Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEALON ACD+GEL REF:HDPRP15

Facility

$575.00

Hospital Charge Code	270703451
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

HEALON GV PRO 0.85ML

Facility

$955.22

Service Code	NDC 50474065165
Hospital Charge Code	606390481
Hospital Revenue Code	272
Min. Negotiated Rate	$143.28
Max. Negotiated Rate	$143.28
Rate for Payer: Qualcare PPO/HMO/WC	$143.28

HEALON GV PRO 0.85ML

Facility

$955.22

Service Code	NDC 50474065165
Hospital Charge Code	606390481
Hospital Revenue Code	272
Min. Negotiated Rate	$124.18
Max. Negotiated Rate	$477.61
Rate for Payer: Aetna Commercial	$286.57
Rate for Payer: Aetna Medicare Advantage	$286.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.58
Rate for Payer: Cigna Commercial	$477.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.18
Rate for Payer: Oxford Commercial	$477.61
Rate for Payer: Qualcare PPO/HMO/WC	$143.28
Rate for Payer: UnitedHealthcare Commercial	$477.61

HEALON OPTH/10G/1ML

Facility

$671.00

Hospital Charge Code	60633079
Hospital Revenue Code	250
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$100.65
Rate for Payer: Qualcare PPO/HMO/WC	$100.65

HEALON OPTH/10G/1ML

Facility

$671.00

Hospital Charge Code	60633079
Hospital Revenue Code	250
Min. Negotiated Rate	$87.23
Max. Negotiated Rate	$335.50
Rate for Payer: Aetna Commercial	$201.30
Rate for Payer: Aetna Medicare Advantage	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.10
Rate for Payer: Cigna Commercial	$335.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.23
Rate for Payer: Oxford Commercial	$335.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.65
Rate for Payer: UnitedHealthcare Commercial	$335.50

HEALOS 10cc

Facility

$8,505.00

Hospital Charge Code	270657919
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.75
Max. Negotiated Rate	$2,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,701.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.75

HEALOS 10cc

Facility

$8,505.00

Hospital Charge Code	270657919
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.75
Max. Negotiated Rate	$4,252.50
Rate for Payer: Aetna Commercial	$2,551.50
Rate for Payer: Aetna Medicare Advantage	$2,551.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,168.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,168.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,168.78
Rate for Payer: Cigna Commercial	$4,252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.75

HEALTH RISK ASSESEMENT

Facility

$442.00

Service Code	HCPCS 99420
Hospital Charge Code	9200090
Hospital Revenue Code	520
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$66.30
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

HEALTH RISK ASSESEMENT

Facility

$442.00

Service Code	HCPCS 99420
Hospital Charge Code	9200090
Hospital Revenue Code	520
Min. Negotiated Rate	$57.46
Max. Negotiated Rate	$221.00
Rate for Payer: Aetna Commercial	$132.60
Rate for Payer: Aetna Medicare Advantage	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.71
Rate for Payer: Cigna Commercial	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.46
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

HEALTH SHAKES

Facility

$12.00

Hospital Charge Code	60634847
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

HEALTH SHAKES

Facility

$12.00

Hospital Charge Code	60634847
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

HEALTH START ENROLLMENT

Facility

$174.55

Service Code	HCPCS 9924152HD
Hospital Charge Code	83652500
Hospital Revenue Code	514
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$52.37
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTH START ENROLLMENT

Facility

$174.55

Service Code	HCPCS 9924152HD
Hospital Charge Code	83652500
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTHSTART INIT ANTE VISIT

Facility

$140.80

Service Code	HCPCS 99201SB
Hospital Charge Code	83652506
Hospital Revenue Code	514
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$70.40
Rate for Payer: Aetna Commercial	$42.24
Rate for Payer: Aetna Medicare Advantage	$42.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.90
Rate for Payer: Cigna Commercial	$70.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.12

HEALTHSTART INIT ANTE VISIT

Facility

$140.80

Service Code	HCPCS 99201SB
Hospital Charge Code	83652506
Hospital Revenue Code	514
Min. Negotiated Rate	$21.12
Max. Negotiated Rate	$21.12
Rate for Payer: Qualcare PPO/HMO/WC	$21.12

HEALTH START PRENATAL DEVELOP

Facility

$174.55

Service Code	HCPCS 9924122HD
Hospital Charge Code	83652502
Hospital Revenue Code	514
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$52.37
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTH START PRENATAL DEVELOP

Facility

$174.55

Service Code	HCPCS 9924122HD
Hospital Charge Code	83652502
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTHSTART SUBANTE 4-6 VISITS

Facility

$1,974.70

Service Code	HCPCS 59425SB
Hospital Charge Code	83652508
Hospital Revenue Code	514
Min. Negotiated Rate	$256.71
Max. Negotiated Rate	$987.35
Rate for Payer: Aetna Commercial	$592.41
Rate for Payer: Aetna Medicare Advantage	$592.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.55
Rate for Payer: Cigna Commercial	$987.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.71
Rate for Payer: Qualcare PPO/HMO/WC	$296.20

HEALTHSTART SUBANTE 4-6 VISITS

Facility

$1,974.70

Service Code	HCPCS 59425SB
Hospital Charge Code	83652508
Hospital Revenue Code	514
Min. Negotiated Rate	$296.20
Max. Negotiated Rate	$296.20
Rate for Payer: Qualcare PPO/HMO/WC	$296.20

HEALTH START SUB PLAN 2ND TRI

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	83652504
Hospital Revenue Code	514
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$52.37
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTH START SUB PLAN 2ND TRI

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	83652504
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83092020
Hospital Revenue Code	471
Min. Negotiated Rate	$67.04
Max. Negotiated Rate	$67.04
Rate for Payer: Qualcare PPO/HMO/WC	$67.04

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83090010
Hospital Revenue Code	471
Min. Negotiated Rate	$67.04
Max. Negotiated Rate	$67.04
Rate for Payer: Qualcare PPO/HMO/WC	$67.04

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$1,180.00

Know your out-of-pocket cost for care.

All Charges