DILATATION***

Facility

$193.00

Hospital Charge Code	2300796
Hospital Revenue Code	759
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$96.50
Rate for Payer: Aetna Commercial	$57.90
Rate for Payer: Aetna Medicare Advantage	$57.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.22
Rate for Payer: Cigna Commercial	$96.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

ANAL DILATATION***

Facility

$193.00

Hospital Charge Code	2300796
Hospital Revenue Code	759
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$28.95
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	3039013
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	3039013
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	39990213
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	39990213
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	38430013
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	38430013
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANALGESICS NON-OPIOID 3-5

Facility

$190.45

Service Code	HCPCS 80330
Hospital Charge Code	39990214
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 3-5

Facility

$190.45

Service Code	HCPCS 80330
Hospital Charge Code	3039014
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

Know your out-of-pocket cost for care.

All Charges