Heights University Hospital

All Charges

Charge

Type

Setting

Price

ICD DEFIB INT W/PROG SINGLE

Facility

$214.68

Service Code	HCPCS 93282
Hospital Charge Code	74117018
Hospital Revenue Code	480
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$32.20
Rate for Payer: Qualcare PPO/HMO/WC	$32.20

ICD DEFIB INT W/PROG SINGLE

Facility

$231.20

Service Code	HCPCS 93282
Hospital Charge Code	5300161
Hospital Revenue Code	480
Min. Negotiated Rate	$34.68
Max. Negotiated Rate	$34.68
Rate for Payer: Qualcare PPO/HMO/WC	$34.68

ICD DEFIB INT W/PROG SINGLE

Facility

$231.20

Service Code	HCPCS 93282
Hospital Charge Code	5300161
Hospital Revenue Code	480
Min. Negotiated Rate	$30.06
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$69.36
Rate for Payer: Aetna Medicare Advantage	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.96
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.68
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ICD DEFIB INT W/PROG SINGLE

Facility

$231.20

Service Code	HCPCS 93282
Hospital Charge Code	94053070
Hospital Revenue Code	480
Min. Negotiated Rate	$34.68
Max. Negotiated Rate	$34.68
Rate for Payer: Qualcare PPO/HMO/WC	$34.68

ICD DEFIB INT W/PROG SINGLE

Facility

$214.68

Service Code	HCPCS 93282
Hospital Charge Code	74117018
Hospital Revenue Code	480
Min. Negotiated Rate	$27.91
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$64.40
Rate for Payer: Aetna Medicare Advantage	$64.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.74
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.91
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.20
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ICD DEFIB INT W/PROG SINGLE

Facility

$231.20

Service Code	HCPCS 93282
Hospital Charge Code	94053070
Hospital Revenue Code	480
Min. Negotiated Rate	$30.06
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$69.36
Rate for Payer: Aetna Medicare Advantage	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.96
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.68
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ICD DEFIB INT W/PROG SINGLE

Facility

$214.68

Service Code	HCPCS 93282
Hospital Charge Code	74116018
Hospital Revenue Code	480
Min. Negotiated Rate	$27.91
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$64.40
Rate for Payer: Aetna Medicare Advantage	$64.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.74
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.91
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.20
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ICD DEFIB INT W/PROG SINGLE

Facility

$214.68

Service Code	HCPCS 93282
Hospital Charge Code	74116018
Hospital Revenue Code	480
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$32.20
Rate for Payer: Qualcare PPO/HMO/WC	$32.20

ICE PACK INSTANT

Facility

$43.25

Hospital Charge Code	270655045
Hospital Revenue Code	270
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

ICE PACK INSTANT

Facility

$43.25

Hospital Charge Code	270655045
Hospital Revenue Code	270
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$12.97
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$21.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$21.62

ICHTHAMMOL OINT 10% 28GM

Facility

$113.30

Hospital Charge Code	6003008
Hospital Revenue Code	252
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.00

ICHTHAMMOL OINT 10% 28GM

Facility

$113.30

Hospital Charge Code	6003008
Hospital Revenue Code	252
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$56.65
Rate for Payer: Aetna Commercial	$33.99
Rate for Payer: Aetna Medicare Advantage	$33.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.89
Rate for Payer: Cigna Commercial	$56.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.73
Rate for Payer: Oxford Commercial	$56.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.00
Rate for Payer: UnitedHealthcare Commercial	$56.65

IC MOLDABLE STRIP 50MM FZ

Facility

$4,115.00

Hospital Charge Code	270671274
Hospital Revenue Code	278
Min. Negotiated Rate	$617.25
Max. Negotiated Rate	$995.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25

IC MOLDABLE STRIP 50MM FZ

Facility

$4,115.00

Hospital Charge Code	270671274
Hospital Revenue Code	278
Min. Negotiated Rate	$617.25
Max. Negotiated Rate	$2,057.50
Rate for Payer: Aetna Commercial	$1,234.50
Rate for Payer: Aetna Medicare Advantage	$1,234.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,049.33
Rate for Payer: Cigna Commercial	$2,057.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25

IC MOLDABLE STRIP 90MM FZ

Facility

$7,000.00

Hospital Charge Code	270671275
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

IC MOLDABLE STRIP 90MM FZ

Facility

$7,000.00

Hospital Charge Code	270671275
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

ICONIX 2.3 GUIDE

Facility

$1,750.00

Hospital Charge Code	270680690
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ICONIX 2.3 GUIDE

Facility

$1,750.00

Hospital Charge Code	270680690
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

ICONIX NEEDLE iNTELLIBRIAN TEC

Facility

$2,447.80

Service Code	HCPCS C1713
Hospital Charge Code	270701807
Hospital Revenue Code	278
Min. Negotiated Rate	$367.17
Max. Negotiated Rate	$1,223.90
Rate for Payer: Aetna Commercial	$734.34
Rate for Payer: Aetna Medicare Advantage	$734.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.19
Rate for Payer: Cigna Commercial	$1,223.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.37
Rate for Payer: Qualcare PPO/HMO/WC	$367.17

ICONIX NEEDLE iNTELLIBRIAN TEC

Facility

$2,447.80

Service Code	HCPCS C1713
Hospital Charge Code	270701807
Hospital Revenue Code	278
Min. Negotiated Rate	$367.17
Max. Negotiated Rate	$592.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.37
Rate for Payer: Qualcare PPO/HMO/WC	$367.17

I & D ABSCESS COMP MULTIPLE

Facility

$2,352.55

Service Code	HCPCS 10061
Hospital Charge Code	1600000566
Hospital Revenue Code	360
Min. Negotiated Rate	$352.88
Max. Negotiated Rate	$352.88
Rate for Payer: Qualcare PPO/HMO/WC	$352.88

I & D ABSCESS COMP MULTIPLE

Facility

$2,352.55

Service Code	HCPCS 10061
Hospital Charge Code	1600000566
Hospital Revenue Code	360
Min. Negotiated Rate	$305.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$705.76
Rate for Payer: Aetna Medicare Advantage	$705.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.90
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	$599.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.88
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

I&D ABSCESS/CYST COMPL/MULTI

Facility

$1,872.25

Service Code	HCPCS 10061
Hospital Charge Code	412310061
Hospital Revenue Code	761
Min. Negotiated Rate	$127.22
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$561.67
Rate for Payer: Aetna Medicare Advantage	$561.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.42
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.39
Rate for Payer: Oxford Commercial	$936.12
Rate for Payer: Qualcare PPO/HMO/WC	$280.84
Rate for Payer: UnitedHealthcare Commercial	$936.12

I&D ABSCESS/CYST COMPL/MULTI

Facility

$1,872.25

Service Code	HCPCS 10061
Hospital Charge Code	412310061
Hospital Revenue Code	761
Min. Negotiated Rate	$280.84
Max. Negotiated Rate	$280.84
Rate for Payer: Qualcare PPO/HMO/WC	$280.84

I&D ABSC, SMPL OR SGL

Facility

$1,896.30

Service Code	HCPCS 10060
Hospital Charge Code	1600000462
Hospital Revenue Code	360
Min. Negotiated Rate	$246.52
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$943.15
Rate for Payer: Aetna Commercial	$568.89
Rate for Payer: Aetna Medicare Advantage	$568.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.56
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	$483.56
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.52
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.44
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01
Rate for Payer: Wellpoint Medicaid Managed Care	$943.15

Know your out-of-pocket cost for care.

All Charges