Heights University Hospital

All Charges

Charge

Type

Setting

Price

AQUAMEPHYTON/10MG/1ML

Facility

$24.00

Hospital Charge Code	60632478
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

AQUAMEPHYTON/1MG/0.5ML

Facility

$23.00

Hospital Charge Code	60632479
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

AQUAMEPHYTON/1MG/0.5ML

Facility

$23.00

Hospital Charge Code	60632479
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

AQUAPAK STERILE WATER 760ml

Facility

$7.67

Hospital Charge Code	270632818
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.83
Rate for Payer: Aetna Commercial	$2.30
Rate for Payer: Aetna Medicare Advantage	$2.30
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	$3.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$3.83

AQUAPAK STERILE WATER 760ml

Facility

$7.67

Hospital Charge Code	270632818
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

AQUAPORIN R AB IGG CBA

Facility

$2,640.00

Service Code	HCPCS 86255
Hospital Charge Code	401086255
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$396.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

AQUAPORIN R AB IGG CBA

Facility

$2,640.00

Service Code	HCPCS 86255
Hospital Charge Code	401086255
Hospital Revenue Code	302
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

AQUA SHIELD CAP

Facility

$55.00

Hospital Charge Code	270657702
Hospital Revenue Code	270
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

AQUA SHIELD CAP

Facility

$55.00

Hospital Charge Code	270657702
Hospital Revenue Code	270
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

AQUASOL A/25KU/CAP

Facility

$3.00

Hospital Charge Code	60632480
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

AQUASOL A/25KU/CAP

Facility

$3.00

Hospital Charge Code	60632480
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

AQUA TRACK HCH

Facility

$11.44

Hospital Charge Code	270615641
Hospital Revenue Code	270
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$5.72
Rate for Payer: Aetna Commercial	$3.43
Rate for Payer: Aetna Medicare Advantage	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.92
Rate for Payer: Cigna Commercial	$5.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.49
Rate for Payer: Oxford Commercial	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.72
Rate for Payer: UnitedHealthcare Commercial	$5.72

AQUA TRACK HCH

Facility

$11.44

Hospital Charge Code	270615641
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.72

AQULX FLD CNTRL SYSTM CAN KIT

Facility

$1,895.00

Hospital Charge Code	270661101
Hospital Revenue Code	270
Min. Negotiated Rate	$284.25
Max. Negotiated Rate	$284.25
Rate for Payer: Qualcare PPO/HMO/WC	$284.25

AQULX FLD CNTRL SYSTM CAN KIT

Facility

$1,895.00

Hospital Charge Code	270661101
Hospital Revenue Code	270
Min. Negotiated Rate	$246.35
Max. Negotiated Rate	$947.50
Rate for Payer: Aetna Commercial	$568.50
Rate for Payer: Aetna Medicare Advantage	$568.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.23
Rate for Payer: Cigna Commercial	$947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.35
Rate for Payer: Oxford Commercial	$947.50
Rate for Payer: Qualcare PPO/HMO/WC	$284.25
Rate for Payer: UnitedHealthcare Commercial	$947.50

AR8827L16SCREWLOCKING 2.7X16MM

Facility

$525.00

Hospital Charge Code	270663077
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

AR8827L16SCREWLOCKING 2.7X16MM

Facility

$525.00

Hospital Charge Code	270663077
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

AR8840CL40SCRCANLONGTHD4MMX40M

Facility

$750.00

Hospital Charge Code	270663291
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

AR8840CL40SCRCANLONGTHD4MMX40M

Facility

$750.00

Hospital Charge Code	270663291
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

AR8840CL42SCRCANLONGTHD4MMX42M

Facility

$750.00

Hospital Charge Code	270663093
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

AR8840CL42SCRCANLONGTHD4MMX42M

Facility

$750.00

Hospital Charge Code	270663093
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

ARALEN/500MG/TAB

Facility

$15.00

Hospital Charge Code	60632481
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

ARALEN/500MG/TAB

Facility

$15.00

Hospital Charge Code	60632481
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

ARBOVIRAL ENCEPHALITIS A/B IGM

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476198
Hospital Revenue Code	302
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ARBOVIRAL ENCEPHALITIS A/B IGM

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476198
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

Know your out-of-pocket cost for care.

All Charges