Heights University Hospital

All Charges

Charge

Type

Setting

Price

REZULIN 400MG TAB

Facility

$27.00

Hospital Charge Code	60635171
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

RF ABLTJ NRV NRVTG SI JT

Facility

$10,782.78

Service Code	HCPCS 64625
Hospital Charge Code	321564625
Hospital Revenue Code	361
Min. Negotiated Rate	$1,401.76
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Medicare Advantage	$3,234.83
Rate for Payer: Aetna Commercial	$3,234.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,749.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,749.61
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	$2,749.61
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,401.76
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

RF ABLTJ NRV NRVTG SI JT

Facility

$8,648.20

Service Code	HCPCS 64625
Hospital Charge Code	1600000855
Hospital Revenue Code	360
Min. Negotiated Rate	$1,297.23
Max. Negotiated Rate	$1,297.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.23

RF ABLTJ NRV NRVTG SI JT

Facility

$10,782.78

Service Code	HCPCS 64625
Hospital Charge Code	321564625
Hospital Revenue Code	361
Min. Negotiated Rate	$1,617.42
Max. Negotiated Rate	$1,617.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42

RF ABLTJ NRV NRVTG SI JT

Facility

$8,648.20

Service Code	HCPCS 64625
Hospital Charge Code	1600000855
Hospital Revenue Code	360
Min. Negotiated Rate	$1,124.27
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$2,594.46
Rate for Payer: Aetna Medicare Advantage	$2,594.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,205.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,205.29
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	$2,205.29
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,124.27
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.23
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

RF BIPOLAR 350MM

Facility

$3,750.00

Hospital Charge Code	270688534
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$1,875.00

RF BIPOLAR 350MM

Facility

$3,750.00

Hospital Charge Code	270688534
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

RF MULTIGEN RENTAL0406900000

Facility

$7,500.00

Hospital Charge Code	270661959
Hospital Revenue Code	270
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.00
Rate for Payer: Oxford Commercial	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$3,750.00

RF MULTIGEN RENTAL0406900000

Facility

$7,500.00

Hospital Charge Code	270661959
Hospital Revenue Code	270
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

RFNA 10MM 420MM 5DEG BEND

Facility

$8,474.10

Service Code	HCPCS C1713
Hospital Charge Code	270692416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.12
Max. Negotiated Rate	$4,237.05
Rate for Payer: Aetna Commercial	$2,542.23
Rate for Payer: Aetna Medicare Advantage	$2,542.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,160.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,160.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,694.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,160.90
Rate for Payer: Cigna Commercial	$4,237.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.12

RFNA 10MM 420MM 5DEG BEND

Facility

$8,474.10

Service Code	HCPCS C1713
Hospital Charge Code	270692416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.12
Max. Negotiated Rate	$2,050.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,694.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.12

RF NEEDLE 100MM 10MM 20GA

Facility

$266.55

Hospital Charge Code	270650125
Hospital Revenue Code	272
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$133.28
Rate for Payer: Aetna Commercial	$79.97
Rate for Payer: Aetna Medicare Advantage	$79.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.97
Rate for Payer: Cigna Commercial	$133.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Oxford Commercial	$133.28
Rate for Payer: Qualcare PPO/HMO/WC	$39.98
Rate for Payer: UnitedHealthcare Commercial	$133.28

RF NEEDLE 100MM 10MM 20GA

Facility

$266.55

Hospital Charge Code	270650125
Hospital Revenue Code	272
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$39.98
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

RF NEEDLE 100MM 5MM

Facility

$300.00

Hospital Charge Code	270680979
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

RF NEEDLE 100MM 5MM

Facility

$300.00

Hospital Charge Code	270680979
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

RF TITER

Facility

$68.00

Service Code	HCPCS 86431
Hospital Charge Code	38476034
Hospital Revenue Code	302
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.37
Rate for Payer: Aetna Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.77
Rate for Payer: Cigna Commercial	$5.67
Rate for Payer: Cigna Medicare Advantage	$2.83
Rate for Payer: Clover Medicare Advantage	$5.39
Rate for Payer: EmblemHealth Commercial	$17.01
Rate for Payer: Humana Medicare Advantage	$5.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.01
Rate for Payer: Wellcare Medicare Advantage	$5.67

RF TITER

Facility

$68.00

Service Code	HCPCS 86431
Hospital Charge Code	38476034
Hospital Revenue Code	302
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.20

RGT-POTASSIUM/K+/5 PK/250 SLDS

Facility

$128.70

Hospital Charge Code	270652642
Hospital Revenue Code	272
Min. Negotiated Rate	$16.73
Max. Negotiated Rate	$64.35
Rate for Payer: Aetna Commercial	$38.61
Rate for Payer: Aetna Medicare Advantage	$38.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.82
Rate for Payer: Cigna Commercial	$64.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.73
Rate for Payer: Oxford Commercial	$64.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.30
Rate for Payer: UnitedHealthcare Commercial	$64.35

RGT-POTASSIUM/K+/5 PK/250 SLDS

Facility

$128.70

Hospital Charge Code	270652642
Hospital Revenue Code	272
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$19.30

RH ANTIBODY TITER

Facility

$117.65

Service Code	HCPCS 86886
Hospital Charge Code	3100674
Hospital Revenue Code	300
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

RH ANTIBODY TITER

Facility

$117.65

Service Code	HCPCS 86886
Hospital Charge Code	3100674
Hospital Revenue Code	300
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$405.73
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	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$405.73
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	$15.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
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

RH BLOOD TYPING

Facility

$141.40

Service Code	HCPCS 86901
Hospital Charge Code	38471071
Hospital Revenue Code	309
Min. Negotiated Rate	$21.21
Max. Negotiated Rate	$21.21
Rate for Payer: Qualcare PPO/HMO/WC	$21.21

RH BLOOD TYPING

Facility

$141.40

Service Code	HCPCS 86901
Hospital Charge Code	38471071
Hospital Revenue Code	309
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.69
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$1.50
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.21
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.17
Rate for Payer: Wellcare Medicare Advantage	$2.99

RHC/LHC/LV CORONARY ANGIO

Facility

$12,026.00

Service Code	HCPCS 93461
Hospital Charge Code	366893461
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

RHC/LHC/LV CORONARY ANGIO

Facility

$12,026.00

Service Code	HCPCS 93461
Hospital Charge Code	366893461
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

Know your out-of-pocket cost for care.

All Charges