Heights University Hospital

All Charges

Charge

Type

Setting

Price

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$6.18
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.15
Rate for Payer: Cigna Commercial	$6.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.61
Rate for Payer: Oxford Commercial	$6.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.85
Rate for Payer: UnitedHealthcare Commercial	$6.18

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.85

REMEDY ZGUARD PHYSOPLEX 4oz

Facility

$20.00

Hospital Charge Code	270602490
Hospital Revenue Code	270
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

REMEDY ZGUARD PHYSOPLEX 4oz

Facility

$20.00

Hospital Charge Code	270602490
Hospital Revenue Code	270
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$440.10

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$36.80
Max. Negotiated Rate	$1,063.82
Rate for Payer: Aetna Commercial	$132.03
Rate for Payer: Aetna Medicare Advantage	$132.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.23
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.21
Rate for Payer: Qualcare PPO/HMO/WC	$66.02

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$440.10

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$66.02
Max. Negotiated Rate	$66.02
Rate for Payer: Qualcare PPO/HMO/WC	$66.02

REMERON 30 MG TAB U/D

Facility

$13.00

Hospital Charge Code	60635288
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

REMERON 30 MG TAB U/D

Facility

$13.00

Hospital Charge Code	60635288
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$4,123.26
Max. Negotiated Rate	$4,123.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,246.52
Rate for Payer: Aetna Commercial	$8,246.52
Rate for Payer: Aetna Medicare Advantage	$8,246.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,009.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,009.54
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	$7,009.54
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,573.49
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REM FB CONJUNCTIVA SUPERFICIAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	2500366
Hospital Revenue Code	761
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$158.66
Rate for Payer: Aetna Medicare Advantage	$158.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.86
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.75
Rate for Payer: Oxford Commercial	$264.43
Rate for Payer: Qualcare PPO/HMO/WC	$79.33
Rate for Payer: UnitedHealthcare Commercial	$264.43

REM FB CONJUNCTIVA SUPERFICIAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	2500366
Hospital Revenue Code	761
Min. Negotiated Rate	$79.33
Max. Negotiated Rate	$79.33
Rate for Payer: Qualcare PPO/HMO/WC	$79.33

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$4,403.65
Max. Negotiated Rate	$4,403.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,807.31
Rate for Payer: Aetna Commercial	$8,807.31
Rate for Payer: Aetna Medicare Advantage	$8,807.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,486.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,486.21
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	$7,486.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,816.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$1,039.08
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$2,397.88
Rate for Payer: Aetna Medicare Advantage	$2,397.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.19
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	$2,038.19
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,039.08
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$1,198.94
Max. Negotiated Rate	$1,198.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94

REMICADE 10MG INJ

Facility

$208.00

Hospital Charge Code	60635384
Hospital Revenue Code	636
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$50.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

REMICADE 10MG INJ

Facility

$208.00

Hospital Charge Code	60635384
Hospital Revenue Code	636
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$62.40
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$41.75
Max. Negotiated Rate	$160.56
Rate for Payer: Aetna Commercial	$96.34
Rate for Payer: Aetna Medicare Advantage	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.89
Rate for Payer: Cigna Commercial	$160.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.75
Rate for Payer: Oxford Commercial	$160.56
Rate for Payer: Qualcare PPO/HMO/WC	$48.17
Rate for Payer: UnitedHealthcare Commercial	$160.56

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$48.17
Max. Negotiated Rate	$48.17
Rate for Payer: Qualcare PPO/HMO/WC	$48.17

REM IMP CERUMEN/IRRIG UNI

Facility

$329.60

Service Code	HCPCS 69209
Hospital Charge Code	5792275
Hospital Revenue Code	450
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$140.48
Rate for Payer: Aetna Commercial	$98.88
Rate for Payer: Aetna Medicare Advantage	$98.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.05
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.85
Rate for Payer: Qualcare PPO/HMO/WC	$49.44

REM IMP CERUMEN/IRRIG UNI

Facility

$329.60

Service Code	HCPCS 69209
Hospital Charge Code	5792275
Hospital Revenue Code	450
Min. Negotiated Rate	$49.44
Max. Negotiated Rate	$49.44
Rate for Payer: Qualcare PPO/HMO/WC	$49.44

REM IMPLANT FROM FINGER ORHAND

Facility

$13,615.50

Service Code	HCPCS 26320
Hospital Charge Code	16000474
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$4,084.65
Rate for Payer: Aetna Commercial	$4,084.65
Rate for Payer: Aetna Medicare Advantage	$4,084.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,471.95
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	$3,471.95
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REM IMPLANT FROM FINGER ORHAND

Facility

$13,615.50

Service Code	HCPCS 26320
Hospital Charge Code	16000474
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

REM MAMMARY IMPLANT

Facility

$31,541.30

Service Code	HCPCS 19328
Hospital Charge Code	16000536
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,462.39
Rate for Payer: Aetna Commercial	$9,462.39
Rate for Payer: Aetna Medicare Advantage	$9,462.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,043.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,043.03
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	$8,043.03
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,100.37
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges