Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$284.44
Max. Negotiated Rate	$284.44
Rate for Payer: Qualcare PPO/HMO/WC	$284.44

IDAMYCIN INJECTION/10MG

Facility

$2,582.00

Hospital Charge Code	60634917
Hospital Revenue Code	636
Min. Negotiated Rate	$387.30
Max. Negotiated Rate	$1,291.00
Rate for Payer: Aetna Commercial	$774.60
Rate for Payer: Aetna Medicare Advantage	$774.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$658.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$658.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$658.41
Rate for Payer: Cigna Commercial	$1,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.84
Rate for Payer: Qualcare PPO/HMO/WC	$387.30

IDAMYCIN INJECTION/10MG

Facility

$2,582.00

Hospital Charge Code	60634917
Hospital Revenue Code	636
Min. Negotiated Rate	$387.30
Max. Negotiated Rate	$624.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.84
Rate for Payer: Qualcare PPO/HMO/WC	$387.30

IDARUCIZUMAB 50MG/ML INJ 50ML

Facility

$14,070.00

Service Code	HCPCS C9399
Hospital Charge Code	606380034
Hospital Revenue Code	636
Min. Negotiated Rate	$2,110.50
Max. Negotiated Rate	$3,404.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,404.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.50

IDARUCIZUMAB 50MG/ML INJ 50ML

Facility

$14,070.00

Service Code	HCPCS C9399
Hospital Charge Code	606380034
Hospital Revenue Code	636
Min. Negotiated Rate	$2,110.50
Max. Negotiated Rate	$7,035.00
Rate for Payer: Aetna Commercial	$4,221.00
Rate for Payer: Aetna Medicare Advantage	$4,221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,587.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,587.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,587.85
Rate for Payer: Cigna Commercial	$7,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,404.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.50

ID BAND YELLOW ADULT SENTRY

Facility

$192.10

Hospital Charge Code	270652389
Hospital Revenue Code	270
Min. Negotiated Rate	$28.82
Max. Negotiated Rate	$28.82
Rate for Payer: Qualcare PPO/HMO/WC	$28.82

ID BAND YELLOW ADULT SENTRY

Facility

$192.10

Hospital Charge Code	270652389
Hospital Revenue Code	270
Min. Negotiated Rate	$24.97
Max. Negotiated Rate	$96.05
Rate for Payer: Aetna Commercial	$57.63
Rate for Payer: Aetna Medicare Advantage	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.99
Rate for Payer: Cigna Commercial	$96.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.97
Rate for Payer: Oxford Commercial	$96.05
Rate for Payer: Qualcare PPO/HMO/WC	$28.82
Rate for Payer: UnitedHealthcare Commercial	$96.05

I&D BARTHOLIN GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	412356420
Hospital Revenue Code	361
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

I&D BARTHOLIN GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	412356420
Hospital Revenue Code	361
Min. Negotiated Rate	$122.48
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$282.64
Rate for Payer: Aetna Medicare Advantage	$282.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.25
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	$240.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.48
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$141.32
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

I&D BARTHOLIN'S GLND ABSCESS

Facility

$1,872.73

Service Code	HCPCS 56420
Hospital Charge Code	1600000705
Hospital Revenue Code	360
Min. Negotiated Rate	$280.91
Max. Negotiated Rate	$280.91
Rate for Payer: Qualcare PPO/HMO/WC	$280.91

I&D BARTHOLIN'S GLND ABSCESS

Facility

$1,872.73

Service Code	HCPCS 56420
Hospital Charge Code	1600000705
Hospital Revenue Code	360
Min. Negotiated Rate	$243.45
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$561.82
Rate for Payer: Aetna Medicare Advantage	$561.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.55
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	$477.55
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.45
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.91
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

I&D BARTHOLOINS CYST

Facility

$1,068.55

Service Code	HCPCS 56420
Hospital Charge Code	87502585
Hospital Revenue Code	761
Min. Negotiated Rate	$138.91
Max. Negotiated Rate	$534.27
Rate for Payer: Aetna Commercial	$320.56
Rate for Payer: Aetna Medicare Advantage	$320.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.48
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.91
Rate for Payer: Oxford Commercial	$534.27
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Commercial	$534.27

I&D BARTHOLOINS CYST

Facility

$1,068.55

Service Code	HCPCS 56420
Hospital Charge Code	87502585
Hospital Revenue Code	761
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$160.28
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

ID BY PROBE

Facility

$137.85

Service Code	HCPCS 87149
Hospital Charge Code	39900273
Hospital Revenue Code	309
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$64.96
Rate for Payer: Aetna Medicare Advantage	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.46
Rate for Payer: Cigna Commercial	$20.05
Rate for Payer: Cigna Medicare Advantage	$10.03
Rate for Payer: Clover Medicare Advantage	$19.05
Rate for Payer: EmblemHealth Commercial	$60.15
Rate for Payer: Humana Medicare Advantage	$20.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.68
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.25
Rate for Payer: Wellcare Medicare Advantage	$20.05

ID BY PROBE

Facility

$137.85

Service Code	HCPCS 87149
Hospital Charge Code	39900273
Hospital Revenue Code	309
Min. Negotiated Rate	$20.68
Max. Negotiated Rate	$20.68
Rate for Payer: Qualcare PPO/HMO/WC	$20.68

I&D CPLX POSTOP WND INF

Facility

$9,748.92

Service Code	HCPCS 10180
Hospital Charge Code	16000463
Hospital Revenue Code	360
Min. Negotiated Rate	$1,462.34
Max. Negotiated Rate	$1,462.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.34

I&D CPLX POSTOP WND INF

Facility

$9,748.92

Service Code	HCPCS 10180
Hospital Charge Code	16000463
Hospital Revenue Code	360
Min. Negotiated Rate	$622.61
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Better Health Medicaid	$622.61
Rate for Payer: Aetna Commercial	$2,924.68
Rate for Payer: Aetna Medicare Advantage	$2,924.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,485.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,485.97
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	$2,485.97
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,267.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$635.06
Rate for Payer: Wellpoint Medicaid Managed Care	$622.61

IDEALBINDE SS WHITE 15X

Facility

$44.45

Hospital Charge Code	270636430
Hospital Revenue Code	271
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

IDEALBINDE SS WHITE 15X

Facility

$44.45

Hospital Charge Code	270636430
Hospital Revenue Code	271
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$22.23
Rate for Payer: Aetna Commercial	$13.34
Rate for Payer: Aetna Medicare Advantage	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.33
Rate for Payer: Cigna Commercial	$22.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$22.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$22.23

I&D EAR ABSCESS COMPLICATED

Facility

$8,548.96

Service Code	HCPCS 69005
Hospital Charge Code	5780255
Hospital Revenue Code	450
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,179.98
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

I&D EAR ABSCESS COMPLICATED

Facility

$8,548.96

Service Code	HCPCS 69005
Hospital Charge Code	5780255
Hospital Revenue Code	450
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	2690020
Hospital Revenue Code	361
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

IDET 1 OR MORE LEVELS

Facility

$30,000.00

Service Code	HCPCS 22527
Hospital Charge Code	16000801
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
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	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,900.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IDET 1 OR MORE LEVELS

Facility

$30,000.00

Service Code	HCPCS 22527
Hospital Charge Code	16000801
Hospital Revenue Code	360
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	2690020
Hospital Revenue Code	361
Min. Negotiated Rate	$573.30
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,323.00
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
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	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.30
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges