Heights University Hospital

All Charges

Charge

Type

Setting

Price

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990E
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

MYOSITIS ASSESSR

Facility

$2,668.85

Hospital Charge Code	3009990
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,334.42
Rate for Payer: Aetna Commercial	$800.65
Rate for Payer: Aetna Medicare Advantage	$800.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.56
Rate for Payer: Cigna Commercial	$1,334.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.33
Rate for Payer: UnitedHealthcare Commercial	$114.00

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990G
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990C
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990A
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990G
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990A
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990C
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990B
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990D
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990F
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990E
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSURE FIBROID REMOVAL XL

Facility

$7,271.67

Hospital Charge Code	270662593
Hospital Revenue Code	272
Min. Negotiated Rate	$945.32
Max. Negotiated Rate	$3,635.84
Rate for Payer: Aetna Commercial	$2,181.50
Rate for Payer: Aetna Medicare Advantage	$2,181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,854.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,854.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,854.28
Rate for Payer: Cigna Commercial	$3,635.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.32
Rate for Payer: Oxford Commercial	$3,635.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,090.75
Rate for Payer: UnitedHealthcare Commercial	$3,635.84

MYOSURE FIBROID REMOVAL XL

Facility

$7,271.67

Hospital Charge Code	270662593
Hospital Revenue Code	272
Min. Negotiated Rate	$1,090.75
Max. Negotiated Rate	$1,090.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,090.75

MYOSURE TISSUE REMOVAL DEVICE

Facility

$7,790.00

Hospital Charge Code	270660314
Hospital Revenue Code	272
Min. Negotiated Rate	$1,012.70
Max. Negotiated Rate	$3,895.00
Rate for Payer: Aetna Commercial	$2,337.00
Rate for Payer: Aetna Medicare Advantage	$2,337.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,986.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,986.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,986.45
Rate for Payer: Cigna Commercial	$3,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,012.70
Rate for Payer: Oxford Commercial	$3,895.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,168.50
Rate for Payer: UnitedHealthcare Commercial	$3,895.00

MYOSURE TISSUE REMOVAL DEVICE

Facility

$7,790.00

Hospital Charge Code	270660314
Hospital Revenue Code	272
Min. Negotiated Rate	$1,168.50
Max. Negotiated Rate	$1,168.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,168.50

MYRIAD ECM MATRIX 10X10 SR3

Facility

$4,593.75

Hospital Charge Code	270692092
Hospital Revenue Code	272
Min. Negotiated Rate	$689.06
Max. Negotiated Rate	$689.06
Rate for Payer: Qualcare PPO/HMO/WC	$689.06

MYRIAD ECM MATRIX 10X10 SR3

Facility

$4,593.75

Hospital Charge Code	270692092
Hospital Revenue Code	272
Min. Negotiated Rate	$597.19
Max. Negotiated Rate	$2,296.88
Rate for Payer: Aetna Commercial	$1,378.12
Rate for Payer: Aetna Medicare Advantage	$1,378.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,171.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,171.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,171.41
Rate for Payer: Cigna Commercial	$2,296.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.19
Rate for Payer: Oxford Commercial	$2,296.88
Rate for Payer: Qualcare PPO/HMO/WC	$689.06
Rate for Payer: UnitedHealthcare Commercial	$2,296.88

MYRIAD ECM MATRIX 10X10 SR5

Facility

$6,354.65

Hospital Charge Code	270692101
Hospital Revenue Code	272
Min. Negotiated Rate	$826.10
Max. Negotiated Rate	$3,177.32
Rate for Payer: Aetna Commercial	$1,906.39
Rate for Payer: Aetna Medicare Advantage	$1,906.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,620.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,620.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,620.44
Rate for Payer: Cigna Commercial	$3,177.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.10
Rate for Payer: Oxford Commercial	$3,177.32
Rate for Payer: Qualcare PPO/HMO/WC	$953.20
Rate for Payer: UnitedHealthcare Commercial	$3,177.32

MYRIAD ECM MATRIX 10X10 SR5

Facility

$6,354.65

Hospital Charge Code	270692101
Hospital Revenue Code	272
Min. Negotiated Rate	$953.20
Max. Negotiated Rate	$953.20
Rate for Payer: Qualcare PPO/HMO/WC	$953.20

MYRINGOTOMY BLADE

Facility

$75.00

Hospital Charge Code	270335209
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MYRINGOTOMY BLADE

Facility

$75.00

Hospital Charge Code	270335209
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

MYSOLINE/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633479
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

MYSOLINE/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633479
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MYSOLINE/50MG/TAB

Facility

$3.00

Hospital Charge Code	60633480
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

Know your out-of-pocket cost for care.

All Charges