Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

MEDICAL VISIT EST PT 40MIN****

Facility

$150.00

Service Code	HCPCS 99215
Hospital Charge Code	9400169
Hospital Revenue Code	519
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$135.96
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MEDICAL VISIT EST PT 40MIN****

Facility

$150.00

Service Code	HCPCS 99215
Hospital Charge Code	9400169
Hospital Revenue Code	519
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MEDICAL VISIT NEW 30M****

Facility

$132.00

Hospital Charge Code	9400128
Hospital Revenue Code	519
Min. Negotiated Rate	$17.16
Max. Negotiated Rate	$66.00
Rate for Payer: Aetna Commercial	$39.60
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

MEDICAL VISIT NEW 30M****

Facility

$132.00

Hospital Charge Code	9400128
Hospital Revenue Code	519
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

MEDICAL VS EST 10 MIN*****

Facility

$55.00

Service Code	HCPCS 99212
Hospital Charge Code	9400144
Hospital Revenue Code	519
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

MEDICAL VS EST 10 MIN*****

Facility

$55.00

Service Code	HCPCS 99212
Hospital Charge Code	9400144
Hospital Revenue Code	519
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$33.58
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

MEDICAL VS EST 30MIN*****

Facility

$90.00

Service Code	HCPCS 99214
Hospital Charge Code	9400151
Hospital Revenue Code	519
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$91.37
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$91.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

MEDICAL VS EST 30MIN*****

Facility

$90.00

Service Code	HCPCS 99214
Hospital Charge Code	9400151
Hospital Revenue Code	519
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

MEDICAL VS NEW 45 MIN*****

Facility

$165.00

Service Code	HCPCS 99204
Hospital Charge Code	9400136
Hospital Revenue Code	519
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$126.45
Rate for Payer: Aetna Commercial	$49.50
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$126.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

MEDICAL VS NEW 45 MIN*****

Facility

$165.00

Service Code	HCPCS 99204
Hospital Charge Code	9400136
Hospital Revenue Code	519
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

MEDICINE GLASS W/LIP 1 OZ

Facility

$9.05

Hospital Charge Code	270659392
Hospital Revenue Code	270
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$4.53
Rate for Payer: Aetna Commercial	$2.71
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.31
Rate for Payer: Cigna Commercial	$4.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.18
Rate for Payer: Oxford Commercial	$4.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.36
Rate for Payer: UnitedHealthcare Commercial	$4.53

MEDICINE GLASS W/LIP 1 OZ

Facility

$9.05

Hospital Charge Code	270659392
Hospital Revenue Code	270
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.36

MEDIHONEY 44ML

Facility

$212.00

Hospital Charge Code	606390572
Hospital Revenue Code	250
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$106.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Commercial	$106.00

MEDIHONEY 44ML

Facility

$212.00

Hospital Charge Code	606390572
Hospital Revenue Code	250
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$31.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

MEDIHONEY GEL TUBE

Facility

$82.19

Hospital Charge Code	606380009
Hospital Revenue Code	250
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$41.09
Rate for Payer: Aetna Commercial	$24.66
Rate for Payer: Aetna Medicare Advantage	$24.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.96
Rate for Payer: Cigna Commercial	$41.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.68
Rate for Payer: Oxford Commercial	$41.09
Rate for Payer: Qualcare PPO/HMO/WC	$12.33
Rate for Payer: UnitedHealthcare Commercial	$41.09

MEDIHONEY GEL TUBE

Facility

$95.12

Hospital Charge Code	606351017
Hospital Revenue Code	250
Min. Negotiated Rate	$12.37
Max. Negotiated Rate	$47.56
Rate for Payer: Aetna Commercial	$28.54
Rate for Payer: Aetna Medicare Advantage	$28.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.26
Rate for Payer: Cigna Commercial	$47.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.37
Rate for Payer: Oxford Commercial	$47.56
Rate for Payer: Qualcare PPO/HMO/WC	$14.27
Rate for Payer: UnitedHealthcare Commercial	$47.56

MEDIHONEY GEL TUBE

Facility

$82.19

Hospital Charge Code	606380009
Hospital Revenue Code	250
Min. Negotiated Rate	$12.33
Max. Negotiated Rate	$12.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.33

MEDIHONEY GEL TUBE

Facility

$66.06

Service Code	NDC 9958003461
Hospital Charge Code	606390420
Hospital Revenue Code	272
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$33.03
Rate for Payer: Aetna Commercial	$19.82
Rate for Payer: Aetna Medicare Advantage	$19.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.85
Rate for Payer: Cigna Commercial	$33.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.59
Rate for Payer: Oxford Commercial	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.91
Rate for Payer: UnitedHealthcare Commercial	$33.03

MEDIHONEY GEL TUBE

Facility

$66.06

Service Code	NDC 9958003461
Hospital Charge Code	606390420
Hospital Revenue Code	272
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.91

MEDIHONEY GEL TUBE

Facility

$95.12

Hospital Charge Code	606351017
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$14.27
Rate for Payer: Qualcare PPO/HMO/WC	$14.27

MEDISKIN

Facility

$89.00

Hospital Charge Code	60634774
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

MEDISKIN

Facility

$89.00

Hospital Charge Code	60634774
Hospital Revenue Code	250
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$26.70
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.57
Rate for Payer: Oxford Commercial	$44.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$44.50

MEDIUM MTAL HEMI IMPLANT

Facility

$8,650.00

Hospital Charge Code	270657408
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.50
Max. Negotiated Rate	$2,093.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,093.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.50

MEDIUM MTAL HEMI IMPLANT

Facility

$8,650.00

Hospital Charge Code	270657408
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.50
Max. Negotiated Rate	$4,325.00
Rate for Payer: Aetna Commercial	$2,595.00
Rate for Payer: Aetna Medicare Advantage	$2,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,205.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,205.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,730.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,205.75
Rate for Payer: Cigna Commercial	$4,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,093.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.50

Know your out-of-pocket cost for care.

All Charges