Heights University Hospital

All Charges

Charge

Type

Setting

Price

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$50,174.31

Service Code	APR-DRG 2234
Min. Negotiated Rate	$47,621.22
Max. Negotiated Rate	$50,174.31
Rate for Payer: Aetna Better Health Medicaid	$49,190.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$50,174.31
Rate for Payer: Wellpoint Medicaid Managed Care	$47,621.22

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$20,291.90

Service Code	APR-DRG 2232
Min. Negotiated Rate	$13,730.19
Max. Negotiated Rate	$20,291.90
Rate for Payer: Aetna Better Health Medicaid	$19,894.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,291.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13,730.19

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$16,339.94

Service Code	APR-DRG 2231
Min. Negotiated Rate	$10,356.32
Max. Negotiated Rate	$16,339.94
Rate for Payer: Aetna Better Health Medicaid	$16,019.55
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,339.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10,356.32

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$17,563.21

Service Code	APR-DRG 2222
Min. Negotiated Rate	$12,377.57
Max. Negotiated Rate	$17,563.21
Rate for Payer: Aetna Better Health Medicaid	$17,218.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,563.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12,377.57

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$50,816.16

Service Code	APR-DRG 2224
Min. Negotiated Rate	$48,938.32
Max. Negotiated Rate	$50,816.16
Rate for Payer: Aetna Better Health Medicaid	$49,819.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$50,816.16
Rate for Payer: Wellpoint Medicaid Managed Care	$48,938.32

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$25,872.95

Service Code	APR-DRG 2223
Min. Negotiated Rate	$20,058.96
Max. Negotiated Rate	$25,872.95
Rate for Payer: Aetna Better Health Medicaid	$25,365.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,872.95
Rate for Payer: Wellpoint Medicaid Managed Care	$20,058.96

OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$10,121.34

Service Code	APR-DRG 2221
Min. Negotiated Rate	$9,671.06
Max. Negotiated Rate	$10,121.34
Rate for Payer: Aetna Better Health Medicaid	$9,922.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,121.34
Rate for Payer: Wellpoint Medicaid Managed Care	$9,671.06

OTHER THAN SPUN HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	3007390B
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

OTHER THAN SPUN HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	3007390B
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

OTHER VASCULAR PROCEDURES WITH CC

Facility

$87,523.32

Service Code	MSDRG 253
Min. Negotiated Rate	$27,601.12
Max. Negotiated Rate	$87,523.32
Rate for Payer: Aetna Commercial	$87,523.32
Rate for Payer: Aetna Medicare Advantage	$28,324.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70,295.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70,295.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,053.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70,295.85
Rate for Payer: Cigna Commercial	$55,859.91
Rate for Payer: Cigna Medicare Advantage	$29,053.81
Rate for Payer: Clover Medicare Advantage	$27,601.12
Rate for Payer: EmblemHealth Commercial	$87,161.43
Rate for Payer: Humana Medicare Advantage	$29,925.42
Rate for Payer: Oxford Commercial	$34,910.82
Rate for Payer: UnitedHealthcare Commercial	$39,627.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,053.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$30,797.04
Rate for Payer: Wellcare Medicare Advantage	$29,053.81

OTHER VASCULAR PROCEDURES WITH MCC

Facility

$117,625.05

Service Code	MSDRG 252
Min. Negotiated Rate	$35,806.36
Max. Negotiated Rate	$117,625.05
Rate for Payer: Aetna Commercial	$117,625.05
Rate for Payer: Aetna Medicare Advantage	$38,066.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92,349.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92,349.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,690.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92,349.45
Rate for Payer: Cigna Commercial	$75,071.70
Rate for Payer: Cigna Medicare Advantage	$37,690.90
Rate for Payer: Clover Medicare Advantage	$35,806.36
Rate for Payer: EmblemHealth Commercial	$113,072.70
Rate for Payer: Humana Medicare Advantage	$38,821.63
Rate for Payer: Oxford Commercial	$46,917.64
Rate for Payer: UnitedHealthcare Commercial	$53,255.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,690.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39,952.35
Rate for Payer: Wellcare Medicare Advantage	$37,690.90

