Heights University Hospital

All Charges

Charge

Type

Setting

Price

PEPTIC ULCER AND GASTRITIS

Facility

$10,326.41

Service Code	APR-DRG 2412
Min. Negotiated Rate	$6,888.69
Max. Negotiated Rate	$10,326.41
Rate for Payer: Aetna Better Health Medicaid	$10,123.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,326.41
Rate for Payer: Wellpoint Medicaid Managed Care	$6,888.69

PEPTO-BISMOL LIQUID

Facility

$7.00

Hospital Charge Code	60634901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

PEPTO-BISMOL LIQUID

Facility

$7.00

Hospital Charge Code	60634901
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

PEPTO-BISMOL TABS

Facility

$4.00

Service Code	NDC 904131546
Hospital Charge Code	60634891
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PEPTO-BISMOL TABS

Facility

$4.00

Service Code	NDC 904131546
Hospital Charge Code	60634891
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

PERATIVE

Facility

$7.00

Hospital Charge Code	60635157
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

PERATIVE

Facility

$7.00

Hospital Charge Code	60635157
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

PERC/AUTO/VAC/ASSIST/BREST BIO

Facility

$6,420.00

Hospital Charge Code	75190110
Hospital Revenue Code	361
Min. Negotiated Rate	$834.60
Max. Negotiated Rate	$3,210.00
Rate for Payer: Aetna Commercial	$1,926.00
Rate for Payer: Aetna Medicare Advantage	$1,926.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.10
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	$1,637.10
Rate for Payer: Cigna Commercial	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.60
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

PERC/AUTO/VAC/ASSIST/BREST BIO

Facility

$6,420.00

Hospital Charge Code	75190110
Hospital Revenue Code	361
Min. Negotiated Rate	$963.00
Max. Negotiated Rate	$963.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

PERC BIOPSY BREAST-LT

Facility

$1,049.00

Hospital Charge Code	2690890
Hospital Revenue Code	361
Min. Negotiated Rate	$136.37
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$314.70
Rate for Payer: Aetna Medicare Advantage	$314.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.50
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	$267.50
Rate for Payer: Cigna Commercial	$524.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.37
Rate for Payer: Qualcare PPO/HMO/WC	$157.35

PERC BIOPSY BREAST-LT

Facility

$1,049.00

Hospital Charge Code	2690890
Hospital Revenue Code	361
Min. Negotiated Rate	$157.35
Max. Negotiated Rate	$157.35
Rate for Payer: Qualcare PPO/HMO/WC	$157.35

PERC BX OR EXC LN, SUPERFICIAL

Facility

$7,367.00

Service Code	HCPCS 38505
Hospital Charge Code	1600000279
Hospital Revenue Code	360
Min. Negotiated Rate	$1,105.05
Max. Negotiated Rate	$1,105.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,105.05

PERC BX OR EXC LN, SUPERFICIAL

Facility

$7,367.00

Service Code	HCPCS 38505
Hospital Charge Code	1600000279
Hospital Revenue Code	360
Min. Negotiated Rate	$957.71
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,210.10
Rate for Payer: Aetna Medicare Advantage	$2,210.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,878.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,878.59
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	$1,878.59
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.71
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,105.05
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

PERC CHOLECYSTECTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	411047490
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,120.27
Rate for Payer: Aetna Medicare Advantage	$5,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,352.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,352.23
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	$4,352.23
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,218.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERC CHOLECYSTECTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	411047490
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

PERC CHOLECYSTECTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	366847490
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

PERC CHOLECYSTECTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	366847490
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,120.27
Rate for Payer: Aetna Medicare Advantage	$5,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,352.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,352.23
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	$4,352.23
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,218.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERC CHOLECYSTOSTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	2250452
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,120.27
Rate for Payer: Aetna Medicare Advantage	$5,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,352.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,352.23
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	$4,352.23
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,218.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERC CHOLECYSTOSTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	2250452
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	2691670
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	2691670
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$4,910.40
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	7411974
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	7411974
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$4,910.40
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	7411975
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$4,910.40
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	2691675
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$4,910.40
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

Know your out-of-pocket cost for care.

All Charges