Heights University Hospital

All Charges

Charge

Type

Setting

Price

NEUROTHERM ELECTRODE

Facility

$525.00

Hospital Charge Code	270339098
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

NEUROTHERM INTRODUCER

Facility

$225.00

Hospital Charge Code	270339465
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

NEUROTHERM INTRODUCER

Facility

$225.00

Hospital Charge Code	270339465
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

NEUROWRAP 7mmX4 cm

Facility

$6,540.00

Service Code	HCPCS C9353
Hospital Charge Code	270682015
Hospital Revenue Code	278
Min. Negotiated Rate	$981.00
Max. Negotiated Rate	$3,270.00
Rate for Payer: Aetna Commercial	$1,962.00
Rate for Payer: Aetna Medicare Advantage	$1,962.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,667.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,667.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,667.70
Rate for Payer: Cigna Commercial	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,582.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.00

NEUROWRAP 7mmX4 cm

Facility

$6,540.00

Service Code	HCPCS C9353
Hospital Charge Code	270682015
Hospital Revenue Code	278
Min. Negotiated Rate	$981.00
Max. Negotiated Rate	$1,582.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,582.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.00

NEURPLASTY,MEDN NRV AT CRP TNL

Facility

$16,437.00

Service Code	HCPCS 64721
Hospital Charge Code	16000267
Hospital Revenue Code	360
Min. Negotiated Rate	$2,465.55
Max. Negotiated Rate	$2,465.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55

NEURPLASTY,MEDN NRV AT CRP TNL

Facility

$16,437.00

Service Code	HCPCS 64721
Hospital Charge Code	16000267
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$4,931.10
Rate for Payer: Aetna Medicare Advantage	$4,931.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,191.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,191.44
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	$4,191.44
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,136.81
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

NEUT ELECTS SELF ADHESIVE

Facility

$100.00

Hospital Charge Code	270664857
Hospital Revenue Code	270
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

NEUT ELECTS SELF ADHESIVE

Facility

$100.00

Hospital Charge Code	270664857
Hospital Revenue Code	270
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

NEUT INJ

Facility

$50.65

Service Code	NDC 409660902
Hospital Charge Code	60635046
Hospital Revenue Code	250
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.60

NEUT INJ

Facility

$50.65

Service Code	NDC 409660902
Hospital Charge Code	60635046
Hospital Revenue Code	250
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$25.32
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$15.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.92
Rate for Payer: Cigna Commercial	$25.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.58
Rate for Payer: Oxford Commercial	$25.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.60
Rate for Payer: UnitedHealthcare Commercial	$25.32

NEUTRAPHOS 1.25MG PKT

Facility

$2.00

Hospital Charge Code	60635562
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

NEUTRAPHOS 1.25MG PKT

Facility

$2.00

Hospital Charge Code	60635562
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

NEUTRON BEAM TX COMPLEX

Facility

$1,164.28

Service Code	HCPCS 77423
Hospital Charge Code	85000775
Hospital Revenue Code	333
Min. Negotiated Rate	$151.36
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$349.28
Rate for Payer: Aetna Medicare Advantage	$349.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.89
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.36
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

NEUTRON BEAM TX COMPLEX

Facility

$1,164.28

Service Code	HCPCS 77423
Hospital Charge Code	85000775
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

NEUTRON BEAM TX SIMPLE

Facility

$1,164.28

Service Code	HCPCS 77422
Hospital Charge Code	85000770
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

NEUTRON BEAM TX SIMPLE

Facility

$1,164.28

Service Code	HCPCS 77422
Hospital Charge Code	85000770
Hospital Revenue Code	333
Min. Negotiated Rate	$151.36
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$349.28
Rate for Payer: Aetna Medicare Advantage	$349.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.89
Rate for Payer: Cigna Commercial	$582.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.36
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

NEVIRAPINE 200 MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	6063943219
Hospital Revenue Code	250
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$36.31
Rate for Payer: Aetna Commercial	$21.79
Rate for Payer: Aetna Medicare Advantage	$21.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.52
Rate for Payer: Cigna Commercial	$36.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.44
Rate for Payer: Oxford Commercial	$36.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.89
Rate for Payer: UnitedHealthcare Commercial	$36.31

NEVIRAPINE 200 MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	6063943219
Hospital Revenue Code	250
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$10.89

NEVIRAPINE 200MG TAB

Facility

$4.00

Hospital Charge Code	6063943147
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

NEVIRAPINE 200MG TAB

Facility

$4.00

Hospital Charge Code	6063943147
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NEVIRAPINE 50MG/5ML

Facility

$5.29

Service Code	NDC 65862005724
Hospital Charge Code	606390249
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

NEVIRAPINE 50MG/5ML

Facility

$5.29

Service Code	NDC 65862005724
Hospital Charge Code	606390249
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$1.59
Rate for Payer: Aetna Medicare Advantage	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.69
Rate for Payer: Oxford Commercial	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$2.65

NEVIRAPINE TAB 200MG

Facility

$43.75

Hospital Charge Code	60629136
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$6.56
Rate for Payer: Qualcare PPO/HMO/WC	$6.56

NEVIRAPINE TAB 200MG

Facility

$43.75

Hospital Charge Code	60629136
Hospital Revenue Code	250
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$21.88
Rate for Payer: Aetna Commercial	$13.12
Rate for Payer: Aetna Medicare Advantage	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.16
Rate for Payer: Cigna Commercial	$21.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.69
Rate for Payer: Oxford Commercial	$21.88
Rate for Payer: Qualcare PPO/HMO/WC	$6.56
Rate for Payer: UnitedHealthcare Commercial	$21.88

Know your out-of-pocket cost for care.

All Charges