OTHER VASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$63,537.39

Service Code	MSDRG 254
Min. Negotiated Rate	$19,442.95
Max. Negotiated Rate	$63,537.39
Rate for Payer: Aetna Commercial	$60,078.72
Rate for Payer: Aetna Medicare Advantage	$19,442.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,966.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,966.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,179.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,966.58
Rate for Payer: Cigna Commercial	$38,343.97
Rate for Payer: Cigna Medicare Advantage	$21,179.13
Rate for Payer: Clover Medicare Advantage	$20,120.17
Rate for Payer: EmblemHealth Commercial	$63,537.39
Rate for Payer: Humana Medicare Advantage	$21,814.50
Rate for Payer: Oxford Commercial	$23,963.87
Rate for Payer: UnitedHealthcare Commercial	$27,201.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,179.13
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,449.88
Rate for Payer: Wellcare Medicare Advantage	$21,179.13

OT HOME MGT SELFCAR 15MIN

Facility

$384.00

Service Code	HCPCS 97535GO
Hospital Charge Code	74203063
Hospital Revenue Code	430
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$57.60
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

OT HOME MGT SELFCAR 15MIN

Facility

$384.00

Service Code	HCPCS 97535GO
Hospital Charge Code	74203063
Hospital Revenue Code	430
Min. Negotiated Rate	$49.92
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$115.20
Rate for Payer: Aetna Medicare Advantage	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.92
Rate for Payer: Cigna Commercial	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.92
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.60
Rate for Payer: UnitedHealthcare Commercial	$686.00

OT HYDROTHERAPY SGL SESSION

Facility

$62.10

Service Code	HCPCS 97022GO
Hospital Charge Code	9100052
Hospital Revenue Code	430
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$686.00

OT HYDROTHERAPY SGL SESSION

Facility

$62.10

Service Code	HCPCS 97022GO
Hospital Charge Code	9100052
Hospital Revenue Code	430
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

OTIC MEDICATION

Facility

$21.15

Hospital Charge Code	6027215
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

OTIC MEDICATION

Facility

$21.15

Hospital Charge Code	6027215
Hospital Revenue Code	251
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

OT IONTOPHORESIS EA 15 MIN

Facility

$77.65

Service Code	HCPCS 97033GO
Hospital Charge Code	9100056
Hospital Revenue Code	430
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$23.30
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

OT IONTOPHORESIS EA 15 MIN

Facility

$77.65

Service Code	HCPCS 97033GO
Hospital Charge Code	9100056
Hospital Revenue Code	430
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

OT IONTO UNATTENDED 15MIN

Facility

$132.00

Service Code	HCPCS 97033GO
Hospital Charge Code	74203037
Hospital Revenue Code	430
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

OT IONTO UNATTENDED 15MIN

Facility

$132.00

Service Code	HCPCS 97033GO
Hospital Charge Code	74203037
Hospital Revenue Code	430
Min. Negotiated Rate	$17.16
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$39.60
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTIRX 10ML

Facility

$122.14

Service Code	NDC 42192010804
Hospital Charge Code	60635362
Hospital Revenue Code	250
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$61.07
Rate for Payer: Aetna Commercial	$36.64
Rate for Payer: Aetna Medicare Advantage	$36.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.15
Rate for Payer: Cigna Commercial	$61.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.88
Rate for Payer: Oxford Commercial	$61.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.32
Rate for Payer: UnitedHealthcare Commercial	$61.07

OTIRX 10ML

Facility

$122.14

Service Code	NDC 42192010804
Hospital Charge Code	60635362
Hospital Revenue Code	250
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$18.32
Rate for Payer: Qualcare PPO/HMO/WC	$18.32

OTITIS MEDIA AND URI WITH MCC

Facility

$46,136.46

Service Code	MSDRG 152
Min. Negotiated Rate	$12,900.86
Max. Negotiated Rate	$46,136.46
Rate for Payer: Aetna Commercial	$39,863.66
Rate for Payer: Aetna Medicare Advantage	$12,900.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,804.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,804.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,378.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,804.73
Rate for Payer: Cigna Commercial	$25,442.13
Rate for Payer: Cigna Medicare Advantage	$15,378.82
Rate for Payer: Clover Medicare Advantage	$14,609.88
Rate for Payer: EmblemHealth Commercial	$46,136.46
Rate for Payer: Humana Medicare Advantage	$15,840.18
Rate for Payer: Oxford Commercial	$15,900.59
Rate for Payer: UnitedHealthcare Commercial	$18,048.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,378.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16,301.55
Rate for Payer: Wellcare Medicare Advantage	$15,378.82

Know your out-of-pocket cost for care.

All Charges