Heights University Hospital

All Charges

Charge

Type

Setting

Price

LAMICTRAL 25MG

Facility

$15.00

Hospital Charge Code	60635089
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

LAMINA IQ

Facility

$455.40

Hospital Charge Code	270653896
Hospital Revenue Code	272
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$227.70
Rate for Payer: Aetna Commercial	$136.62
Rate for Payer: Aetna Medicare Advantage	$136.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.13
Rate for Payer: Cigna Commercial	$227.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.20
Rate for Payer: Oxford Commercial	$227.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.31
Rate for Payer: UnitedHealthcare Commercial	$227.70

LAMINA IQ

Facility

$455.40

Hospital Charge Code	270653896
Hospital Revenue Code	272
Min. Negotiated Rate	$68.31
Max. Negotiated Rate	$68.31
Rate for Payer: Qualcare PPO/HMO/WC	$68.31

LAMINCT IMPL NS ELCTRDS,EPIDRL

Facility

$88,183.60

Service Code	HCPCS 63655
Hospital Charge Code	1600000858
Hospital Revenue Code	360
Min. Negotiated Rate	$13,227.54
Max. Negotiated Rate	$13,227.54
Rate for Payer: Qualcare PPO/HMO/WC	$13,227.54

LAMINCT IMPL NS ELCTRDS,EPIDRL

Facility

$88,183.60

Service Code	HCPCS 63655
Hospital Charge Code	1600000858
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,199.32
Rate for Payer: Aetna Commercial	$26,455.08
Rate for Payer: Aetna Medicare Advantage	$26,455.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,486.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,486.82
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	$22,486.82
Rate for Payer: Cigna Commercial	$46,199.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,463.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,227.54
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

LAMINECTOMY WITH RHIZOTOMY; MORE THAN 2 SEGMENTS

Facility

$10,997.00

Service Code	CPT 63190
Hospital Revenue Code	360
Min. Negotiated Rate	$1,233.21
Max. Negotiated Rate	$10,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Cigna Commercial	$1,233.21
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

LAMINOTOMY ADDL CERVICAL

Facility

$7,312.94

Service Code	HCPCS 63043
Hospital Charge Code	1600000556
Hospital Revenue Code	360
Min. Negotiated Rate	$950.68
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,193.88
Rate for Payer: Aetna Medicare Advantage	$2,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,864.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,864.80
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	$1,864.80
Rate for Payer: Cigna Commercial	$3,656.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$950.68
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,096.94
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

LAMINOTOMY ADDL CERVICAL

Facility

$7,312.94

Service Code	HCPCS 63043
Hospital Charge Code	1600000556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,096.94
Max. Negotiated Rate	$1,096.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,096.94

LAMINOTOMY ADDL LUMBAR

Facility

$63,107.55

Service Code	HCPCS 63044
Hospital Charge Code	1600000303
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$31,553.78
Rate for Payer: Aetna Commercial	$18,932.26
Rate for Payer: Aetna Medicare Advantage	$18,932.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,092.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,092.43
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	$16,092.43
Rate for Payer: Cigna Commercial	$31,553.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,203.98
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

LAMINOTOMY ADDL LUMBAR

Facility

$63,107.55

Service Code	HCPCS 63044
Hospital Charge Code	1600000303
Hospital Revenue Code	360
Min. Negotiated Rate	$9,466.13
Max. Negotiated Rate	$9,466.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13

LAMINOTOMY SINGLE CERVICAL

Facility

$47,548.90

Service Code	HCPCS 63040
Hospital Charge Code	1600000507
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

LAMINOTOMY SINGLE CERVICAL

Facility

$47,548.90

Service Code	HCPCS 63040
Hospital Charge Code	1600000507
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAMINOTOMY SINGLE LUMBAR-LT

Facility

$63,107.55

Service Code	HCPCS 63042
Hospital Charge Code	16001020
Hospital Revenue Code	360
Min. Negotiated Rate	$9,466.13
Max. Negotiated Rate	$9,466.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13

LAMINOTOMY SINGLE LUMBAR-LT

Facility

$63,107.55

Service Code	HCPCS 63042
Hospital Charge Code	16001020
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,932.26
Rate for Payer: Aetna Commercial	$18,932.26
Rate for Payer: Aetna Medicare Advantage	$18,932.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,092.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,092.43
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	$16,092.43
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,203.98
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAMITRODE TRIPOLE 16 LEAD 60 C

Facility

$29,500.00

Hospital Charge Code	270659614
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

LAMITRODE TRIPOLE 16 LEAD 60 C

Facility

$29,500.00

Hospital Charge Code	270659614
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$8,850.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

LAMIVUDINE 150 MG TAB

Facility

$54.74

Service Code	NDC 68084057821
Hospital Charge Code	6016539
Hospital Revenue Code	250
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$27.37
Rate for Payer: Aetna Commercial	$16.42
Rate for Payer: Aetna Medicare Advantage	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.96
Rate for Payer: Cigna Commercial	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$27.37
Rate for Payer: Qualcare PPO/HMO/WC	$8.21
Rate for Payer: UnitedHealthcare Commercial	$27.37

LAMIVUDINE 150 MG TAB

Facility

$54.74

Service Code	NDC 68084057821
Hospital Charge Code	6016539
Hospital Revenue Code	250
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$8.21

LAMIVUDINE ELIX 10MG/ML 240ML

Facility

$34.10

Service Code	NDC 49702020548
Hospital Charge Code	60628772
Hospital Revenue Code	250
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$17.05
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$10.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.70
Rate for Payer: Cigna Commercial	$17.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.43
Rate for Payer: Oxford Commercial	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.12
Rate for Payer: UnitedHealthcare Commercial	$17.05

LAMIVUDINE ELIX 10MG/ML 240ML

Facility

$34.10

Service Code	NDC 49702020548
Hospital Charge Code	60628772
Hospital Revenue Code	250
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.12

LAMIVUDINE/ZIDOVUDINE 1 TAB

Facility

$104.05

Service Code	NDC 378518091
Hospital Charge Code	60629151
Hospital Revenue Code	250
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$52.02
Rate for Payer: Aetna Commercial	$31.21
Rate for Payer: Aetna Medicare Advantage	$31.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.53
Rate for Payer: Cigna Commercial	$52.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.53
Rate for Payer: Oxford Commercial	$52.02
Rate for Payer: Qualcare PPO/HMO/WC	$15.61
Rate for Payer: UnitedHealthcare Commercial	$52.02

LAMIVUDINE/ZIDOVUDINE 1 TAB

Facility

$104.05

Service Code	NDC 378518091
Hospital Charge Code	60629151
Hospital Revenue Code	250
Min. Negotiated Rate	$15.61
Max. Negotiated Rate	$15.61
Rate for Payer: Qualcare PPO/HMO/WC	$15.61

LAMOTRIGINE

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3007565
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

LAMOTRIGINE

Facility

$75.00

Service Code	HCPCS 80299
Hospital Charge Code	38472309
Hospital Revenue Code	301
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

LAMOTRIGINE

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3007565
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

Know your out-of-pocket cost for care.

All Charges