Heights University Hospital

All Charges

Charge

Type

Setting

Price

MECLOMEN/100MG/CAP

Facility

$6.00

Hospital Charge Code	60633363
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

MECLOMEN/100MG/CAP

Facility

$6.00

Hospital Charge Code	60633363
Hospital Revenue Code	250
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

MED CAGE H14 10

Facility

$25,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270703621
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

MED CAGE H14 10

Facility

$25,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270703621
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

MEDEKAST CAST OR BOOT 4 INCHES

Facility

$175.00

Hospital Charge Code	270639632
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

MEDEKAST CAST OR BOOT 4 INCHES

Facility

$175.00

Hospital Charge Code	270639632
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

MEDEKAST KIT W/2 BOOTS 4

Facility

$537.08

Hospital Charge Code	270639682
Hospital Revenue Code	272
Min. Negotiated Rate	$80.56
Max. Negotiated Rate	$80.56
Rate for Payer: Qualcare PPO/HMO/WC	$80.56

MEDEKAST KIT W/2 BOOTS 4

Facility

$537.08

Hospital Charge Code	270639682
Hospital Revenue Code	272
Min. Negotiated Rate	$69.82
Max. Negotiated Rate	$268.54
Rate for Payer: Aetna Commercial	$161.12
Rate for Payer: Aetna Medicare Advantage	$161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.96
Rate for Payer: Cigna Commercial	$268.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.82
Rate for Payer: Oxford Commercial	$268.54
Rate for Payer: Qualcare PPO/HMO/WC	$80.56
Rate for Payer: UnitedHealthcare Commercial	$268.54

MED E KAST ULTRA TCC2ULTR

Facility

$375.00

Hospital Charge Code	270641932
Hospital Revenue Code	270
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED E KAST ULTRA TCC2ULTR

Facility

$375.00

Hospital Charge Code	270641932
Hospital Revenue Code	270
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

MEDIAL DISTAL TIBIAL PLT 6H LT

Facility

$3,833.60

Hospital Charge Code	270663178
Hospital Revenue Code	270
Min. Negotiated Rate	$498.37
Max. Negotiated Rate	$1,916.80
Rate for Payer: Aetna Commercial	$1,150.08
Rate for Payer: Aetna Medicare Advantage	$1,150.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.57
Rate for Payer: Cigna Commercial	$1,916.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$498.37
Rate for Payer: Oxford Commercial	$1,916.80
Rate for Payer: Qualcare PPO/HMO/WC	$575.04
Rate for Payer: UnitedHealthcare Commercial	$1,916.80

MEDIAL DISTAL TIBIAL PLT 6H LT

Facility

$3,833.60

Hospital Charge Code	270663178
Hospital Revenue Code	270
Min. Negotiated Rate	$575.04
Max. Negotiated Rate	$575.04
Rate for Payer: Qualcare PPO/HMO/WC	$575.04

MEDIAL MENISCUS LEFT

Facility

$21,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270675518
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

MEDIAL MENISCUS LEFT

Facility

$21,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270675518
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$6,300.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

MEDICAL BACK PROBLEMS WITH MCC

Facility

$60,472.26

Service Code	MSDRG 551
Min. Negotiated Rate	$18,290.58
Max. Negotiated Rate	$60,472.26
Rate for Payer: Aetna Commercial	$56,517.89
Rate for Payer: Aetna Medicare Advantage	$18,290.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,863.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,863.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,157.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,863.90
Rate for Payer: Cigna Commercial	$36,071.35
Rate for Payer: Cigna Medicare Advantage	$20,157.42
Rate for Payer: Clover Medicare Advantage	$19,149.55
Rate for Payer: EmblemHealth Commercial	$60,472.26
Rate for Payer: Humana Medicare Advantage	$20,762.14
Rate for Payer: Oxford Commercial	$22,543.54
Rate for Payer: UnitedHealthcare Commercial	$25,589.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,157.42
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21,366.87
Rate for Payer: Wellcare Medicare Advantage	$20,157.42

MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$39,724.65

Service Code	MSDRG 552
Min. Negotiated Rate	$10,490.27
Max. Negotiated Rate	$39,724.65
Rate for Payer: Aetna Commercial	$32,414.93
Rate for Payer: Aetna Medicare Advantage	$10,490.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,739.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,739.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,241.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,739.99
Rate for Payer: Cigna Commercial	$20,688.14
Rate for Payer: Cigna Medicare Advantage	$13,241.55
Rate for Payer: Clover Medicare Advantage	$12,579.47
Rate for Payer: EmblemHealth Commercial	$39,724.65
Rate for Payer: Humana Medicare Advantage	$13,638.80
Rate for Payer: Oxford Commercial	$12,929.49
Rate for Payer: UnitedHealthcare Commercial	$14,676.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,241.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,036.04
Rate for Payer: Wellcare Medicare Advantage	$13,241.55

MEDICAL FAMILY PLANNING WHC***

Facility

$25.30

Service Code	HCPCS 99212WF
Hospital Charge Code	9600015
Hospital Revenue Code	519
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$12.65
Rate for Payer: Aetna Commercial	$7.59
Rate for Payer: Aetna Medicare Advantage	$7.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.45
Rate for Payer: Cigna Commercial	$12.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.79

MEDICAL FAMILY PLANNING WHC***

Facility

$25.30

Service Code	HCPCS 99212WF
Hospital Charge Code	9600015
Hospital Revenue Code	519
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$3.79
Rate for Payer: Qualcare PPO/HMO/WC	$3.79

MEDICAL FOLLOW UP*****

Facility

$40.00

Service Code	HCPCS 90801
Hospital Charge Code	9300070
Hospital Revenue Code	910
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

MEDICAL FOLLOW UP*****

Facility

$40.00

Service Code	HCPCS 90801
Hospital Charge Code	9300070
Hospital Revenue Code	910
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

MEDICAL FP VISIT W/MD OR NP***

Facility

$25.30

Service Code	HCPCS 99212WF
Hospital Charge Code	9600024
Hospital Revenue Code	519
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$12.65
Rate for Payer: Aetna Commercial	$7.59
Rate for Payer: Aetna Medicare Advantage	$7.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.45
Rate for Payer: Cigna Commercial	$12.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.79

MEDICAL FP VISIT W/MD OR NP***

Facility

$25.30

Service Code	HCPCS 99212WF
Hospital Charge Code	9600024
Hospital Revenue Code	519
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$3.79
Rate for Payer: Qualcare PPO/HMO/WC	$3.79

MEDICAL RECORDING CHART PAPER

Facility

$44.40

Hospital Charge Code	270665693
Hospital Revenue Code	270
Min. Negotiated Rate	$6.66
Max. Negotiated Rate	$6.66
Rate for Payer: Qualcare PPO/HMO/WC	$6.66

MEDICAL RECORDING CHART PAPER

Facility

$44.40

Hospital Charge Code	270665693
Hospital Revenue Code	270
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$22.20
Rate for Payer: Aetna Commercial	$13.32
Rate for Payer: Aetna Medicare Advantage	$13.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.32
Rate for Payer: Cigna Commercial	$22.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.77
Rate for Payer: Oxford Commercial	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.66
Rate for Payer: UnitedHealthcare Commercial	$22.20

MEDICAL REVIEW OFFICER

Facility

$225.20

Service Code	HCPCS 99211
Hospital Charge Code	MROCLIENT
Hospital Revenue Code	510
Min. Negotiated Rate	$33.78
Max. Negotiated Rate	$33.78
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

Know your out-of-pocket cost for care.

All Charges