Heights University Hospital

All Charges

Charge

Type

Setting

Price

LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$41,149.83

Service Code	MSDRG 842
Min. Negotiated Rate	$11,026.07
Max. Negotiated Rate	$41,149.83
Rate for Payer: Aetna Commercial	$34,070.56
Rate for Payer: Aetna Medicare Advantage	$11,026.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,496.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,496.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,716.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,496.69
Rate for Payer: Cigna Commercial	$21,744.82
Rate for Payer: Cigna Medicare Advantage	$13,716.61
Rate for Payer: Clover Medicare Advantage	$13,030.78
Rate for Payer: EmblemHealth Commercial	$41,149.83
Rate for Payer: Humana Medicare Advantage	$14,128.11
Rate for Payer: Oxford Commercial	$13,589.88
Rate for Payer: UnitedHealthcare Commercial	$15,425.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,716.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,539.61
Rate for Payer: Wellcare Medicare Advantage	$13,716.61

LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$11,652.17

Service Code	APR-DRG 6911
Min. Negotiated Rate	$10,419.79
Max. Negotiated Rate	$11,652.17
Rate for Payer: Aetna Better Health Medicaid	$11,423.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,652.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10,419.79

LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$43,731.06

Service Code	APR-DRG 6914
Min. Negotiated Rate	$39,174.10
Max. Negotiated Rate	$43,731.06
Rate for Payer: Aetna Better Health Medicaid	$42,873.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,731.06
Rate for Payer: Wellpoint Medicaid Managed Care	$39,174.10

LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$15,414.48

Service Code	APR-DRG 6912
Min. Negotiated Rate	$12,031.64
Max. Negotiated Rate	$15,414.48
Rate for Payer: Aetna Better Health Medicaid	$15,112.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,414.48
Rate for Payer: Wellpoint Medicaid Managed Care	$12,031.64

LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA

Facility

$22,794.48

Service Code	APR-DRG 6913
Min. Negotiated Rate	$18,625.34
Max. Negotiated Rate	$22,794.48
Rate for Payer: Aetna Better Health Medicaid	$22,347.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,794.48
Rate for Payer: Wellpoint Medicaid Managed Care	$18,625.34

LYPRESSIN NASL 185MCG/ML

Facility

$281.60

Hospital Charge Code	6003388
Hospital Revenue Code	252
Min. Negotiated Rate	$42.24
Max. Negotiated Rate	$42.24
Rate for Payer: Qualcare PPO/HMO/WC	$42.24

LYPRESSIN NASL 185MCG/ML

Facility

$281.60

Hospital Charge Code	6003388
Hospital Revenue Code	252
Min. Negotiated Rate	$36.61
Max. Negotiated Rate	$140.80
Rate for Payer: Aetna Commercial	$84.48
Rate for Payer: Aetna Medicare Advantage	$84.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.81
Rate for Payer: Cigna Commercial	$140.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.61
Rate for Payer: Oxford Commercial	$140.80
Rate for Payer: Qualcare PPO/HMO/WC	$42.24
Rate for Payer: UnitedHealthcare Commercial	$140.80

LYRICA 50MG CAPSULE

Facility

$9.00

Hospital Charge Code	60635630
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

LYRICA 50MG CAPSULE

Facility

$9.00

Hospital Charge Code	60635630
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

LYRICA 75MG

Facility

$12.00

Hospital Charge Code	60635622
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

LYRICA 75MG

Facility

$12.00

Hospital Charge Code	60635622
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

LYSIS ADHESIONS, MULTI 2DAYS

Facility

$4,344.06

Service Code	HCPCS 62263
Hospital Charge Code	1600000758
Hospital Revenue Code	360
Min. Negotiated Rate	$564.73
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,303.22
Rate for Payer: Aetna Medicare Advantage	$1,303.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,107.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,107.74
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	$1,107.74
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.73
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

LYSIS ADHESIONS, MULTI 2DAYS

Facility

$4,344.06

Service Code	HCPCS 62263
Hospital Charge Code	1600000758
Hospital Revenue Code	360
Min. Negotiated Rate	$651.61
Max. Negotiated Rate	$651.61
Rate for Payer: Qualcare PPO/HMO/WC	$651.61

LYSIS OF LABIAL LESION (S)

Facility

$14,977.64

Service Code	HCPCS 56441
Hospital Charge Code	1600000536
Hospital Revenue Code	360
Min. Negotiated Rate	$2,246.65
Max. Negotiated Rate	$2,246.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.65

LYSIS OF LABIAL LESION (S)

Facility

$14,977.64

Service Code	HCPCS 56441
Hospital Charge Code	1600000536
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$4,493.29
Rate for Payer: Aetna Medicare Advantage	$4,493.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.30
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	$3,819.30
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,947.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.65
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

LYSIS PENIL CIRCUMIC LESION

Facility

$12,062.25

Service Code	HCPCS 54162
Hospital Charge Code	1600000583
Hospital Revenue Code	360
Min. Negotiated Rate	$1,568.09
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$3,618.68
Rate for Payer: Aetna Medicare Advantage	$3,618.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,075.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,075.87
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	$3,075.87
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

LYSIS PENIL CIRCUMIC LESION

Facility

$12,062.25

Service Code	HCPCS 54162
Hospital Charge Code	1600000583
Hospital Revenue Code	360
Min. Negotiated Rate	$1,809.34
Max. Negotiated Rate	$1,809.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34

LYSOZYME, Lactofferin Liquid

Facility

$37.80

Hospital Charge Code	60628758
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

LYSOZYME, Lactofferin Liquid

Facility

$37.80

Hospital Charge Code	60628758
Hospital Revenue Code	250
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

LYSOZYME (MURAMIDASE)

Facility

$280.00

Service Code	HCPCS 85549
Hospital Charge Code	38473055
Hospital Revenue Code	305
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.75
Rate for Payer: Aetna Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.70
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: Cigna Medicare Advantage	$9.38
Rate for Payer: Clover Medicare Advantage	$17.81
Rate for Payer: EmblemHealth Commercial	$56.25
Rate for Payer: Humana Medicare Advantage	$19.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.88
Rate for Payer: Wellcare Medicare Advantage	$18.75

LYSOZYME (MURAMIDASE)

Facility

$204.00

Service Code	HCPCS 85549
Hospital Charge Code	3006392
Hospital Revenue Code	305
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

LYSOZYME (MURAMIDASE)

Facility

$204.00

Service Code	HCPCS 85549
Hospital Charge Code	3006392
Hospital Revenue Code	305
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.75
Rate for Payer: Aetna Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.70
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: Cigna Medicare Advantage	$9.38
Rate for Payer: Clover Medicare Advantage	$17.81
Rate for Payer: EmblemHealth Commercial	$56.25
Rate for Payer: Humana Medicare Advantage	$19.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.88
Rate for Payer: Wellcare Medicare Advantage	$18.75

LYSOZYME (MURAMIDASE)

Facility

$280.00

Service Code	HCPCS 85549
Hospital Charge Code	38473055
Hospital Revenue Code	305
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

LYSOZYME,SERUM

Facility

$128.90

Service Code	HCPCS 85549
Hospital Charge Code	39900176
Hospital Revenue Code	305
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$19.34
Rate for Payer: Qualcare PPO/HMO/WC	$19.34

LYSOZYME,SERUM

Facility

$128.90

Service Code	HCPCS 85549
Hospital Charge Code	39900176
Hospital Revenue Code	305
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.75
Rate for Payer: Aetna Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.70
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: Cigna Medicare Advantage	$9.38
Rate for Payer: Clover Medicare Advantage	$17.81
Rate for Payer: EmblemHealth Commercial	$56.25
Rate for Payer: Humana Medicare Advantage	$19.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.34
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.88
Rate for Payer: Wellcare Medicare Advantage	$18.75

Know your out-of-pocket cost for care.

All Charges