Heights University Hospital

All Charges

Charge

Type

Setting

Price

MS CONTIN/15MG/TAB

Facility

$7.00

Hospital Charge Code	60633460
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

MS CONTIN/15MG/TAB

Facility

$7.00

Hospital Charge Code	60633460
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

MS CONTIN/30MG/TAB

Facility

$12.00

Hospital Charge Code	60633459
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MS CONTIN/30MG/TAB

Facility

$12.00

Hospital Charge Code	60633459
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

M.S. CONTIN/60MG/TAB

Facility

$35.64

Service Code	NDC 406838023
Hospital Charge Code	60634411
Hospital Revenue Code	250
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$17.82
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$10.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.09
Rate for Payer: Cigna Commercial	$17.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.63
Rate for Payer: Oxford Commercial	$17.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.35
Rate for Payer: UnitedHealthcare Commercial	$17.82

M.S. CONTIN/60MG/TAB

Facility

$35.64

Service Code	NDC 406838023
Hospital Charge Code	60634411
Hospital Revenue Code	250
Min. Negotiated Rate	$5.35
Max. Negotiated Rate	$5.35
Rate for Payer: Qualcare PPO/HMO/WC	$5.35

MSIR/15MG/TAB

Facility

$4.00

Hospital Charge Code	60634942
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

MSIR/15MG/TAB

Facility

$4.00

Hospital Charge Code	60634942
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MSIR/30MG/TAB

Facility

$4.00

Hospital Charge Code	60634943
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

MSIR/30MG/TAB

Facility

$4.00

Hospital Charge Code	60634943
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MSLT OR MWT

Facility

$40,000.00

Service Code	HCPCS 95805
Hospital Charge Code	90000015
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

MSLT OR MWT

Facility

$40,000.00

Service Code	HCPCS 95805
Hospital Charge Code	90000015
Hospital Revenue Code	920
Min. Negotiated Rate	$1,409.90
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$12,000.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,409.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,200.00
Rate for Payer: Oxford Commercial	$10,292.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$11,682.00

MS,MS/MS.ANALYTE QUAL EA SPECI

Facility

$127.84

Service Code	HCPCS 83789
Hospital Charge Code	38477150
Hospital Revenue Code	301
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

MS,MS/MS.ANALYTE QUAL EA SPECI

Facility

$127.84

Service Code	HCPCS 83789
Hospital Charge Code	38477150
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

MS PANEL I

Facility

$390.00

Service Code	HCPCS 82040
Hospital Charge Code	39990130A
Hospital Revenue Code	307
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.04
Rate for Payer: Aetna Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.14
Rate for Payer: Cigna Commercial	$4.95
Rate for Payer: Cigna Medicare Advantage	$2.48
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
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	$4.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.25
Rate for Payer: Wellcare Medicare Advantage	$4.95

MS PANEL I

Facility

$390.00

Service Code	HCPCS 82040
Hospital Charge Code	39990130A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MS PANEL II

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39990130B
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MS PANEL II

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39990130B
Hospital Revenue Code	307
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.21
Rate for Payer: Aetna Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.51
Rate for Payer: Cigna Commercial	$7.78
Rate for Payer: Cigna Medicare Advantage	$3.89
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
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	$7.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.25
Rate for Payer: Wellcare Medicare Advantage	$7.78

MS PANEL III

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39990130C
Hospital Revenue Code	301
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.13
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$9.30
Rate for Payer: Cigna Medicare Advantage	$4.65
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
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	$9.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.86
Rate for Payer: Wellcare Medicare Advantage	$9.30

MS PANEL III

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39990130C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MS PANEL IV

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39990130D
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MS PANEL IV

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39990130D
Hospital Revenue Code	301
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.13
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$9.30
Rate for Payer: Cigna Medicare Advantage	$4.65
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
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	$9.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.86
Rate for Payer: Wellcare Medicare Advantage	$9.30

MS PANEL V

Facility

$390.00

Service Code	HCPCS 83916
Hospital Charge Code	39990130E
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MS PANEL V

Facility

$390.00

Service Code	HCPCS 83916
Hospital Charge Code	39990130E
Hospital Revenue Code	301
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.74
Rate for Payer: Aetna Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.36
Rate for Payer: Cigna Commercial	$27.39
Rate for Payer: Cigna Medicare Advantage	$13.70
Rate for Payer: Clover Medicare Advantage	$26.02
Rate for Payer: EmblemHealth Commercial	$82.17
Rate for Payer: Humana Medicare Advantage	$28.21
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	$27.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.03
Rate for Payer: Wellcare Medicare Advantage	$27.39

MS PROFILE I

Facility

$216.65

Service Code	HCPCS 82030
Hospital Charge Code	3037060A
Hospital Revenue Code	307
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.50

Know your out-of-pocket cost for care.

All Charges