Heights University Hospital

All Charges

Charge

Type

Setting

Price

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3024M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3234M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3043M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3033M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3037M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3230M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3047M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3230M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3190M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3048M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3024M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3240M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3235M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3080M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3050M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3046M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3234M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	4229M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3046M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$464.40
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.24
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$103.00

BANADAGE CONFORM STRETCH STR4

Facility

$5.00

Hospital Charge Code	270659161
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

BANADAGE CONFORM STRETCH STR4

Facility

$5.00

Hospital Charge Code	270659161
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

BANANA TIT IMP 12X27X14MM 5DEG

Facility

$22,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693943
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

BANANA TIT IMP 12X27X14MM 5DEG

Facility

$22,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693943
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$6,600.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

BANDAGE ACE 2

Facility

$9.65

Hospital Charge Code	270300215
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

BANDAGE ACE 2

Facility

$9.65

Hospital Charge Code	270300215
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

Know your out-of-pocket cost for care.

All Charges