Heights University Hospital

All Charges

Charge

Type

Setting

Price

LANTHANUM CARBONATE 750MG CTAB

Facility

$39.00

Hospital Charge Code	60630027
Hospital Revenue Code	250
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$19.50

LANTHANUM CARBONATE 750MG CTAB

Facility

$39.00

Hospital Charge Code	60630027
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

LANTUS INSULIN 10ML VIAL

Facility

$539.22

Service Code	HCPCS J1815
Hospital Charge Code	606390414
Hospital Revenue Code	636
Min. Negotiated Rate	$80.88
Max. Negotiated Rate	$130.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$80.88

LANTUS INSULIN 10ML VIAL

Facility

$539.22

Service Code	HCPCS J1815
Hospital Charge Code	606390414
Hospital Revenue Code	636
Min. Negotiated Rate	$80.88
Max. Negotiated Rate	$269.61
Rate for Payer: Aetna Commercial	$161.77
Rate for Payer: Aetna Medicare Advantage	$161.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.50
Rate for Payer: Cigna Commercial	$269.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$80.88

LANTUS VIAL PER 50 UNITS

Facility

$4.00

Service Code	NDC 88222033
Hospital Charge Code	60632262
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LANTUS VIAL PER 50 UNITS

Facility

$4.00

Service Code	NDC 88222033
Hospital Charge Code	60632262
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

LAP ABD PERIT OMTUM W DRAINAGE

Facility

$35,550.90

Service Code	HCPCS 49323
Hospital Charge Code	1600000405
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$10,665.27
Rate for Payer: Aetna Medicare Advantage	$10,665.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,065.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,065.48
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	$9,065.48
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,621.62
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,332.64
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LAP ABD PERIT OMTUM W DRAINAGE

Facility

$35,550.90

Service Code	HCPCS 49323
Hospital Charge Code	1600000405
Hospital Revenue Code	360
Min. Negotiated Rate	$5,332.64
Max. Negotiated Rate	$5,332.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,332.64

LAP,ABD PET OMENTUM W BX

Facility

$36,033.50

Service Code	HCPCS 49321
Hospital Charge Code	16000987
Hospital Revenue Code	360
Min. Negotiated Rate	$5,405.02
Max. Negotiated Rate	$5,405.02
Rate for Payer: Qualcare PPO/HMO/WC	$5,405.02

LAP,ABD PET OMENTUM W BX

Facility

$36,033.50

Service Code	HCPCS 49321
Hospital Charge Code	16000987
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$10,810.05
Rate for Payer: Aetna Medicare Advantage	$10,810.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,188.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,188.54
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	$9,188.54
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,684.35
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,405.02
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LAP,ADB PET OMENUTM W ASP CYST

Facility

$45,838.40

Service Code	HCPCS 49322
Hospital Charge Code	16000645
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,751.52
Rate for Payer: Aetna Medicare Advantage	$13,751.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,688.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,688.79
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	$11,688.79
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,958.99
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,875.76
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LAP,ADB PET OMENUTM W ASP CYST

Facility

$45,838.40

Service Code	HCPCS 49322
Hospital Charge Code	16000645
Hospital Revenue Code	360
Min. Negotiated Rate	$6,875.76
Max. Negotiated Rate	$6,875.76
Rate for Payer: Qualcare PPO/HMO/WC	$6,875.76

LAPARAST VAG HYSTRCTMY=<250GM

Facility

$63,727.20

Service Code	HCPCS 58550
Hospital Charge Code	1600000675
Hospital Revenue Code	360
Min. Negotiated Rate	$9,559.08
Max. Negotiated Rate	$9,559.08
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08

LAPARAST VAG HYSTRCTMY=<250GM

Facility

$63,727.20

Service Code	HCPCS 58550
Hospital Charge Code	1600000675
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,118.16
Rate for Payer: Aetna Commercial	$19,118.16
Rate for Payer: Aetna Medicare Advantage	$19,118.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,250.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,250.44
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	$16,250.44
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,284.54
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAPAR. FIXATION SYSTEM

Facility

$752.00

Hospital Charge Code	270332703
Hospital Revenue Code	272
Min. Negotiated Rate	$97.76
Max. Negotiated Rate	$376.00
Rate for Payer: Aetna Commercial	$225.60
Rate for Payer: Aetna Medicare Advantage	$225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.76
Rate for Payer: Cigna Commercial	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.76
Rate for Payer: Oxford Commercial	$376.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.80
Rate for Payer: UnitedHealthcare Commercial	$376.00

LAPAR. FIXATION SYSTEM

Facility

$752.00

Hospital Charge Code	270332703
Hospital Revenue Code	272
Min. Negotiated Rate	$112.80
Max. Negotiated Rate	$112.80
Rate for Payer: Qualcare PPO/HMO/WC	$112.80

LAPARO ABLATE LIVER TUMOR RF

Facility

$61,304.40

Service Code	HCPCS 47370
Hospital Charge Code	1600000339
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$18,391.32
Rate for Payer: Aetna Medicare Advantage	$18,391.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,632.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,632.62
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	$15,632.62
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,969.57
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

LAPARO ABLATE LIVER TUMOR RF

Facility

$61,304.40

Service Code	HCPCS 47370
Hospital Charge Code	1600000339
Hospital Revenue Code	360
Min. Negotiated Rate	$9,195.66
Max. Negotiated Rate	$9,195.66
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66

LAPARO RADICAL PROSTATECTOMY

Facility

$39,439.32

Service Code	HCPCS 55866
Hospital Charge Code	160000214
Hospital Revenue Code	360
Min. Negotiated Rate	$5,915.90
Max. Negotiated Rate	$5,915.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

LAPARO RADICAL PROSTATECTOMY

Facility

$39,439.32

Service Code	HCPCS 55866
Hospital Charge Code	160000214
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$11,831.80
Rate for Payer: Aetna Medicare Advantage	$11,831.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,057.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,057.03
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	$10,057.03
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,127.11
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

LAPAROS,CHOLECYSTONTERSTMY

Facility

$8,594.70

Service Code	HCPCS 47570
Hospital Charge Code	1600000525
Hospital Revenue Code	360
Min. Negotiated Rate	$1,289.20
Max. Negotiated Rate	$1,289.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,289.20

LAPAROS,CHOLECYSTONTERSTMY

Facility

$8,594.70

Service Code	HCPCS 47570
Hospital Charge Code	1600000525
Hospital Revenue Code	360
Min. Negotiated Rate	$804.20
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,578.41
Rate for Payer: Aetna Medicare Advantage	$2,578.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,191.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,191.65
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	$2,191.65
Rate for Payer: Cigna Commercial	$804.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,117.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,289.20
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

LAPAROSCOPE PROCEDURE LIVER

Facility

$33,033.35

Service Code	HCPCS 47379
Hospital Charge Code	1600000403
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$9,910.00
Rate for Payer: Aetna Medicare Advantage	$9,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,423.50
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	$8,423.50
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,294.34
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LAPAROSCOPE PROCEDURE LIVER

Facility

$33,033.35

Service Code	HCPCS 47379
Hospital Charge Code	1600000403
Hospital Revenue Code	360
Min. Negotiated Rate	$4,955.00
Max. Negotiated Rate	$4,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00

LAPAROSCOPE PROC INTESTINE

Facility

$22,659.64

Service Code	HCPCS 44238
Hospital Charge Code	16000974
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,797.89
Rate for Payer: Aetna Medicare Advantage	$6,797.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,778.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,778.21
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	$5,778.21
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,945.75
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,398.95
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

Know your out-of-pocket cost for care.

All Charges