Heights University Hospital

All Charges

Charge

Type

Setting

Price

MIDODRINE TAB 2.5MG

Facility

$7.70

Hospital Charge Code	60628652
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

MIDODRINE TAB 2.5MG

Facility

$7.70

Hospital Charge Code	60628652
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

MIDOS REX BUR AM-8 14-AM

Facility

$926.25

Hospital Charge Code	270663922
Hospital Revenue Code	270
Min. Negotiated Rate	$138.94
Max. Negotiated Rate	$138.94
Rate for Payer: Qualcare PPO/HMO/WC	$138.94

MIDOS REX BUR AM-8 14-AM

Facility

$926.25

Hospital Charge Code	270663922
Hospital Revenue Code	270
Min. Negotiated Rate	$120.41
Max. Negotiated Rate	$463.12
Rate for Payer: Aetna Commercial	$277.88
Rate for Payer: Aetna Medicare Advantage	$277.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.19
Rate for Payer: Cigna Commercial	$463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.41
Rate for Payer: Oxford Commercial	$463.12
Rate for Payer: Qualcare PPO/HMO/WC	$138.94
Rate for Payer: UnitedHealthcare Commercial	$463.12

MID-PHALANX FUSION IMPLT.NEXA

Facility

$340.00

Hospital Charge Code	270339448
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MID-PHALANX FUSION IMPLT.NEXA

Facility

$340.00

Hospital Charge Code	270339448
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MI-EYE DISP NEEDLESCOPE 95MM

Facility

$3,475.00

Hospital Charge Code	270697110
Hospital Revenue Code	272
Min. Negotiated Rate	$451.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,042.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.75
Rate for Payer: Oxford Commercial	$1,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$1,737.50

MI-EYE DISP NEEDLESCOPE 95MM

Facility

$3,475.00

Hospital Charge Code	270697110
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

MIGRAINE AND OTHER HEADACHES

Facility

$18,956.30

Service Code	APR-DRG 0544
Min. Negotiated Rate	$14,510.74
Max. Negotiated Rate	$18,956.30
Rate for Payer: Aetna Better Health Medicaid	$18,584.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,956.30
Rate for Payer: Wellpoint Medicaid Managed Care	$14,510.74

MIGRAINE AND OTHER HEADACHES

Facility

$7,683.40

Service Code	APR-DRG 0541
Min. Negotiated Rate	$5,446.83
Max. Negotiated Rate	$7,683.40
Rate for Payer: Aetna Better Health Medicaid	$7,532.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,683.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5,446.83

MIGRAINE AND OTHER HEADACHES

Facility

$11,577.70

Service Code	APR-DRG 0543
Min. Negotiated Rate	$7,679.28
Max. Negotiated Rate	$11,577.70
Rate for Payer: Aetna Better Health Medicaid	$11,350.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,577.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7,679.28

MIGRAINE AND OTHER HEADACHES

Facility

$9,183.22

Service Code	APR-DRG 0542
Min. Negotiated Rate	$6,278.44
Max. Negotiated Rate	$9,183.22
Rate for Payer: Aetna Better Health Medicaid	$9,003.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,183.22
Rate for Payer: Wellpoint Medicaid Managed Care	$6,278.44

MIGRAINE TREATMENT

Facility

$2,793.75

Hospital Charge Code	1001165
Hospital Revenue Code	360
Min. Negotiated Rate	$419.06
Max. Negotiated Rate	$419.06
Rate for Payer: Qualcare PPO/HMO/WC	$419.06

MIGRAINE TREATMENT

Facility

$2,793.75

Hospital Charge Code	1001165
Hospital Revenue Code	360
Min. Negotiated Rate	$363.19
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$838.12
Rate for Payer: Aetna Medicare Advantage	$838.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.41
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	$712.41
Rate for Payer: Cigna Commercial	$1,396.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.19
Rate for Payer: Qualcare PPO/HMO/WC	$419.06

MILAGRO ADVANCE SCREW 9 X 30MM

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663885
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$667.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

MILAGRO ADVANCE SCREW 9 X 30MM

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663885
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$538.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

MILAGRO BR INTERFERENCE SCREW

Facility

$2,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270679989
Hospital Revenue Code	278
Min. Negotiated Rate	$373.50
Max. Negotiated Rate	$602.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$602.58
Rate for Payer: Qualcare PPO/HMO/WC	$373.50

MILAGRO BR INTERFERENCE SCREW

Facility

$2,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270679989
Hospital Revenue Code	278
Min. Negotiated Rate	$373.50
Max. Negotiated Rate	$1,245.00
Rate for Payer: Aetna Commercial	$747.00
Rate for Payer: Aetna Medicare Advantage	$747.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$634.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$634.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$634.95
Rate for Payer: Cigna Commercial	$1,245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$602.58
Rate for Payer: Qualcare PPO/HMO/WC	$373.50

MILAGRO SCREW 10MM X 30MM

Facility

$1,950.00

Hospital Charge Code	270658625
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$975.00
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: Aetna Commercial	$585.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

MILAGRO SCREW 10MM X 30MM

Facility

$1,950.00

Hospital Charge Code	270658625
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

MILAGRO SCREW 10 X 30

Facility

$1,645.00

Hospital Charge Code	270657368
Hospital Revenue Code	278
Min. Negotiated Rate	$246.75
Max. Negotiated Rate	$822.50
Rate for Payer: Aetna Commercial	$493.50
Rate for Payer: Aetna Medicare Advantage	$493.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$419.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$419.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$419.48
Rate for Payer: Cigna Commercial	$822.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$246.75

MILAGRO SCREW 10 X 30

Facility

$1,645.00

Hospital Charge Code	270657368
Hospital Revenue Code	278
Min. Negotiated Rate	$246.75
Max. Negotiated Rate	$398.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$329.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.09
Rate for Payer: Qualcare PPO/HMO/WC	$246.75

MILD KIT DEVICE MIN INVASIVE 2

Facility

$17,500.00

Hospital Charge Code	270704246
Hospital Revenue Code	279
Min. Negotiated Rate	$2,275.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,275.00
Rate for Payer: Oxford Commercial	$8,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$8,750.00

MILD KIT DEVICE MIN INVASIVE 2

Facility

$17,500.00

Hospital Charge Code	270704246
Hospital Revenue Code	279
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

MILK HINGE FREE LUBE

Facility

$76.25

Hospital Charge Code	270665153
Hospital Revenue Code	270
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$11.44
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

Know your out-of-pocket cost for care.

All Charges