Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSULIN REGULAR HIGH COVERAGE

Facility

$100.85

Hospital Charge Code	60629888
Hospital Revenue Code	250
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$30.25
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.11
Rate for Payer: Oxford Commercial	$50.42
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$50.42

INSULIN REGULAR HIGH COVERAGE

Facility

$100.85

Hospital Charge Code	60629888
Hospital Revenue Code	250
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

INSULIN SEM ILENT 10ML 1000ML

Facility

$97.30

Hospital Charge Code	6003107
Hospital Revenue Code	250
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.60

INSULIN SEM ILENT 10ML 1000ML

Facility

$97.30

Hospital Charge Code	6003107
Hospital Revenue Code	250
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$48.65
Rate for Payer: Aetna Commercial	$29.19
Rate for Payer: Aetna Medicare Advantage	$29.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.81
Rate for Payer: Cigna Commercial	$48.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.65
Rate for Payer: Oxford Commercial	$48.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.60
Rate for Payer: UnitedHealthcare Commercial	$48.65

INSULIN SERUM

Facility

$91.25

Service Code	HCPCS 83525
Hospital Charge Code	3001658
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

INSULIN SERUM

Facility

$91.25

Service Code	HCPCS 83525
Hospital Charge Code	3001658
Hospital Revenue Code	301
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.03
Rate for Payer: Aetna Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.88
Rate for Payer: Cigna Commercial	$11.43
Rate for Payer: Cigna Medicare Advantage	$5.71
Rate for Payer: Clover Medicare Advantage	$10.86
Rate for Payer: EmblemHealth Commercial	$34.29
Rate for Payer: Humana Medicare Advantage	$11.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.43
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.12
Rate for Payer: Wellcare Medicare Advantage	$11.43

INSULIN,SERUM

Facility

$667.59

Service Code	HCPCS 83525
Hospital Charge Code	39900099
Hospital Revenue Code	301
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.03
Rate for Payer: Aetna Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.88
Rate for Payer: Cigna Commercial	$11.43
Rate for Payer: Cigna Medicare Advantage	$5.71
Rate for Payer: Clover Medicare Advantage	$10.86
Rate for Payer: EmblemHealth Commercial	$34.29
Rate for Payer: Humana Medicare Advantage	$11.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.43
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.12
Rate for Payer: Wellcare Medicare Advantage	$11.43

INSULIN,SERUM

Facility

$667.59

Service Code	HCPCS 83525
Hospital Charge Code	39900099
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

INSULIN,TOTAL

Facility

$360.00

Service Code	HCPCS 83525
Hospital Charge Code	38472422
Hospital Revenue Code	301
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.03
Rate for Payer: Aetna Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.88
Rate for Payer: Cigna Commercial	$11.43
Rate for Payer: Cigna Medicare Advantage	$5.71
Rate for Payer: Clover Medicare Advantage	$10.86
Rate for Payer: EmblemHealth Commercial	$34.29
Rate for Payer: Humana Medicare Advantage	$11.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.43
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.12
Rate for Payer: Wellcare Medicare Advantage	$11.43

INSULIN,TOTAL

Facility

$360.00

Service Code	HCPCS 83525
Hospital Charge Code	38472422
Hospital Revenue Code	301
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

INSULIN ULTRALEN BEEF 10ML

Facility

$12.80

Hospital Charge Code	6003115
Hospital Revenue Code	250
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.40

INSULIN ULTRALEN BEEF 10ML

Facility

$12.80

Hospital Charge Code	6003115
Hospital Revenue Code	250
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

INS URETERAL STENT-BIL

Facility

$5,100.00

Hospital Charge Code	2690725
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

INS URETERAL STENT-BIL

Facility

$5,100.00

Hospital Charge Code	2690725
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INS URETERAL STENT-LT

Facility

$2,717.00

Hospital Charge Code	2691790
Hospital Revenue Code	320
Min. Negotiated Rate	$353.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$815.10
Rate for Payer: Aetna Medicare Advantage	$815.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.84
Rate for Payer: Cigna Commercial	$1,358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$407.55
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INS URETERAL STENT-LT

Facility

$2,717.00

Hospital Charge Code	2691790
Hospital Revenue Code	320
Min. Negotiated Rate	$407.55
Max. Negotiated Rate	$407.55
Rate for Payer: Qualcare PPO/HMO/WC	$407.55

INS URETERAL STENT-RT

Facility

$919.00

Hospital Charge Code	2691795
Hospital Revenue Code	320
Min. Negotiated Rate	$119.47
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$275.70
Rate for Payer: Aetna Medicare Advantage	$275.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.34
Rate for Payer: Cigna Commercial	$459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.47
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$137.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INS URETERAL STENT-RT

Facility

$919.00

Hospital Charge Code	2691795
Hospital Revenue Code	320
Min. Negotiated Rate	$137.85
Max. Negotiated Rate	$137.85
Rate for Payer: Qualcare PPO/HMO/WC	$137.85

INSYTE 16G 1 1/4 IN

Facility

$11.25

Hospital Charge Code	270041006
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

INSYTE 16G 1 1/4 IN

Facility

$11.25

Hospital Charge Code	270041006
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

INTAKE ASSESSMENT

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84504015
Hospital Revenue Code	900
Min. Negotiated Rate	$168.48
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$388.80
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.48
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTAKE ASSESSMENT

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84504015
Hospital Revenue Code	900
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

INTAL/10MG/1ML

Facility

$3.00

Hospital Charge Code	60633185
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

INTAL/10MG/1ML

Facility

$3.00

Hospital Charge Code	60633185
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

INTAL/8.1GM

Facility

$3.00

Hospital Charge Code	60633186
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

Know your out-of-pocket cost for care.

All Charges