Heights University Hospital

All Charges

Charge

Type

Setting

Price

RABIES VACCINE (RABAVERT) EX

Facility

$2,048.26

Service Code	NDC 63851050101
Hospital Charge Code	60639517EX
Hospital Revenue Code	259
Min. Negotiated Rate	$266.27
Max. Negotiated Rate	$1,024.13
Rate for Payer: Aetna Commercial	$614.48
Rate for Payer: Aetna Medicare Advantage	$614.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.31
Rate for Payer: Cigna Commercial	$1,024.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.27
Rate for Payer: Oxford Commercial	$1,024.13
Rate for Payer: Qualcare PPO/HMO/WC	$307.24
Rate for Payer: UnitedHealthcare Commercial	$1,024.13

RACEMIC EPINEPH 2.25% ASTH

Facility

$82.00

Service Code	HCPCS J7640
Hospital Charge Code	6006316
Hospital Revenue Code	294
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$24.60
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

RACEMIC EPINEPH 2.25% ASTH

Facility

$82.00

Service Code	HCPCS J7640
Hospital Charge Code	6006316
Hospital Revenue Code	294
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

RACEMIC EPINEPH SOL 2.25% 15ML

Facility

$16.75

Service Code	NDC 487590199
Hospital Charge Code	60627447
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

RACEMIC EPINEPH SOL 2.25% 15ML

Facility

$16.75

Service Code	NDC 487590199
Hospital Charge Code	60627447
Hospital Revenue Code	250
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$8.38
Rate for Payer: Aetna Commercial	$5.03
Rate for Payer: Aetna Medicare Advantage	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.18
Rate for Payer: Oxford Commercial	$8.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$8.38

RACEPINEPHRINE SOL 2.25% 0.5ML

Facility

$5.15

Hospital Charge Code	60629190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$2.58
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.31
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$2.58

RACEPINEPHRINE SOL 2.25% 0.5ML

Facility

$5.15

Hospital Charge Code	60629190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

RACK F/7.3MM CANN SCREW

Facility

$1,523.35

Hospital Charge Code	270677620
Hospital Revenue Code	272
Min. Negotiated Rate	$198.04
Max. Negotiated Rate	$761.67
Rate for Payer: Aetna Commercial	$457.00
Rate for Payer: Aetna Medicare Advantage	$457.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.45
Rate for Payer: Cigna Commercial	$761.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.04
Rate for Payer: Oxford Commercial	$761.67
Rate for Payer: Qualcare PPO/HMO/WC	$228.50
Rate for Payer: UnitedHealthcare Commercial	$761.67

RACK F/7.3MM CANN SCREW

Facility

$1,523.35

Hospital Charge Code	270677620
Hospital Revenue Code	272
Min. Negotiated Rate	$228.50
Max. Negotiated Rate	$228.50
Rate for Payer: Qualcare PPO/HMO/WC	$228.50

RACK JURGAN PIN BALL .035****

Facility

$125.00

Hospital Charge Code	1604792
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGAN PIN BALL .035****

Facility

$125.00

Hospital Charge Code	1604792
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK JURGAN PIN BALL .062*****

Facility

$125.00

Hospital Charge Code	1604768
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK JURGAN PIN BALL .062*****

Facility

$125.00

Hospital Charge Code	1604768
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGAN PIN BALL 3/32****

Facility

$125.00

Hospital Charge Code	1604800
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGAN PIN BALL 3/32****

Facility

$125.00

Hospital Charge Code	1604800
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK JURGAN PIN BALL 5/64****

Facility

$125.00

Hospital Charge Code	1604784
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK JURGAN PIN BALL 5/64****

Facility

$125.00

Hospital Charge Code	1604784
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGAN PIN BL .045 W045**

Facility

$125.00

Hospital Charge Code	1604750
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGAN PIN BL .045 W045**

Facility

$125.00

Hospital Charge Code	1604750
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK JURGN PIN BALL .028 W28**

Facility

$125.00

Hospital Charge Code	1604776
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RACK JURGN PIN BALL .028 W28**

Facility

$125.00

Hospital Charge Code	1604776
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

RACK LID F/7.3MM CANN SCREW

Facility

$398.60

Hospital Charge Code	270677619
Hospital Revenue Code	272
Min. Negotiated Rate	$59.79
Max. Negotiated Rate	$59.79
Rate for Payer: Qualcare PPO/HMO/WC	$59.79

RACK LID F/7.3MM CANN SCREW

Facility

$398.60

Hospital Charge Code	270677619
Hospital Revenue Code	272
Min. Negotiated Rate	$51.82
Max. Negotiated Rate	$199.30
Rate for Payer: Aetna Commercial	$119.58
Rate for Payer: Aetna Medicare Advantage	$119.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.64
Rate for Payer: Cigna Commercial	$199.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.82
Rate for Payer: Oxford Commercial	$199.30
Rate for Payer: Qualcare PPO/HMO/WC	$59.79
Rate for Payer: UnitedHealthcare Commercial	$199.30

RACK WECK 15.0

Facility

$684.35

Hospital Charge Code	270666117
Hospital Revenue Code	270
Min. Negotiated Rate	$88.97
Max. Negotiated Rate	$342.18
Rate for Payer: Aetna Commercial	$205.31
Rate for Payer: Aetna Medicare Advantage	$205.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.51
Rate for Payer: Cigna Commercial	$342.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.97
Rate for Payer: Oxford Commercial	$342.18
Rate for Payer: Qualcare PPO/HMO/WC	$102.65
Rate for Payer: UnitedHealthcare Commercial	$342.18

RACK WECK 15.0

Facility

$684.35

Hospital Charge Code	270666117
Hospital Revenue Code	270
Min. Negotiated Rate	$102.65
Max. Negotiated Rate	$102.65
Rate for Payer: Qualcare PPO/HMO/WC	$102.65

Know your out-of-pocket cost for care.

All Charges