Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEMORRHOIDAL SUPPOSITORY

Facility

$4.00

Service Code	NDC 904768822
Hospital Charge Code	60628754
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

HEMORRHOIDAL SUPPOSITORY

Facility

$4.00

Service Code	NDC 904768822
Hospital Charge Code	60628754
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEMORRHOID ANESTH OINT 28GM

Facility

$34.60

Hospital Charge Code	6002729
Hospital Revenue Code	257
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

HEMORRHOID ANESTH OINT 28GM

Facility

$34.60

Hospital Charge Code	6002729
Hospital Revenue Code	257
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

HEMORRHOID EMOLL OINT 30GM

Facility

$37.80

Hospital Charge Code	6002737
Hospital Revenue Code	257
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

HEMORRHOID EMOLL OINT 30GM

Facility

$37.80

Hospital Charge Code	6002737
Hospital Revenue Code	257
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

HEMORRHOIDOPEXY BY STAPLING

Facility

$27,441.80

Service Code	HCPCS 46947
Hospital Charge Code	1600000751
Hospital Revenue Code	360
Min. Negotiated Rate	$4,116.27
Max. Negotiated Rate	$4,116.27
Rate for Payer: Qualcare PPO/HMO/WC	$4,116.27

HEMORRHOIDOPEXY BY STAPLING

Facility

$27,441.80

Service Code	HCPCS 46947
Hospital Charge Code	1600000751
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,232.54
Rate for Payer: Aetna Commercial	$8,232.54
Rate for Payer: Aetna Medicare Advantage	$8,232.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,997.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,997.66
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	$6,997.66
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,567.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,116.27
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

HEMORRHOID PREPARATION/60

Facility

$18.00

Hospital Charge Code	60633081
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

HEMORRHOID PREPARATION/60

Facility

$18.00

Hospital Charge Code	60633081
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

HEMORRHOID STAPLER

Facility

$2,144.17

Hospital Charge Code	270658015
Hospital Revenue Code	272
Min. Negotiated Rate	$321.63
Max. Negotiated Rate	$321.63
Rate for Payer: Qualcare PPO/HMO/WC	$321.63

HEMORRHOID STAPLER

Facility

$2,144.17

Hospital Charge Code	270658015
Hospital Revenue Code	272
Min. Negotiated Rate	$278.74
Max. Negotiated Rate	$1,072.09
Rate for Payer: Aetna Commercial	$643.25
Rate for Payer: Aetna Medicare Advantage	$643.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.76
Rate for Payer: Cigna Commercial	$1,072.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.74
Rate for Payer: Oxford Commercial	$1,072.09
Rate for Payer: Qualcare PPO/HMO/WC	$321.63
Rate for Payer: UnitedHealthcare Commercial	$1,072.09

HEMOSIDERIN,QL,URINE

Facility

$390.00

Service Code	HCPCS 83070
Hospital Charge Code	39900093
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOSIDERIN,QL,URINE

Facility

$390.00

Service Code	HCPCS 83070
Hospital Charge Code	39900093
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
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	$4.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.04
Rate for Payer: Wellcare Medicare Advantage	$4.75

HEMOSIDERIN (QUAL URINE)

Facility

$99.25

Service Code	HCPCS 83070
Hospital Charge Code	3007440
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.04
Rate for Payer: Wellcare Medicare Advantage	$4.75

HEMOSIDERIN (QUAL URINE)

Facility

$99.25

Service Code	HCPCS 83070
Hospital Charge Code	3007440
Hospital Revenue Code	301
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

HEMOSIDERIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005282
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEMOSIDERIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005282
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

HEMOSIDERIN,URINE

Facility

$68.00

Service Code	HCPCS 83070
Hospital Charge Code	38472331
Hospital Revenue Code	301
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.20

HEMOSIDERIN,URINE

Facility

$68.00

Service Code	HCPCS 83070
Hospital Charge Code	38472331
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.04
Rate for Payer: Wellcare Medicare Advantage	$4.75

HEMOSPLIT 27CM

Facility

$1,615.00

Service Code	HCPCS C1750
Hospital Charge Code	270637768
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

HEMOSPLIT 27CM

Facility

$1,615.00

Service Code	HCPCS C1750
Hospital Charge Code	270637768
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$390.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

HEMOSPLIT 31cm 5733313

Facility

$1,755.00

Service Code	HCPCS C1750
Hospital Charge Code	270637885
Hospital Revenue Code	278
Min. Negotiated Rate	$263.25
Max. Negotiated Rate	$877.50
Rate for Payer: Aetna Commercial	$526.50
Rate for Payer: Aetna Medicare Advantage	$526.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.52
Rate for Payer: Cigna Commercial	$877.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.71
Rate for Payer: Qualcare PPO/HMO/WC	$263.25

HEMOSPLIT 31cm 5733313

Facility

$1,755.00

Service Code	HCPCS C1750
Hospital Charge Code	270637885
Hospital Revenue Code	278
Min. Negotiated Rate	$263.25
Max. Negotiated Rate	$424.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.71
Rate for Payer: Qualcare PPO/HMO/WC	$263.25

HEMOSPRAY HEMOSTAT HEMO7

Facility

$12,250.00

Service Code	HCPCS C1052
Hospital Charge Code	270687359
Hospital Revenue Code	272
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$1,837.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

Know your out-of-pocket cost for care.

All Charges