Heights University Hospital

All Charges

Charge

Type

Setting

Price

RAMIPRIL 2.5 MG CAP

Facility

$13.00

Service Code	NDC 68084026601
Hospital Charge Code	60629223
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

RAMIPRIL 5 MG CAP

Facility

$13.67

Service Code	NDC 68084026701
Hospital Charge Code	60629229
Hospital Revenue Code	250
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

RAMIPRIL 5 MG CAP

Facility

$13.67

Service Code	NDC 68084026701
Hospital Charge Code	60629229
Hospital Revenue Code	250
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.10
Rate for Payer: Aetna Medicare Advantage	$4.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.49
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.78
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

RANDOLPH CYCLODIALYIS CANNULA

Facility

$139.75

Hospital Charge Code	270678870
Hospital Revenue Code	272
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$69.88
Rate for Payer: Aetna Commercial	$41.92
Rate for Payer: Aetna Medicare Advantage	$41.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.64
Rate for Payer: Cigna Commercial	$69.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.17
Rate for Payer: Oxford Commercial	$69.88
Rate for Payer: Qualcare PPO/HMO/WC	$20.96
Rate for Payer: UnitedHealthcare Commercial	$69.88

RANDOLPH CYCLODIALYIS CANNULA

Facility

$139.75

Hospital Charge Code	270678870
Hospital Revenue Code	272
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$20.96
Rate for Payer: Qualcare PPO/HMO/WC	$20.96

RANDOM URINE CHLORIDE

Facility

$390.00

Service Code	HCPCS 82436
Hospital Charge Code	39900529
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.75
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	$21.07
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: Cigna Medicare Advantage	$2.88
Rate for Payer: Clover Medicare Advantage	$5.46
Rate for Payer: EmblemHealth Commercial	$17.25
Rate for Payer: Humana Medicare Advantage	$5.92
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	$5.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.09
Rate for Payer: Wellcare Medicare Advantage	$5.75

RANDOM URINE CHLORIDE

Facility

$390.00

Service Code	HCPCS 82436
Hospital Charge Code	39900529
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANDOM URINE MICROALBUMIN I

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39990129A
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
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	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

RANDOM URINE MICROALBUMIN I

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39990129A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANDOM URINE MICROALBUMIN II

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990129B
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

RANDOM URINE MICROALBUMIN II

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990129B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	39990065C
Hospital Revenue Code	301
Min. Negotiated Rate	$8.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.77
Rate for Payer: Aetna Medicare Advantage	$17.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.83
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	$65.33
Rate for Payer: Cigna Commercial	$17.83
Rate for Payer: Cigna Medicare Advantage	$8.91
Rate for Payer: Clover Medicare Advantage	$16.94
Rate for Payer: EmblemHealth Commercial	$53.49
Rate for Payer: Humana Medicare Advantage	$18.36
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	$17.83
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.90
Rate for Payer: Wellcare Medicare Advantage	$17.83

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990065A
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

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	39990065B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	39990065C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	39990065B
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
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	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

RANDOM URINE PROTEIN ELECTROPH

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990065A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RANEXA 500MG TAB

Facility

$37.05

Service Code	NDC 61958100301
Hospital Charge Code	60635580
Hospital Revenue Code	250
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$5.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.56

RANEXA 500MG TAB

Facility

$37.05

Service Code	NDC 61958100301
Hospital Charge Code	60635580
Hospital Revenue Code	250
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$18.52
Rate for Payer: Aetna Commercial	$11.12
Rate for Payer: Aetna Medicare Advantage	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.45
Rate for Payer: Cigna Commercial	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.82
Rate for Payer: Oxford Commercial	$18.52
Rate for Payer: Qualcare PPO/HMO/WC	$5.56
Rate for Payer: UnitedHealthcare Commercial	$18.52

RANEY CLIP APPLIER

Facility

$85.00

Hospital Charge Code	270335531
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$42.50

RANEY CLIP APPLIER

Facility

$85.00

Hospital Charge Code	270335531
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

RANEY CLIPS

Facility

$52.00

Hospital Charge Code	270335100
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

RANEY CLIPS

Facility

$52.00

Hospital Charge Code	270335100
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

RANFAC CHOLANGIOGRAM CATH

Facility

$172.00

Hospital Charge Code	270335123
Hospital Revenue Code	272
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

RANFAC CHOLANGIOGRAM CATH

Facility

$172.00

Hospital Charge Code	270335123
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

Know your out-of-pocket cost for care.

All Charges