Heights University Hospital

All Charges

Charge

Type

Setting

Price

REDUCTION PIN CANCELL THD 5.0M

Facility

$3,335.00

Hospital Charge Code	270701156
Hospital Revenue Code	279
Min. Negotiated Rate	$433.55
Max. Negotiated Rate	$1,667.50
Rate for Payer: Aetna Commercial	$1,000.50
Rate for Payer: Aetna Medicare Advantage	$1,000.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$850.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$850.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$850.42
Rate for Payer: Cigna Commercial	$1,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.55
Rate for Payer: Oxford Commercial	$1,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$500.25
Rate for Payer: UnitedHealthcare Commercial	$1,667.50

REDUCTION TALOTARSAL JOINT

Facility

$713.00

Service Code	HCPCS 28570
Hospital Charge Code	5780115
Hospital Revenue Code	450
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$213.90
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.69
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

REDUCTION TALOTARSAL JOINT

Facility

$713.00

Service Code	HCPCS 28570
Hospital Charge Code	5780115
Hospital Revenue Code	450
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

REDUCTN OF TORSION TESTIS SURG

Facility

$20,610.70

Service Code	HCPCS 54600
Hospital Charge Code	1600000816
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$6,183.21
Rate for Payer: Aetna Medicare Advantage	$6,183.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,255.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,255.73
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	$5,255.73
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,679.39
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REDUCTN OF TORSION TESTIS SURG

Facility

$20,610.70

Service Code	HCPCS 54600
Hospital Charge Code	1600000816
Hospital Revenue Code	360
Min. Negotiated Rate	$3,091.61
Max. Negotiated Rate	$3,091.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61

REDUCTN TARSOMETATARSAL JOINT

Facility

$645.00

Service Code	HCPCS 28600
Hospital Charge Code	5780120
Hospital Revenue Code	450
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$193.50
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

REDUCTN TARSOMETATARSAL JOINT

Facility

$645.00

Service Code	HCPCS 28600
Hospital Charge Code	5780120
Hospital Revenue Code	450
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

RE-EVALUATION OT

Facility

$286.00

Service Code	HCPCS 97004GO
Hospital Charge Code	74203023
Hospital Revenue Code	434
Min. Negotiated Rate	$37.18
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$85.80
Rate for Payer: Aetna Medicare Advantage	$85.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.93
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	$72.93
Rate for Payer: Cigna Commercial	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

RE-EVALUATION OT

Facility

$286.00

Service Code	HCPCS 97004GO
Hospital Charge Code	74203023
Hospital Revenue Code	434
Min. Negotiated Rate	$42.90
Max. Negotiated Rate	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.90

RE EVALUATION PT

Facility

$394.00

Service Code	HCPCS 97164
Hospital Charge Code	409297164
Hospital Revenue Code	424
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$59.10
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

RE EVALUATION PT

Facility

$394.00

Service Code	HCPCS 97164
Hospital Charge Code	409297164
Hospital Revenue Code	424
Min. Negotiated Rate	$51.22
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$118.20
Rate for Payer: Aetna Medicare Advantage	$118.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.47
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	$100.47
Rate for Payer: Cigna Commercial	$75.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.22
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Commercial	$686.00

REFECOXIB 12.5MG TAB

Facility

$12.20

Hospital Charge Code	60629184
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$6.10
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.11
Rate for Payer: Cigna Commercial	$6.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.59
Rate for Payer: Oxford Commercial	$6.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$6.10

REFECOXIB 12.5MG TAB

Facility

$12.20

Hospital Charge Code	60629184
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

REFERRED AB ID, COMPLEX

Facility

$149.00

Service Code	HCPCS 86870
Hospital Charge Code	38471152
Hospital Revenue Code	302
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$44.70
Rate for Payer: Aetna Medicare Advantage	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.99
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

REFERRED AB ID, COMPLEX

Facility

$149.00

Service Code	HCPCS 86870
Hospital Charge Code	38471152
Hospital Revenue Code	302
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

REFILL/MAINT IMPL PUMP SYSTEMI

Facility

$884.30

Service Code	HCPCS 96522
Hospital Charge Code	3401152
Hospital Revenue Code	335
Min. Negotiated Rate	$132.65
Max. Negotiated Rate	$132.65
Rate for Payer: Qualcare PPO/HMO/WC	$132.65

REFILL/MAINT IMPL PUMP SYSTEMI

Facility

$884.30

Service Code	HCPCS 96522
Hospital Charge Code	3401152
Hospital Revenue Code	335
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$265.29
Rate for Payer: Aetna Medicare Advantage	$265.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.50
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.96
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.65
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

REFILL/MAINT PORTABLE PUMP

Facility

$1,292.25

Service Code	HCPCS 96521
Hospital Charge Code	3401151
Hospital Revenue Code	335
Min. Negotiated Rate	$167.99
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$387.68
Rate for Payer: Aetna Medicare Advantage	$387.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.52
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.99
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.84
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

REFILL/MAINT PORTABLE PUMP

Facility

$1,292.25

Service Code	HCPCS 96521
Hospital Charge Code	3401151
Hospital Revenue Code	335
Min. Negotiated Rate	$193.84
Max. Negotiated Rate	$193.84
Rate for Payer: Qualcare PPO/HMO/WC	$193.84

REFIT MULTIPLE DROP & LOCATION

Facility

$3,076.25

Hospital Charge Code	270659148
Hospital Revenue Code	278
Min. Negotiated Rate	$461.44
Max. Negotiated Rate	$1,538.12
Rate for Payer: Aetna Commercial	$922.88
Rate for Payer: Aetna Medicare Advantage	$922.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.44
Rate for Payer: Cigna Commercial	$1,538.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.45
Rate for Payer: Qualcare PPO/HMO/WC	$461.44

REFIT MULTIPLE DROP & LOCATION

Facility

$3,076.25

Hospital Charge Code	270659148
Hospital Revenue Code	278
Min. Negotiated Rate	$461.44
Max. Negotiated Rate	$744.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.45
Rate for Payer: Qualcare PPO/HMO/WC	$461.44

REFLEX OVARIAN AB TITER

Facility

$390.00

Service Code	HCPCS 86256
Hospital Charge Code	38479451B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
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	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

REFLEX OVARIAN AB TITER

Facility

$390.00

Service Code	HCPCS 86256
Hospital Charge Code	38479451B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

REFOBACIN BC R 1X40 US

Facility

$3,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270682262
Hospital Revenue Code	278
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: Aetna Commercial	$960.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.40
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

REFOBACIN BC R 1X40 US

Facility

$3,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270682262
Hospital Revenue Code	278
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.40
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

Know your out-of-pocket cost for care.

All Charges