Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROUTER TAPER

Facility

$640.00

Hospital Charge Code	270673070
Hospital Revenue Code	272
Min. Negotiated Rate	$83.20
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$192.00
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.20
Rate for Payer: Oxford Commercial	$320.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00
Rate for Payer: UnitedHealthcare Commercial	$320.00

ROUTER TAPER 1.5 MM

Facility

$560.00

Hospital Charge Code	270687582
Hospital Revenue Code	272
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$280.00

ROUTER TAPER 1.5 MM

Facility

$560.00

Hospital Charge Code	270687582
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROUTER TAPERED 2.3 MM

Facility

$577.55

Hospital Charge Code	270687583
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$173.26
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$288.77
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$288.77

ROUTER TAPERED 2.3 MM

Facility

$577.55

Hospital Charge Code	270687583
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

ROUTINE VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	3400073
Hospital Revenue Code	300
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

ROUTINE VENIPUNCTURE

Facility

$390.00

Service Code	HCPCS 36415
Hospital Charge Code	412336415
Hospital Revenue Code	300
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: Cigna Medicare Advantage	$4.67
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
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	$9.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.90
Rate for Payer: Wellcare Medicare Advantage	$9.34

ROUTINE VENIPUNCTURE

Facility

$390.00

Service Code	HCPCS 36415
Hospital Charge Code	412336415
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ROUTINE VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	3400073
Hospital Revenue Code	300
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: Cigna Medicare Advantage	$4.67
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.90
Rate for Payer: Wellcare Medicare Advantage	$9.34

ROWASA/4GM/60ML

Facility

$303.00

Hospital Charge Code	60633850
Hospital Revenue Code	250
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

ROWASA/4GM/60ML

Facility

$303.00

Hospital Charge Code	60633850
Hospital Revenue Code	250
Min. Negotiated Rate	$39.39
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$90.90
Rate for Payer: Aetna Medicare Advantage	$90.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.39
Rate for Payer: Oxford Commercial	$151.50
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$151.50

ROWASA SUPP

Facility

$15.00

Hospital Charge Code	60634990
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

ROWASA SUPP

Facility

$15.00

Hospital Charge Code	60634990
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

ROXANOL-T ORAL SOL 20MG/M

Facility

$5.03

Service Code	NDC 406800330
Hospital Charge Code	60635311
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ROXANOL-T ORAL SOL 20MG/M

Facility

$5.03

Service Code	NDC 406800330
Hospital Charge Code	60635311
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.52
Rate for Payer: Aetna Commercial	$1.51
Rate for Payer: Aetna Medicare Advantage	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.28
Rate for Payer: Cigna Commercial	$2.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.52

RPLC GTUBE NO REVJ TRC

Facility

$1,286.08

Service Code	HCPCS 43762
Hospital Charge Code	16000344
Hospital Revenue Code	360
Min. Negotiated Rate	$167.19
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$385.82
Rate for Payer: Aetna Medicare Advantage	$385.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.95
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	$327.95
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.19
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.91
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RPLC GTUBE NO REVJ TRC

Facility

$1,286.08

Service Code	HCPCS 43762
Hospital Charge Code	16000344
Hospital Revenue Code	360
Min. Negotiated Rate	$192.91
Max. Negotiated Rate	$192.91
Rate for Payer: Qualcare PPO/HMO/WC	$192.91

RP LOCALTUM 2+AREA 1+D IMG

Facility

$2,155.44

Service Code	HCPCS 78801
Hospital Charge Code	406078801
Hospital Revenue Code	341
Min. Negotiated Rate	$323.32
Max. Negotiated Rate	$323.32
Rate for Payer: Qualcare PPO/HMO/WC	$323.32

RP LOCALTUM 2+AREA 1+D IMG

Facility

$2,155.44

Service Code	HCPCS 78801
Hospital Charge Code	406078801
Hospital Revenue Code	341
Min. Negotiated Rate	$280.21
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$646.63
Rate for Payer: Aetna Medicare Advantage	$646.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$549.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$549.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$281.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$549.64
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.21
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$323.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RP LOCAL TUM SPECT 2 AREAS

Facility

$7,449.00

Service Code	HCPCS 78831
Hospital Charge Code	406078831
Hospital Revenue Code	341
Min. Negotiated Rate	$1,117.35
Max. Negotiated Rate	$1,117.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.35

RP LOCAL TUM SPECT 2 AREAS

Facility

$7,449.00

Service Code	HCPCS 78831
Hospital Charge Code	406078831
Hospital Revenue Code	341
Min. Negotiated Rate	$616.02
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$2,234.70
Rate for Payer: Aetna Medicare Advantage	$2,234.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,899.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,899.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,899.49
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.37
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.35
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RP LOCAL TUM SPECT W/CT 1

Facility

$7,449.00

Service Code	HCPCS 78830
Hospital Charge Code	406078830
Hospital Revenue Code	341
Min. Negotiated Rate	$425.31
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$2,234.70
Rate for Payer: Aetna Medicare Advantage	$2,234.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,899.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,899.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,899.49
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.37
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.35
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RP LOCAL TUM SPECT W/CT 1

Facility

$7,449.00

Service Code	HCPCS 78830
Hospital Charge Code	406078830
Hospital Revenue Code	341
Min. Negotiated Rate	$1,117.35
Max. Negotiated Rate	$1,117.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.35

RP LOCAL TUM SPECT W/CT 2

Facility

$8,450.06

Service Code	HCPCS 78832
Hospital Charge Code	406078832
Hospital Revenue Code	341
Min. Negotiated Rate	$802.45
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$2,535.02
Rate for Payer: Aetna Medicare Advantage	$2,535.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,154.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,154.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,154.77
Rate for Payer: Cigna Commercial	$3,405.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,098.51
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.51
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RP LOCAL TUM SPECT W/CT 2

Facility

$8,450.06

Service Code	HCPCS 78832
Hospital Charge Code	406078832
Hospital Revenue Code	341
Min. Negotiated Rate	$1,267.51
Max. Negotiated Rate	$1,267.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.51

Know your out-of-pocket cost for care.

All Charges