Heights University Hospital

All Charges

Charge

Type

Setting

Price

ASSY S/S CABL 1.8/559 22320118

Facility

$1,866.25

Hospital Charge Code	270606981
Hospital Revenue Code	278
Min. Negotiated Rate	$279.94
Max. Negotiated Rate	$451.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.63
Rate for Payer: Qualcare PPO/HMO/WC	$279.94

ASSY S/S CABL 1.8/559 22320118

Facility

$1,866.25

Hospital Charge Code	270606981
Hospital Revenue Code	278
Min. Negotiated Rate	$279.94
Max. Negotiated Rate	$933.12
Rate for Payer: Aetna Commercial	$559.88
Rate for Payer: Aetna Medicare Advantage	$559.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.89
Rate for Payer: Cigna Commercial	$933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.63
Rate for Payer: Qualcare PPO/HMO/WC	$279.94

ASTHMA

Facility

$7,788.67

Service Code	APR-DRG 1412
Min. Negotiated Rate	$5,301.82
Max. Negotiated Rate	$7,788.67
Rate for Payer: Aetna Better Health Medicaid	$7,635.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,788.67
Rate for Payer: Wellpoint Medicaid Managed Care	$5,301.82

ASTHMA

Facility

$18,036.46

Service Code	APR-DRG 1414
Min. Negotiated Rate	$14,366.21
Max. Negotiated Rate	$18,036.46
Rate for Payer: Aetna Better Health Medicaid	$17,682.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,036.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14,366.21

ASTHMA

Facility

$5,318.40

Service Code	APR-DRG 1411
Min. Negotiated Rate	$3,699.16
Max. Negotiated Rate	$5,318.40
Rate for Payer: Aetna Better Health Medicaid	$5,214.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,318.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3,699.16

ASTHMA

Facility

$9,239.42

Service Code	APR-DRG 1413
Min. Negotiated Rate	$7,598.39
Max. Negotiated Rate	$9,239.42
Rate for Payer: Aetna Better Health Medicaid	$9,058.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,239.42
Rate for Payer: Wellpoint Medicaid Managed Care	$7,598.39

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$9.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.28

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$30.93
Rate for Payer: Aetna Commercial	$18.56
Rate for Payer: Aetna Medicare Advantage	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.77
Rate for Payer: Cigna Commercial	$30.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.04
Rate for Payer: Oxford Commercial	$30.93
Rate for Payer: Qualcare PPO/HMO/WC	$9.28
Rate for Payer: UnitedHealthcare Commercial	$30.93

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

AST - SGOT PANEL***

Facility

$25.20

Service Code	HCPCS 84450
Hospital Charge Code	3002441P
Hospital Revenue Code	301
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.78

AST - SGOT PANEL***

Facility

$25.20

Service Code	HCPCS 84450
Hospital Charge Code	3002441P
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$401.70
Max. Negotiated Rate	$1,339.00
Rate for Payer: Aetna Commercial	$803.40
Rate for Payer: Aetna Medicare Advantage	$803.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.89
Rate for Payer: Cigna Commercial	$1,339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: Qualcare PPO/HMO/WC	$401.70

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$401.70
Max. Negotiated Rate	$648.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: Qualcare PPO/HMO/WC	$401.70

ATARAX/25MG/TAB

Facility

$6.00

Hospital Charge Code	60632495
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

ATARAX/25MG/TAB

Facility

$7.00

Hospital Charge Code	60632494
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

ATARAX/25MG/TAB

Facility

$7.00

Hospital Charge Code	60632494
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

ATARAX/25MG/TAB

Facility

$6.00

Hospital Charge Code	60632495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$19.15
Max. Negotiated Rate	$73.64
Rate for Payer: Aetna Commercial	$44.18
Rate for Payer: Aetna Medicare Advantage	$44.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.55
Rate for Payer: Cigna Commercial	$73.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.15
Rate for Payer: Oxford Commercial	$73.64
Rate for Payer: Qualcare PPO/HMO/WC	$22.09
Rate for Payer: UnitedHealthcare Commercial	$73.64

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.09

ATAZANAVIR 150 MG CAPSULE

Facility

$171.45

Service Code	NDC 3362412
Hospital Charge Code	60630010
Hospital Revenue Code	250
Min. Negotiated Rate	$25.72
Max. Negotiated Rate	$25.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72

ATAZANAVIR 150 MG CAPSULE

Facility

$171.45

Service Code	NDC 3362412
Hospital Charge Code	60630010
Hospital Revenue Code	250
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$85.72
Rate for Payer: Aetna Commercial	$51.44
Rate for Payer: Aetna Medicare Advantage	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.72
Rate for Payer: Cigna Commercial	$85.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.29
Rate for Payer: Oxford Commercial	$85.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72
Rate for Payer: UnitedHealthcare Commercial	$85.72

ATAZANAVIR 200MG CAP

Facility

$171.45

Service Code	NDC 3363112
Hospital Charge Code	6063943059
Hospital Revenue Code	250
Min. Negotiated Rate	$25.72
Max. Negotiated Rate	$25.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72

ATAZANAVIR 200MG CAP

Facility

$171.45

Service Code	NDC 3363112
Hospital Charge Code	6063943059
Hospital Revenue Code	250
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$85.72
Rate for Payer: Aetna Commercial	$51.44
Rate for Payer: Aetna Medicare Advantage	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.72
Rate for Payer: Cigna Commercial	$85.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.29
Rate for Payer: Oxford Commercial	$85.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72
Rate for Payer: UnitedHealthcare Commercial	$85.72

ATAZANAVIR 300 MG CAPSULE

Facility

$339.62

Service Code	NDC 3362212
Hospital Charge Code	60630009
Hospital Revenue Code	250
Min. Negotiated Rate	$44.15
Max. Negotiated Rate	$169.81
Rate for Payer: Aetna Commercial	$101.89
Rate for Payer: Aetna Medicare Advantage	$101.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.60
Rate for Payer: Cigna Commercial	$169.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.15
Rate for Payer: Oxford Commercial	$169.81
Rate for Payer: Qualcare PPO/HMO/WC	$50.94
Rate for Payer: UnitedHealthcare Commercial	$169.81

Know your out-of-pocket cost for care.

All Charges