Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANAPROX/275MG/TAB

Facility

$5.00

Hospital Charge Code	60632459
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ANAPROX/275MG/TAB

Facility

$15.34

Service Code	NDC 53746019301
Hospital Charge Code	60632458
Hospital Revenue Code	250
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$7.67
Rate for Payer: Aetna Commercial	$4.60
Rate for Payer: Aetna Medicare Advantage	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.91
Rate for Payer: Cigna Commercial	$7.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$7.67
Rate for Payer: Qualcare PPO/HMO/WC	$2.30
Rate for Payer: UnitedHealthcare Commercial	$7.67

ANAPROX/275MG/TAB

Facility

$15.34

Service Code	NDC 53746019301
Hospital Charge Code	60632458
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.30

ANAPROX DS/550MG/TAB

Facility

$5.00

Hospital Charge Code	60632461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ANAPROX DS/550MG/TAB

Facility

$23.92

Service Code	NDC 53746019401
Hospital Charge Code	60632460
Hospital Revenue Code	250
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$3.59

ANAPROX DS/550MG/TAB

Facility

$23.92

Service Code	NDC 53746019401
Hospital Charge Code	60632460
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$11.96
Rate for Payer: Aetna Commercial	$7.18
Rate for Payer: Aetna Medicare Advantage	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.10
Rate for Payer: Cigna Commercial	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.11
Rate for Payer: Oxford Commercial	$11.96
Rate for Payer: Qualcare PPO/HMO/WC	$3.59
Rate for Payer: UnitedHealthcare Commercial	$11.96

ANAPROX DS/550MG/TAB

Facility

$5.00

Hospital Charge Code	60632461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

ANA SCREEN IFA W RFLX TITR/PAT

Facility

$390.00

Service Code	HCPCS 86038
Hospital Charge Code	401387449
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANA SCREEN IFA W RFLX TITR/PAT

Facility

$390.00

Service Code	HCPCS 86038
Hospital Charge Code	401387449
Hospital Revenue Code	302
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.17
Rate for Payer: Aetna Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.30
Rate for Payer: Cigna Commercial	$12.09
Rate for Payer: Cigna Medicare Advantage	$6.04
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
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	$12.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.82
Rate for Payer: Wellcare Medicare Advantage	$12.09

ANA SCREEN W/ REFLEX DS-DNA

Facility

$164.85

Service Code	HCPCS 86038
Hospital Charge Code	3006776
Hospital Revenue Code	302
Min. Negotiated Rate	$24.73
Max. Negotiated Rate	$24.73
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

ANA SCREEN W/ REFLEX DS-DNA

Facility

$164.85

Service Code	HCPCS 86038
Hospital Charge Code	3006776
Hospital Revenue Code	302
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.17
Rate for Payer: Aetna Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.30
Rate for Payer: Cigna Commercial	$12.09
Rate for Payer: Cigna Medicare Advantage	$6.04
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.82
Rate for Payer: Wellcare Medicare Advantage	$12.09

ANASPAZ/0.125MG/TAB

Facility

$3.00

Hospital Charge Code	60632462
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ANASPAZ/0.125MG/TAB

Facility

$3.00

Hospital Charge Code	60632462
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

ANASTROZOLE 1 MG TAB

Facility

$127.90

Service Code	NDC 310020130
Hospital Charge Code	60627362
Hospital Revenue Code	250
Min. Negotiated Rate	$16.63
Max. Negotiated Rate	$63.95
Rate for Payer: Aetna Commercial	$38.37
Rate for Payer: Aetna Medicare Advantage	$38.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.61
Rate for Payer: Cigna Commercial	$63.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.63
Rate for Payer: Oxford Commercial	$63.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$63.95

ANASTROZOLE 1 MG TAB

Facility

$127.90

Service Code	NDC 310020130
Hospital Charge Code	60627362
Hospital Revenue Code	250
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	39900192
Hospital Revenue Code	302
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.16
Rate for Payer: Aetna Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
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	$40.89
Rate for Payer: Cigna Commercial	$11.16
Rate for Payer: Cigna Medicare Advantage	$5.58
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
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	$11.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.83
Rate for Payer: Wellcare Medicare Advantage	$11.16

ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	39900192
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANA TITER

Facility

$427.00

Service Code	HCPCS 86039
Hospital Charge Code	38476046
Hospital Revenue Code	302
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.16
Rate for Payer: Aetna Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
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	$40.89
Rate for Payer: Cigna Commercial	$11.16
Rate for Payer: Cigna Medicare Advantage	$5.58
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.83
Rate for Payer: Wellcare Medicare Advantage	$11.16

ANA TITER

Facility

$427.00

Service Code	HCPCS 86039
Hospital Charge Code	38476046
Hospital Revenue Code	302
Min. Negotiated Rate	$64.05
Max. Negotiated Rate	$64.05
Rate for Payer: Qualcare PPO/HMO/WC	$64.05

ANATOMIC BODY 128DEGREE SZ 6/8

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685583
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

ANATOMIC BODY 128DEGREE SZ 6/8

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685583
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

ANATOMIC FIB LOCK LEFT 6H

Facility

$3,666.00

Service Code	HCPCS C1713
Hospital Charge Code	270682380
Hospital Revenue Code	278
Min. Negotiated Rate	$549.90
Max. Negotiated Rate	$887.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.17
Rate for Payer: Qualcare PPO/HMO/WC	$549.90

ANATOMIC FIB LOCK LEFT 6H

Facility

$3,666.00

Service Code	HCPCS C1713
Hospital Charge Code	270682380
Hospital Revenue Code	278
Min. Negotiated Rate	$549.90
Max. Negotiated Rate	$1,833.00
Rate for Payer: Aetna Commercial	$1,099.80
Rate for Payer: Aetna Medicare Advantage	$1,099.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$934.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$934.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$934.83
Rate for Payer: Cigna Commercial	$1,833.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.17
Rate for Payer: Qualcare PPO/HMO/WC	$549.90

ANATOMIC HEAD 36MM +5MM

Facility

$11,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270675960
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.25
Max. Negotiated Rate	$2,854.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25

ANATOMIC HEAD 36MM +5MM

Facility

$11,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270675960
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.25
Max. Negotiated Rate	$5,897.50
Rate for Payer: Aetna Commercial	$3,538.50
Rate for Payer: Aetna Medicare Advantage	$3,538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,007.72
Rate for Payer: Cigna Commercial	$5,897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25

Know your out-of-pocket cost for care.

All Charges