Heights University Hospital

All Charges

Charge

Type

Setting

Price

POD REM/BIVALVIN,FULL LEG

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$60.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
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	$119.53
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

POD REM/BIVALVIN,FULL LEG

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD REMOVAL OF CAST

Facility

$468.75

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$60.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
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	$119.53
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

POD REMOVAL OF CAST

Facility

$468.75

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD SOFT CAST - UNNA

Facility

$468.75

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD SOFT CAST - UNNA

Facility

$468.75

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING FOOT-ANKLE

Facility

$468.75

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING FOOT-ANKLE

Facility

$468.75

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING TOE

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING TOE

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$140.62
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$478.50
Max. Negotiated Rate	$771.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: Qualcare PPO/HMO/WC	$478.50

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$478.50
Max. Negotiated Rate	$1,595.00
Rate for Payer: Aetna Commercial	$957.00
Rate for Payer: Aetna Medicare Advantage	$957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$813.45
Rate for Payer: Cigna Commercial	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: Qualcare PPO/HMO/WC	$478.50

POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC

Facility

$57,346.20

Service Code	MSDRG 917
Min. Negotiated Rate	$17,115.30
Max. Negotiated Rate	$57,346.20
Rate for Payer: Aetna Commercial	$52,886.28
Rate for Payer: Aetna Medicare Advantage	$17,115.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,107.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,107.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,115.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,107.20
Rate for Payer: Cigna Commercial	$33,753.54
Rate for Payer: Cigna Medicare Advantage	$19,115.40
Rate for Payer: Clover Medicare Advantage	$18,159.63
Rate for Payer: EmblemHealth Commercial	$57,346.20
Rate for Payer: Humana Medicare Advantage	$19,688.86
Rate for Payer: Oxford Commercial	$21,094.98
Rate for Payer: UnitedHealthcare Commercial	$23,944.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,115.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20,262.32
Rate for Payer: Wellcare Medicare Advantage	$19,115.40

POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC

Facility

$36,700.17

Service Code	MSDRG 918
Min. Negotiated Rate	$9,353.17
Max. Negotiated Rate	$36,700.17
Rate for Payer: Aetna Commercial	$28,901.30
Rate for Payer: Aetna Medicare Advantage	$9,353.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,233.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,707.62
Rate for Payer: Cigna Commercial	$18,445.65
Rate for Payer: Cigna Medicare Advantage	$12,233.39
Rate for Payer: Clover Medicare Advantage	$11,621.72
Rate for Payer: EmblemHealth Commercial	$36,700.17
Rate for Payer: Humana Medicare Advantage	$12,600.39
Rate for Payer: Oxford Commercial	$11,528.00
Rate for Payer: UnitedHealthcare Commercial	$13,085.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,233.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,967.39
Rate for Payer: Wellcare Medicare Advantage	$12,233.39

POISONING OF MEDICINAL AGENTS

Facility

$4,720.09

Service Code	APR-DRG 8121
Min. Negotiated Rate	$3,322.80
Max. Negotiated Rate	$4,720.09
Rate for Payer: Aetna Better Health Medicaid	$4,627.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,720.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3,322.80

POISONING OF MEDICINAL AGENTS

Facility

$6,850.54

Service Code	APR-DRG 8122
Min. Negotiated Rate	$4,232.39
Max. Negotiated Rate	$6,850.54
Rate for Payer: Aetna Better Health Medicaid	$6,716.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,850.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4,232.39

POISONING OF MEDICINAL AGENTS

Facility

$10,396.66

Service Code	APR-DRG 8123
Min. Negotiated Rate	$7,511.58
Max. Negotiated Rate	$10,396.66
Rate for Payer: Aetna Better Health Medicaid	$10,192.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,396.66
Rate for Payer: Wellpoint Medicaid Managed Care	$7,511.58

POISONING OF MEDICINAL AGENTS

Facility

$19,803.14

Service Code	APR-DRG 8124
Min. Negotiated Rate	$17,613.08
Max. Negotiated Rate	$19,803.14
Rate for Payer: Aetna Better Health Medicaid	$19,414.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,803.14
Rate for Payer: Wellpoint Medicaid Managed Care	$17,613.08

POISON IVY EXTRACT/1ML

Facility

$43.00

Hospital Charge Code	60633670
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

POISON IVY EXTRACT/1ML

Facility

$43.00

Hospital Charge Code	60633670
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

POLARAMINE/6MG/TAB

Facility

$3.00

Hospital Charge Code	60634391
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

POLARAMINE/6MG/TAB

Facility

$3.00

Hospital Charge Code	60634391
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

POLARCATH .014 2.5X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642198
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,269.67
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

POLARCATH .014 2.5X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642198
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

POLAR CATH .014 2x100 150cm

Facility

$4,745.25

Hospital Charge Code	270639685
Hospital Revenue Code	278
Min. Negotiated Rate	$711.79
Max. Negotiated Rate	$1,148.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.35
Rate for Payer: Qualcare PPO/HMO/WC	$711.79

Know your out-of-pocket cost for care.

All Charges