Heights University Hospital

All Charges

Charge

Type

Setting

Price

MICROSPORIDIA ID

Facility

$390.00

Service Code	HCPCS 87207
Hospital Charge Code	39900494
Hospital Revenue Code	309
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.41
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.95
Rate for Payer: Cigna Commercial	$5.99
Rate for Payer: Cigna Medicare Advantage	$3.00
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.35
Rate for Payer: Wellcare Medicare Advantage	$5.99

MICROSTENT HYDRUS I STENT

Facility

$9,500.00

Service Code	HCPCS C1783
Hospital Charge Code	270690093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

MICROSTENT HYDRUS I STENT

Facility

$9,500.00

Service Code	HCPCS C1783
Hospital Charge Code	270690093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

MICRO-STICK 5F REGULAR

Facility

$105.00

Hospital Charge Code	270681204
Hospital Revenue Code	272
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$52.50

MICRO-STICK 5F REGULAR

Facility

$105.00

Hospital Charge Code	270681204
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

MICROSURGERY ADD-ON

Facility

$6,832.37

Service Code	HCPCS 14061
Hospital Charge Code	16000596
Hospital Revenue Code	360
Min. Negotiated Rate	$888.21
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$2,049.71
Rate for Payer: Aetna Medicare Advantage	$2,049.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,742.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,742.25
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	$1,742.25
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.21
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,024.86
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MICROSURGERY ADD-ON

Facility

$6,832.37

Service Code	HCPCS 14061
Hospital Charge Code	16000596
Hospital Revenue Code	360
Min. Negotiated Rate	$1,024.86
Max. Negotiated Rate	$1,024.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,024.86

MICROTAINER CAPILLARY BLOOD CL

Facility

$471.85

Hospital Charge Code	270652781
Hospital Revenue Code	272
Min. Negotiated Rate	$61.34
Max. Negotiated Rate	$235.93
Rate for Payer: Aetna Commercial	$141.56
Rate for Payer: Aetna Medicare Advantage	$141.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.32
Rate for Payer: Cigna Commercial	$235.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.34
Rate for Payer: Oxford Commercial	$235.93
Rate for Payer: Qualcare PPO/HMO/WC	$70.78
Rate for Payer: UnitedHealthcare Commercial	$235.93

MICROTAINER CAPILLARY BLOOD CL

Facility

$471.85

Hospital Charge Code	270652781
Hospital Revenue Code	272
Min. Negotiated Rate	$70.78
Max. Negotiated Rate	$70.78
Rate for Payer: Qualcare PPO/HMO/WC	$70.78

MICROTEMP MACHINE

Facility

$99.25

Hospital Charge Code	2708002974
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

MICROTEMP MACHINE

Facility

$99.25

Hospital Charge Code	2708002974
Hospital Revenue Code	270
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$49.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$49.62

MICRO TEMP PUMP***

Facility

$38.00

Hospital Charge Code	8002974
Hospital Revenue Code	279
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

MICRO TEMP PUMP***

Facility

$38.00

Hospital Charge Code	8002974
Hospital Revenue Code	279
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$19.00

MICROTIP TURBOSONIC PEA ******

Facility

$50.00

Hospital Charge Code	1608223
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

MICROTIP TURBOSONIC PEA ******

Facility

$50.00

Hospital Charge Code	1608223
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

MICROTIP TURBOSONIC PEA 20111S

Facility

$1,068.00

Hospital Charge Code	270600241
Hospital Revenue Code	272
Min. Negotiated Rate	$138.84
Max. Negotiated Rate	$534.00
Rate for Payer: Aetna Commercial	$320.40
Rate for Payer: Aetna Medicare Advantage	$320.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.34
Rate for Payer: Cigna Commercial	$534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.84
Rate for Payer: Oxford Commercial	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.20
Rate for Payer: UnitedHealthcare Commercial	$534.00

MICROTIP TURBOSONIC PEA 20111S

Facility

$1,068.00

Hospital Charge Code	270600241
Hospital Revenue Code	272
Min. Negotiated Rate	$160.20
Max. Negotiated Rate	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$160.20

MICRO TIP TX1

Facility

$3,825.00

Hospital Charge Code	270663886
Hospital Revenue Code	272
Min. Negotiated Rate	$497.25
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,147.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$497.25
Rate for Payer: Oxford Commercial	$1,912.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Commercial	$1,912.50

MICRO TIP TX1

Facility

$3,825.00

Hospital Charge Code	270663886
Hospital Revenue Code	272
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$573.75
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

MICROWICK SILVERSTEIN 0T-1700

Facility

$450.00

Hospital Charge Code	270647471
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

MICROWICK SILVERSTEIN 0T-1700

Facility

$450.00

Hospital Charge Code	270647471
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MICU AMBULANCE

Facility

$981.15

Hospital Charge Code	1100015
Hospital Revenue Code	540
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$294.35
Rate for Payer: Aetna Medicare Advantage	$294.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.19
Rate for Payer: Cigna Commercial	$490.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.55
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.17
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

MICU AMBULANCE

Facility

$981.15

Hospital Charge Code	1100015
Hospital Revenue Code	540
Min. Negotiated Rate	$147.17
Max. Negotiated Rate	$147.17
Rate for Payer: Qualcare PPO/HMO/WC	$147.17

MIDAMOR/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633430
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

MIDAMOR/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633430
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges