Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIZER WMT FLEX TOE REG 4460105

Facility

$341.65

Hospital Charge Code	270622822
Hospital Revenue Code	272
Min. Negotiated Rate	$44.41
Max. Negotiated Rate	$170.82
Rate for Payer: Aetna Commercial	$102.50
Rate for Payer: Aetna Medicare Advantage	$102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.12
Rate for Payer: Cigna Commercial	$170.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.41
Rate for Payer: Oxford Commercial	$170.82
Rate for Payer: Qualcare PPO/HMO/WC	$51.25
Rate for Payer: UnitedHealthcare Commercial	$170.82

SIZER WMT FLEX TOE REG 4460105

Facility

$341.65

Hospital Charge Code	270622822
Hospital Revenue Code	272
Min. Negotiated Rate	$51.25
Max. Negotiated Rate	$51.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.25

SIZING CATH PIGTAIL 5F 100CM

Facility

$3,431.25

Hospital Charge Code	270670896
Hospital Revenue Code	272
Min. Negotiated Rate	$514.69
Max. Negotiated Rate	$514.69
Rate for Payer: Qualcare PPO/HMO/WC	$514.69

SIZING CATH PIGTAIL 5F 100CM

Facility

$3,431.25

Hospital Charge Code	270670896
Hospital Revenue Code	272
Min. Negotiated Rate	$446.06
Max. Negotiated Rate	$1,715.62
Rate for Payer: Aetna Commercial	$1,029.38
Rate for Payer: Aetna Medicare Advantage	$1,029.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$874.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$874.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$874.97
Rate for Payer: Cigna Commercial	$1,715.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$446.06
Rate for Payer: Oxford Commercial	$1,715.62
Rate for Payer: Qualcare PPO/HMO/WC	$514.69
Rate for Payer: UnitedHealthcare Commercial	$1,715.62

SJOGREN'S ANTIBODIES-ANTI-SS-A

Facility

$746.00

Service Code	HCPCS 86235
Hospital Charge Code	38476155
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	$96.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.90
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

SJOGREN'S ANTIBODIES-ANTI-SS-A

Facility

$746.00

Service Code	HCPCS 86235
Hospital Charge Code	38476155
Hospital Revenue Code	302
Min. Negotiated Rate	$111.90
Max. Negotiated Rate	$111.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.90

SJORGEN'S AB ANTI SSA/SSB #1

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3006897A
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	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
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

SJORGEN'S AB ANTI SSA/SSB #1

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3006897A
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

SJORGEN'S AB ANTI SSA/SSB #2

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3006897B
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	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
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

SJORGEN'S AB ANTI SSA/SSB #2

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3006897B
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

SKELETAL MUSCLE RELAXANT INJ

Facility

$154.25

Hospital Charge Code	6025050
Hospital Revenue Code	251
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$23.14
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

SKELETAL MUSCLE RELAXANT INJ

Facility

$154.25

Hospital Charge Code	6025050
Hospital Revenue Code	251
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.05
Rate for Payer: Oxford Commercial	$77.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.14
Rate for Payer: UnitedHealthcare Commercial	$77.12

SKIN ARM PROTECTOR TAN

Facility

$36.15

Hospital Charge Code	270649354
Hospital Revenue Code	272
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$18.07
Rate for Payer: Aetna Commercial	$10.85
Rate for Payer: Aetna Medicare Advantage	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.22
Rate for Payer: Cigna Commercial	$18.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.70
Rate for Payer: Oxford Commercial	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$18.07

SKIN ARM PROTECTOR TAN

Facility

$36.15

Hospital Charge Code	270649354
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

SKIN CLEANSER ADULT

Facility

$26.90

Hospital Charge Code	60628317
Hospital Revenue Code	250
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SKIN CLEANSER ADULT

Facility

$26.90

Hospital Charge Code	60628317
Hospital Revenue Code	250
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.45
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.45

SKIN CLEANSER BABY

Facility

$17.95

Hospital Charge Code	60628318
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

SKIN CLEANSER BABY

Facility

$17.95

Hospital Charge Code	60628318
Hospital Revenue Code	250
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.33
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$8.97

SKIN CLOSURE DERMABOND PRINEO

Facility

$1,574.28

Service Code	HCPCS A4649
Hospital Charge Code	270687929
Hospital Revenue Code	272
Min. Negotiated Rate	$236.14
Max. Negotiated Rate	$236.14
Rate for Payer: Qualcare PPO/HMO/WC	$236.14

SKIN CLOSURE DERMABOND PRINEO

Facility

$1,574.28

Service Code	HCPCS A4649
Hospital Charge Code	270687929
Hospital Revenue Code	272
Min. Negotiated Rate	$204.66
Max. Negotiated Rate	$787.14
Rate for Payer: Aetna Commercial	$472.28
Rate for Payer: Aetna Medicare Advantage	$472.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.44
Rate for Payer: Cigna Commercial	$787.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.66
Rate for Payer: Oxford Commercial	$787.14
Rate for Payer: Qualcare PPO/HMO/WC	$236.14
Rate for Payer: UnitedHealthcare Commercial	$787.14

SKIN CLOSURE SYSTEM DERMABOND

Facility

$615.00

Hospital Charge Code	270655959
Hospital Revenue Code	271
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$184.50
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.95
Rate for Payer: Oxford Commercial	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Commercial	$307.50

SKIN CLOSURE SYSTEM DERMABOND

Facility

$615.00

Hospital Charge Code	270655959
Hospital Revenue Code	271
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

SKIN CREAM

Facility

$12.99

Hospital Charge Code	270302495
Hospital Revenue Code	270
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

SKIN CREAM

Facility

$12.99

Hospital Charge Code	270302495
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

SKIN DEBRIDEMENT WITH CC

Facility

$60,861.21

Service Code	MSDRG 571
Min. Negotiated Rate	$18,436.81
Max. Negotiated Rate	$60,861.21
Rate for Payer: Aetna Commercial	$56,969.74
Rate for Payer: Aetna Medicare Advantage	$18,436.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,588.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,588.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,287.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,588.23
Rate for Payer: Cigna Commercial	$36,359.73
Rate for Payer: Cigna Medicare Advantage	$20,287.07
Rate for Payer: Clover Medicare Advantage	$19,272.72
Rate for Payer: EmblemHealth Commercial	$60,861.21
Rate for Payer: Humana Medicare Advantage	$20,895.68
Rate for Payer: Oxford Commercial	$22,723.78
Rate for Payer: UnitedHealthcare Commercial	$25,793.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,287.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21,504.29
Rate for Payer: Wellcare Medicare Advantage	$20,287.07

Know your out-of-pocket cost for care.

All Charges