Heights University Hospital

All Charges

Charge

Type

Setting

Price

ORAL COLON LAVAGE SOL

Facility

$154.10

Service Code	NDC 52268010001
Hospital Charge Code	60628134
Hospital Revenue Code	250
Min. Negotiated Rate	$20.03
Max. Negotiated Rate	$77.05
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$46.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.30
Rate for Payer: Cigna Commercial	$77.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.03
Rate for Payer: Oxford Commercial	$77.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.11
Rate for Payer: UnitedHealthcare Commercial	$77.05

ORAL COLON LAVAGE SOL

Facility

$154.10

Service Code	NDC 52268010001
Hospital Charge Code	60628134
Hospital Revenue Code	250
Min. Negotiated Rate	$23.11
Max. Negotiated Rate	$23.11
Rate for Payer: Qualcare PPO/HMO/WC	$23.11

ORAL COLON LAVAGE SOL GAL

Facility

$122.90

Hospital Charge Code	6004030
Hospital Revenue Code	251
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$61.45
Rate for Payer: Aetna Commercial	$36.87
Rate for Payer: Aetna Medicare Advantage	$36.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.34
Rate for Payer: Cigna Commercial	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.98
Rate for Payer: Oxford Commercial	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.43
Rate for Payer: UnitedHealthcare Commercial	$61.45

ORAL COLON LAVAGE SOL GAL

Facility

$122.90

Hospital Charge Code	6004030
Hospital Revenue Code	251
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$18.43

ORAL ELECRO MIXTURE SOL 80Z

Facility

$15.40

Hospital Charge Code	6013080
Hospital Revenue Code	251
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

ORAL ELECRO MIXTURE SOL 80Z

Facility

$15.40

Hospital Charge Code	6013080
Hospital Revenue Code	251
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

ORAL SUCTION KIT VAPREVENT

Facility

$84.06

Hospital Charge Code	270644015
Hospital Revenue Code	270
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$42.03
Rate for Payer: Aetna Commercial	$25.22
Rate for Payer: Aetna Medicare Advantage	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.44
Rate for Payer: Cigna Commercial	$42.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.93
Rate for Payer: Oxford Commercial	$42.03
Rate for Payer: Qualcare PPO/HMO/WC	$12.61
Rate for Payer: UnitedHealthcare Commercial	$42.03

ORAL SUCTION KIT VAPREVENT

Facility

$84.06

Hospital Charge Code	270644015
Hospital Revenue Code	270
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$12.61
Rate for Payer: Qualcare PPO/HMO/WC	$12.61

ORAL SWAB SUCTION SYST W/PEROX

Facility

$26.65

Hospital Charge Code	270650069
Hospital Revenue Code	270
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$13.32
Rate for Payer: Aetna Commercial	$8.00
Rate for Payer: Aetna Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.80
Rate for Payer: Cigna Commercial	$13.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.46
Rate for Payer: Oxford Commercial	$13.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.00
Rate for Payer: UnitedHealthcare Commercial	$13.32

ORAL SWAB SUCTION SYST W/PEROX

Facility

$26.65

Hospital Charge Code	270650069
Hospital Revenue Code	270
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.00

OR BILAYER MATRIX WND DRSG

Facility

$10,000.00

Hospital Charge Code	1610005
Hospital Revenue Code	272
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$5,000.00

OR BILAYER MATRIX WND DRSG

Facility

$10,000.00

Hospital Charge Code	1610005
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

ORBITAL PROCEDURES WITH CC/MCC

Facility

$80,064.63

Service Code	MSDRG 113
Min. Negotiated Rate	$25,353.80
Max. Negotiated Rate	$80,064.63
Rate for Payer: Aetna Commercial	$79,278.80
Rate for Payer: Aetna Medicare Advantage	$25,656.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69,193.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69,193.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,688.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69,193.17
Rate for Payer: Cigna Commercial	$50,598.02
Rate for Payer: Cigna Medicare Advantage	$26,688.21
Rate for Payer: Clover Medicare Advantage	$25,353.80
Rate for Payer: EmblemHealth Commercial	$80,064.63
Rate for Payer: Humana Medicare Advantage	$27,488.86
Rate for Payer: Oxford Commercial	$31,622.29
Rate for Payer: UnitedHealthcare Commercial	$35,894.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,688.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28,289.50
Rate for Payer: Wellcare Medicare Advantage	$26,688.21

