Heights University Hospital

All Charges

Charge

Type

Setting

Price

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3246M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3246M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$103.00

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3024M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3048M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	4201M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3020M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$103.00

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3190M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3042M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3121M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3049M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3190M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

REGENERATION MESHED TEMPLATE

Facility

$18,500.00

Hospital Charge Code	270703940
Hospital Revenue Code	272
Min. Negotiated Rate	$2,405.00
Max. Negotiated Rate	$9,250.00
Rate for Payer: Aetna Commercial	$5,550.00
Rate for Payer: Aetna Medicare Advantage	$5,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,717.50
Rate for Payer: Cigna Commercial	$9,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,405.00
Rate for Payer: Oxford Commercial	$9,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,775.00
Rate for Payer: UnitedHealthcare Commercial	$9,250.00

REGENERATION MESHED TEMPLATE

Facility

$18,500.00

Hospital Charge Code	270703940
Hospital Revenue Code	272
Min. Negotiated Rate	$2,775.00
Max. Negotiated Rate	$2,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,775.00

REGENERON EUA 2400MG VIAL

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	606390393
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

REGENERON EUA 2400MG VIAL

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	606390393
Hospital Revenue Code	636
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

REGENKIT THT AUTOLOG FOR PRP

Facility

$1,738.15

Service Code	HCPCS A4649
Hospital Charge Code	270700253
Hospital Revenue Code	272
Min. Negotiated Rate	$260.72
Max. Negotiated Rate	$260.72
Rate for Payer: Qualcare PPO/HMO/WC	$260.72

REGENKIT THT AUTOLOG FOR PRP

Facility

$1,738.15

Service Code	HCPCS A4649
Hospital Charge Code	270700253
Hospital Revenue Code	272
Min. Negotiated Rate	$225.96
Max. Negotiated Rate	$869.08
Rate for Payer: Aetna Commercial	$521.45
Rate for Payer: Aetna Medicare Advantage	$521.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.23
Rate for Payer: Cigna Commercial	$869.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.96
Rate for Payer: Oxford Commercial	$869.08
Rate for Payer: Qualcare PPO/HMO/WC	$260.72
Rate for Payer: UnitedHealthcare Commercial	$869.08

REGITINE/5MG

Facility

$61.00

Hospital Charge Code	60633805
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

REGITINE/5MG

Facility

$61.00

Hospital Charge Code	60633805
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

REGLAN/10MG/BULK

Facility

$3.00

Hospital Charge Code	60634683
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

REGLAN/10MG/BULK

Facility

$3.00

Hospital Charge Code	60634683
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

REGLAN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60633806
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

REGLAN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60633806
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

REGLAN/5MG/1ML

Facility

$61.00

Hospital Charge Code	60633809
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

REGLAN/5MG/1ML

Facility

$61.00

Hospital Charge Code	60633809
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

Know your out-of-pocket cost for care.

All Charges