Heights University Hospital

All Charges

Charge

Type

Setting

Price

RMVL OF SPINL LAMINA SGL THRCC

Facility

$47,548.90

Service Code	HCPCS 63046
Hospital Charge Code	16001021
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RMVL OF SPNL LMNA LMBR,1-2VERT

Facility

$47,548.90

Service Code	HCPCS 63005
Hospital Charge Code	16000769
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RMVL OF SPNL LMNA LMBR,1-2VERT

Facility

$47,548.90

Service Code	HCPCS 63005
Hospital Charge Code	16000769
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

RMVL TIS XPNDR WO INSJ IMPLT

Facility

$11,452.64

Service Code	HCPCS 11971
Hospital Charge Code	16000595
Hospital Revenue Code	360
Min. Negotiated Rate	$1,717.90
Max. Negotiated Rate	$1,717.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90

RMVL TIS XPNDR WO INSJ IMPLT

Facility

$11,452.64

Service Code	HCPCS 11971
Hospital Charge Code	16000595
Hospital Revenue Code	360
Min. Negotiated Rate	$1,488.84
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,435.79
Rate for Payer: Aetna Medicare Advantage	$3,435.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,920.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,920.42
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	$2,920.42
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.84
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

RMVL W REINSERT DRUG IMPL DEL

Facility

$1,670.85

Service Code	HCPCS 11983
Hospital Charge Code	412311983
Hospital Revenue Code	361
Min. Negotiated Rate	$217.21
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$501.25
Rate for Payer: Aetna Medicare Advantage	$501.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$426.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$426.07
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	$426.07
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.21
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.63
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RMVL W REINSERT DRUG IMPL DEL

Facility

$1,670.85

Service Code	HCPCS 11983
Hospital Charge Code	412311983
Hospital Revenue Code	361
Min. Negotiated Rate	$250.63
Max. Negotiated Rate	$250.63
Rate for Payer: Qualcare PPO/HMO/WC	$250.63

RMV OR BIVLVNG GNTLT BT

Facility

$288.00

Service Code	HCPCS 29700
Hospital Charge Code	94186080
Hospital Revenue Code	361
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

RMV OR BIVLVNG GNTLT BT

Facility

$288.00

Service Code	HCPCS 29700
Hospital Charge Code	94186080
Hospital Revenue Code	361
Min. Negotiated Rate	$37.44
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$86.40
Rate for Payer: Aetna Medicare Advantage	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.44
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	$73.44
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

[RMYPCOGU;;OMR 400MG TABS****

Facility

$1.30

Hospital Charge Code	6027031
Hospital Revenue Code	251
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

[RMYPCOGU;;OMR 400MG TABS****

Facility

$1.30

Hospital Charge Code	6027031
Hospital Revenue Code	251
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.65
Rate for Payer: Aetna Commercial	$0.39
Rate for Payer: Aetna Medicare Advantage	$0.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.33
Rate for Payer: Cigna Commercial	$0.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.17
Rate for Payer: Oxford Commercial	$0.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.65

RNA POLYMERASE III ANTIBODY

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
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	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

RNA POLYMERASE III ANTIBODY

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RNGD STC 18MCROCATH .018 150cm

Facility

$2,240.00

Hospital Charge Code	2709003623
Hospital Revenue Code	272
Min. Negotiated Rate	$291.20
Max. Negotiated Rate	$1,120.00
Rate for Payer: Aetna Commercial	$672.00
Rate for Payer: Aetna Medicare Advantage	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.20
Rate for Payer: Cigna Commercial	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.20
Rate for Payer: Oxford Commercial	$1,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00
Rate for Payer: UnitedHealthcare Commercial	$1,120.00

RNGD STC 18MCROCATH .018 150cm

Facility

$2,240.00

Hospital Charge Code	2709003623
Hospital Revenue Code	272
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$336.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00

RNL NEUROLYSIS W USE OF OP MIC

Facility

$7,922.15

Service Code	HCPCS 64727
Hospital Charge Code	16000462
Hospital Revenue Code	360
Min. Negotiated Rate	$157.57
Max. Negotiated Rate	$2,376.64
Rate for Payer: Aetna Commercial	$2,376.64
Rate for Payer: Aetna Medicare Advantage	$2,376.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,020.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,020.15
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	$2,020.15
Rate for Payer: Cigna Commercial	$157.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.32
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RNL NEUROLYSIS W USE OF OP MIC

Facility

$7,922.15

Service Code	HCPCS 64727
Hospital Charge Code	16000462
Hospital Revenue Code	360
Min. Negotiated Rate	$1,188.32
Max. Negotiated Rate	$1,188.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.32

RNP ANTIBODY

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900449
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RNP ANTIBODY

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900449
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
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	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

ROBAX/500MG/TAB

Facility

$4.00

Hospital Charge Code	60634700
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ROBAX/500MG/TAB

Facility

$4.00

Hospital Charge Code	60634700
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

ROBAXIN-750/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633826
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

ROBAXIN-750/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633827
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

ROBAXIN-750/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633827
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ROBAXIN-750/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633826
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges