Heights University Hospital

All Charges

Charge

Type

Setting

Price

ORBITS COMP MIN 4VW-RT

Facility

$250.00

Service Code	HCPCS 70200RT
Hospital Charge Code	94061263
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

OR CALL TIME

Facility

$511.25

Hospital Charge Code	1600162
Hospital Revenue Code	361
Min. Negotiated Rate	$66.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$153.38
Rate for Payer: Aetna Medicare Advantage	$153.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.37
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	$130.37
Rate for Payer: Cigna Commercial	$255.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.46
Rate for Payer: Qualcare PPO/HMO/WC	$76.69

OR CALL TIME

Facility

$511.25

Hospital Charge Code	1600162
Hospital Revenue Code	361
Min. Negotiated Rate	$76.69
Max. Negotiated Rate	$76.69
Rate for Payer: Qualcare PPO/HMO/WC	$76.69

ORCHIECTOMY SIMPLE BL

Facility

$25,837.00

Service Code	HCPCS 54520
Hospital Charge Code	1600000692
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$7,751.10
Rate for Payer: Aetna Medicare Advantage	$7,751.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,588.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,588.44
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	$6,588.44
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,358.81
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,875.55
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ORCHIECTOMY SIMPLE BL

Facility

$25,837.00

Service Code	HCPCS 54520
Hospital Charge Code	1600000692
Hospital Revenue Code	360
Min. Negotiated Rate	$3,875.55
Max. Negotiated Rate	$3,875.55
Rate for Payer: Qualcare PPO/HMO/WC	$3,875.55

ORCHIOPEXY INGUINAL APPROACH

Facility

$30,877.00

Service Code	HCPCS 54640
Hospital Charge Code	16001002
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

ORCHIOPEXY INGUINAL APPROACH

Facility

$30,877.00

Service Code	HCPCS 54640
Hospital Charge Code	16001002
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,263.10
Rate for Payer: Aetna Commercial	$9,263.10
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,014.01
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ORENCIA 250MG

Facility

$2,648.00

Hospital Charge Code	60635721
Hospital Revenue Code	636
Min. Negotiated Rate	$397.20
Max. Negotiated Rate	$640.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.82
Rate for Payer: Qualcare PPO/HMO/WC	$397.20

ORENCIA 250MG

Facility

$2,648.00

Hospital Charge Code	60635721
Hospital Revenue Code	636
Min. Negotiated Rate	$397.20
Max. Negotiated Rate	$1,324.00
Rate for Payer: Aetna Commercial	$794.40
Rate for Payer: Aetna Medicare Advantage	$794.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.24
Rate for Payer: Cigna Commercial	$1,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.82
Rate for Payer: Qualcare PPO/HMO/WC	$397.20

ORENCIA 250MG VIAL

Facility

$2,481.00

Hospital Charge Code	60635588
Hospital Revenue Code	636
Min. Negotiated Rate	$372.15
Max. Negotiated Rate	$1,240.50
Rate for Payer: Aetna Commercial	$744.30
Rate for Payer: Aetna Medicare Advantage	$744.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.65
Rate for Payer: Cigna Commercial	$1,240.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.40
Rate for Payer: Qualcare PPO/HMO/WC	$372.15

ORENCIA 250MG VIAL

Facility

$2,481.00

Hospital Charge Code	60635588
Hospital Revenue Code	636
Min. Negotiated Rate	$372.15
Max. Negotiated Rate	$600.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.40
Rate for Payer: Qualcare PPO/HMO/WC	$372.15

Orencia(Abatacept) 250mg iv

Facility

$805.25

Hospital Charge Code	6063943273
Hospital Revenue Code	636
Min. Negotiated Rate	$120.79
Max. Negotiated Rate	$402.62
Rate for Payer: Aetna Commercial	$241.57
Rate for Payer: Aetna Medicare Advantage	$241.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.34
Rate for Payer: Cigna Commercial	$402.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.87
Rate for Payer: Qualcare PPO/HMO/WC	$120.79

Orencia(Abatacept) 250mg iv

Facility

$805.25

Hospital Charge Code	6063943273
Hospital Revenue Code	636
Min. Negotiated Rate	$120.79
Max. Negotiated Rate	$194.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.87
Rate for Payer: Qualcare PPO/HMO/WC	$120.79

ORETIC/25MG/TAB

Facility

$4.00

Hospital Charge Code	60633580
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ORETIC/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633581
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ORETIC/25MG/TAB

Facility

$4.00

Hospital Charge Code	60633580
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

ORETIC/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633581
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

ORGANIC ACID ANALYSIS, URINE

Facility

$80.85

Service Code	HCPCS 83919
Hospital Charge Code	3035004
Hospital Revenue Code	301
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.27
Rate for Payer: Cigna Commercial	$16.45
Rate for Payer: Cigna Medicare Advantage	$8.22
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.44
Rate for Payer: Wellcare Medicare Advantage	$16.45

ORGANIC ACID ANALYSIS, URINE

Facility

$80.85

Service Code	HCPCS 83919
Hospital Charge Code	3035004
Hospital Revenue Code	301
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

ORGANIC ACID FULL QUANT A

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39708015A
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	$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	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ORGANIC ACID FULL QUANT A

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39708015A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID FULL QUANT B

Facility

$390.00

Service Code	HCPCS 83918
Hospital Charge Code	39708015B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID FULL QUANT B

Facility

$390.00

Service Code	HCPCS 83918
Hospital Charge Code	39708015B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.46
Rate for Payer: Aetna Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.47
Rate for Payer: Cigna Commercial	$23.60
Rate for Payer: Cigna Medicare Advantage	$11.80
Rate for Payer: Clover Medicare Advantage	$22.42
Rate for Payer: EmblemHealth Commercial	$70.80
Rate for Payer: Humana Medicare Advantage	$24.31
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	$23.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.02
Rate for Payer: Wellcare Medicare Advantage	$23.60

ORGANIC ACID QUAL EA SPEC

Facility

$390.00

Service Code	HCPCS 83919
Hospital Charge Code	39708052A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID QUAL EA SPEC

Facility

$390.00

Service Code	HCPCS 83919
Hospital Charge Code	39708052A
Hospital Revenue Code	301
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.27
Rate for Payer: Cigna Commercial	$16.45
Rate for Payer: Cigna Medicare Advantage	$8.22
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
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	$16.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.44
Rate for Payer: Wellcare Medicare Advantage	$16.45

Know your out-of-pocket cost for care.

All Charges