Heights University Hospital

All Charges

Charge

Type

Setting

Price

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

MASSE BREAST CREAM/60GM

Facility

$28.00

Hospital Charge Code	60633355
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

MASSE BREAST CREAM/60GM

Facility

$28.00

Hospital Charge Code	60633355
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MASSON TRICHROME STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005332
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

MASSON TRICHROME STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005332
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

MASTECTOMY FOR MALIGNANCY WITH CC/MCC

Facility

$67,743.21

Service Code	MSDRG 582
Min. Negotiated Rate	$21,024.18
Max. Negotiated Rate	$67,743.21
Rate for Payer: Aetna Commercial	$64,964.72
Rate for Payer: Aetna Medicare Advantage	$21,024.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,966.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,966.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,581.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,966.58
Rate for Payer: Cigna Commercial	$41,462.36
Rate for Payer: Cigna Medicare Advantage	$22,581.07
Rate for Payer: Clover Medicare Advantage	$21,452.02
Rate for Payer: EmblemHealth Commercial	$67,743.21
Rate for Payer: Humana Medicare Advantage	$23,258.50
Rate for Payer: Oxford Commercial	$25,912.77
Rate for Payer: UnitedHealthcare Commercial	$29,413.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,581.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23,935.93
Rate for Payer: Wellcare Medicare Advantage	$22,581.07

MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC

Facility

$61,874.22

Service Code	MSDRG 583
Min. Negotiated Rate	$18,817.66
Max. Negotiated Rate	$61,874.22
Rate for Payer: Aetna Commercial	$58,146.57
Rate for Payer: Aetna Medicare Advantage	$18,817.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,901.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,901.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,624.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,901.84
Rate for Payer: Cigna Commercial	$37,110.81
Rate for Payer: Cigna Medicare Advantage	$20,624.74
Rate for Payer: Clover Medicare Advantage	$19,593.50
Rate for Payer: EmblemHealth Commercial	$61,874.22
Rate for Payer: Humana Medicare Advantage	$21,243.48
Rate for Payer: Oxford Commercial	$23,193.18
Rate for Payer: UnitedHealthcare Commercial	$26,326.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,624.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21,862.22
Rate for Payer: Wellcare Medicare Advantage	$20,624.74

MASTECTOMY PROCEDURES

Facility

$26,333.53

Service Code	APR-DRG 3622
Min. Negotiated Rate	$15,227.34
Max. Negotiated Rate	$26,333.53
Rate for Payer: Aetna Better Health Medicaid	$25,817.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,333.53
Rate for Payer: Wellpoint Medicaid Managed Care	$15,227.34

MASTECTOMY PROCEDURES

Facility

$17,348.31

Service Code	APR-DRG 3621
Min. Negotiated Rate	$12,459.97
Max. Negotiated Rate	$17,348.31
Rate for Payer: Aetna Better Health Medicaid	$17,008.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,348.31
Rate for Payer: Wellpoint Medicaid Managed Care	$12,459.97

MASTECTOMY PROCEDURES

Facility

$48,786.81

Service Code	APR-DRG 3624
Min. Negotiated Rate	$39,462.49
Max. Negotiated Rate	$48,786.81
Rate for Payer: Aetna Better Health Medicaid	$47,830.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$48,786.81
Rate for Payer: Wellpoint Medicaid Managed Care	$39,462.49

MASTECTOMY PROCEDURES

Facility

$29,695.62

Service Code	APR-DRG 3623
Min. Negotiated Rate	$18,739.38
Max. Negotiated Rate	$29,695.62
Rate for Payer: Aetna Better Health Medicaid	$29,113.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,695.62
Rate for Payer: Wellpoint Medicaid Managed Care	$18,739.38

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$243.43
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$561.75
Rate for Payer: Aetna Medicare Advantage	$561.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.49
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	$477.49
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.43
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$243.43
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$561.75
Rate for Payer: Aetna Medicare Advantage	$561.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.49
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	$477.49
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.43
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$243.43
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$561.75
Rate for Payer: Aetna Medicare Advantage	$561.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.49
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	$477.49
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.43
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MASTIC SOL 0.666ML

Facility

$3.85

Hospital Charge Code	60628642
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

MASTIC SOL 0.666ML

Facility

$3.85

Hospital Charge Code	60628642
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MASTIC SOL 120ML

Facility

$179.20

Hospital Charge Code	60628532
Hospital Revenue Code	250
Min. Negotiated Rate	$26.88
Max. Negotiated Rate	$26.88
Rate for Payer: Qualcare PPO/HMO/WC	$26.88

MASTIC SOL 120ML

Facility

$133.80

Hospital Charge Code	60628643
Hospital Revenue Code	250
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$66.90
Rate for Payer: Aetna Commercial	$40.14
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.12
Rate for Payer: Cigna Commercial	$66.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.39
Rate for Payer: Oxford Commercial	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$20.07
Rate for Payer: UnitedHealthcare Commercial	$66.90

MASTIC SOL 120ML

Facility

$133.80

Hospital Charge Code	60628643
Hospital Revenue Code	250
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$20.07
Rate for Payer: Qualcare PPO/HMO/WC	$20.07

MASTIC SOL 120ML

Facility

$179.20

Hospital Charge Code	60628532
Hospital Revenue Code	250
Min. Negotiated Rate	$23.30
Max. Negotiated Rate	$89.60
Rate for Payer: Aetna Commercial	$53.76
Rate for Payer: Aetna Medicare Advantage	$53.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.70
Rate for Payer: Cigna Commercial	$89.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$89.60
Rate for Payer: Qualcare PPO/HMO/WC	$26.88
Rate for Payer: UnitedHealthcare Commercial	$89.60

MASTISOL ADHESIVE****

Facility

$6.00

Hospital Charge Code	8003634
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

MASTISOL ADHESIVE****

Facility

$6.00

Hospital Charge Code	8003634
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

Know your out-of-pocket cost for care.

All Charges