ORBITAL PROCEDURES WITHOUT CC/MCC

Facility

$51,094.05

Service Code	MSDRG 114
Min. Negotiated Rate	$14,764.72
Max. Negotiated Rate	$51,094.05
Rate for Payer: Aetna Commercial	$45,622.98
Rate for Payer: Aetna Medicare Advantage	$14,764.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,907.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,907.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,031.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,907.41
Rate for Payer: Cigna Commercial	$29,117.91
Rate for Payer: Cigna Medicare Advantage	$17,031.35
Rate for Payer: Clover Medicare Advantage	$16,179.78
Rate for Payer: EmblemHealth Commercial	$51,094.05
Rate for Payer: Humana Medicare Advantage	$17,542.29
Rate for Payer: Oxford Commercial	$18,197.85
Rate for Payer: UnitedHealthcare Commercial	$20,656.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,031.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,053.23
Rate for Payer: Wellcare Medicare Advantage	$17,031.35

ORBITAL RIM 7mm MTX 04.503.373

Facility

$1,548.75

Hospital Charge Code	270640448
Hospital Revenue Code	272
Min. Negotiated Rate	$232.31
Max. Negotiated Rate	$232.31
Rate for Payer: Qualcare PPO/HMO/WC	$232.31

ORBITAL RIM 7mm MTX 04.503.373

Facility

$1,548.75

Hospital Charge Code	270640448
Hospital Revenue Code	272
Min. Negotiated Rate	$201.34
Max. Negotiated Rate	$774.38
Rate for Payer: Aetna Commercial	$464.62
Rate for Payer: Aetna Medicare Advantage	$464.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.93
Rate for Payer: Cigna Commercial	$774.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.34
Rate for Payer: Oxford Commercial	$774.38
Rate for Payer: Qualcare PPO/HMO/WC	$232.31
Rate for Payer: UnitedHealthcare Commercial	$774.38

ORBIT AND EYE PROCEDURES

Facility

$15,502.94

Service Code	APR-DRG 0732
Min. Negotiated Rate	$9,587.69
Max. Negotiated Rate	$15,502.94
Rate for Payer: Aetna Better Health Medicaid	$15,198.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,502.94
Rate for Payer: Wellpoint Medicaid Managed Care	$9,587.69

ORBIT AND EYE PROCEDURES

Facility

$44,506.26

Service Code	APR-DRG 0734
Min. Negotiated Rate	$34,649.50
Max. Negotiated Rate	$44,506.26
Rate for Payer: Aetna Better Health Medicaid	$43,633.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$44,506.26
Rate for Payer: Wellpoint Medicaid Managed Care	$34,649.50

ORBIT AND EYE PROCEDURES

Facility

$12,607.11

Service Code	APR-DRG 0731
Min. Negotiated Rate	$8,111.18
Max. Negotiated Rate	$12,607.11
Rate for Payer: Aetna Better Health Medicaid	$12,359.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,607.11
Rate for Payer: Wellpoint Medicaid Managed Care	$8,111.18

ORBIT AND EYE PROCEDURES

Facility

$24,412.37

Service Code	APR-DRG 0733
Min. Negotiated Rate	$16,024.10
Max. Negotiated Rate	$24,412.37
Rate for Payer: Aetna Better Health Medicaid	$23,933.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,412.37
Rate for Payer: Wellpoint Medicaid Managed Care	$16,024.10

ORBITS COMP MIN 4VW-BI

Facility

$5,100.00

Service Code	HCPCS 7020050
Hospital Charge Code	94061205
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ORBITS COMP MIN 4VW-BI

Facility

$5,100.00

Service Code	HCPCS 7020050
Hospital Charge Code	94061205
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ORBITS COMP MIN 4VW-LT

Facility

$5,100.00

Service Code	HCPCS 70200LT
Hospital Charge Code	94061261
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ORBITS COMP MIN 4VW-LT

Facility

$5,100.00

Service Code	HCPCS 70200LT
Hospital Charge Code	94061261
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ORBITS COMP MIN 4VW-RT

Facility

$250.00

Service Code	HCPCS 70200RT
Hospital Charge Code	94061263
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges