Heights University Hospital

All Charges

Charge

Type

Setting

Price

HIGH CONT 200 TO 249 PRML

Facility

$8.00

Hospital Charge Code	2009385
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIGH CONT 250 TO 299 PRML

Facility

$8.00

Hospital Charge Code	2009390
Hospital Revenue Code	255
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

HIGH CONT 250 TO 299 PRML

Facility

$8.00

Hospital Charge Code	2009390
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIGH DENSITY LIPOPROTEIN-DIR

Facility

$294.00

Service Code	HCPCS 83718
Hospital Charge Code	38472365
Hospital Revenue Code	301
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.10

HIGH DENSITY LIPOPROTEIN-DIR

Facility

$294.00

Service Code	HCPCS 83718
Hospital Charge Code	38472365
Hospital Revenue Code	301
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.54
Rate for Payer: Aetna Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.01
Rate for Payer: Cigna Commercial	$8.19
Rate for Payer: Cigna Medicare Advantage	$4.09
Rate for Payer: Clover Medicare Advantage	$7.78
Rate for Payer: EmblemHealth Commercial	$24.57
Rate for Payer: Humana Medicare Advantage	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.68
Rate for Payer: Wellcare Medicare Advantage	$8.19

HIGH FLOW CARTRIDGE LOW FLOW

Facility

$42,030.00

Hospital Charge Code	270664888
Hospital Revenue Code	270
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$6,304.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

HIGH FLOW CARTRIDGE LOW FLOW

Facility

$42,030.00

Hospital Charge Code	270664888
Hospital Revenue Code	270
Min. Negotiated Rate	$5,463.90
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$12,609.00
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,463.90
Rate for Payer: Oxford Commercial	$21,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50
Rate for Payer: UnitedHealthcare Commercial	$21,015.00

HIGH FLOW CATHETER 5FR X 100CM

Facility

$146.00

Hospital Charge Code	270332314
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

HIGH FLOW CATHETER 5FR X 100CM

Facility

$146.00

Hospital Charge Code	270332314
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

HIGH-FLOW NASAL CANNULA TX

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	317094660A
Hospital Revenue Code	410
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$361.71
Rate for Payer: Aetna Medicare Advantage	$361.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.45
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.74
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.85
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

HIGH-FLOW NASAL CANNULA TX

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	317094660A
Hospital Revenue Code	410
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$180.85
Rate for Payer: Qualcare PPO/HMO/WC	$180.85

HIGH FREQUENCY CABLE

Facility

$676.50

Hospital Charge Code	270655905
Hospital Revenue Code	271
Min. Negotiated Rate	$87.94
Max. Negotiated Rate	$338.25
Rate for Payer: Aetna Commercial	$202.95
Rate for Payer: Aetna Medicare Advantage	$202.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.51
Rate for Payer: Cigna Commercial	$338.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.94
Rate for Payer: Oxford Commercial	$338.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.47
Rate for Payer: UnitedHealthcare Commercial	$338.25

HIGH FREQUENCY CABLE

Facility

$676.50

Hospital Charge Code	270655905
Hospital Revenue Code	271
Min. Negotiated Rate	$101.47
Max. Negotiated Rate	$101.47
Rate for Payer: Qualcare PPO/HMO/WC	$101.47

HIGH INTENSITY ARC LAMP

Facility

$579.00

Hospital Charge Code	270332550
Hospital Revenue Code	272
Min. Negotiated Rate	$75.27
Max. Negotiated Rate	$289.50
Rate for Payer: Aetna Commercial	$173.70
Rate for Payer: Aetna Medicare Advantage	$173.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.65
Rate for Payer: Cigna Commercial	$289.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.27
Rate for Payer: Oxford Commercial	$289.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.85
Rate for Payer: UnitedHealthcare Commercial	$289.50

HIGH INTENSITY ARC LAMP

Facility

$579.00

Hospital Charge Code	270332550
Hospital Revenue Code	272
Min. Negotiated Rate	$86.85
Max. Negotiated Rate	$86.85
Rate for Payer: Qualcare PPO/HMO/WC	$86.85

HIGH/LOW GLUCOSE

Facility

$7.70

Hospital Charge Code	6012637
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

HIGH/LOW GLUCOSE

Facility

$7.70

Hospital Charge Code	6012637
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

HIGH/LOW GLUCOSE CONT

Facility

$7.70

Hospital Charge Code	6006308
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

HIGH/LOW GLUCOSE CONT

Facility

$7.70

Hospital Charge Code	6006308
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

HIGH MOLECULAR WT KININOG

Facility

$131.25

Service Code	HCPCS 85293
Hospital Charge Code	3032351
Hospital Revenue Code	300
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

HIGH MOLECULAR WT KININOG

Facility

$131.25

Service Code	HCPCS 85293
Hospital Charge Code	3032351
Hospital Revenue Code	300
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.33
Rate for Payer: Aetna Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: Cigna Medicare Advantage	$9.46
Rate for Payer: Clover Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$56.79
Rate for Payer: Humana Medicare Advantage	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.07
Rate for Payer: Wellcare Medicare Advantage	$18.93

HIGH OFFSET COLLARED HA CEMENT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$3,450.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

HIGH OFFSET COLLARED HA CEMENT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270706145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

HIGH PRESSURE TUBING 900 10

Facility

$16.50

Hospital Charge Code	2709002682
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$8.25
Rate for Payer: Aetna Commercial	$4.95
Rate for Payer: Aetna Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.21
Rate for Payer: Cigna Commercial	$8.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.48
Rate for Payer: UnitedHealthcare Commercial	$8.25

HIGH PRESSURE TUBING 900 10

Facility

$16.50

Hospital Charge Code	2709002682
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$2.48
Rate for Payer: Qualcare PPO/HMO/WC	$2.48

Know your out-of-pocket cost for care.

All Charges