Heights University Hospital

All Charges

Charge

Type

Setting

Price

BANK CRAFTSTICK BARREL CS507J

Facility

$4.80

Hospital Charge Code	270645737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

BANK CRAFTSTICK BARREL CS507J

Facility

$4.80

Hospital Charge Code	270645737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$1.44
Rate for Payer: Aetna Medicare Advantage	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$2.40

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

BARBITURATES ID & QN 1

Facility

$78.70

Service Code	HCPCS 80345
Hospital Charge Code	39900047
Hospital Revenue Code	301
Min. Negotiated Rate	$11.80
Max. Negotiated Rate	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$11.80

BARBITURATES ID & QN 1

Facility

$78.70

Service Code	HCPCS 80345
Hospital Charge Code	39900047
Hospital Revenue Code	301
Min. Negotiated Rate	$10.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.61
Rate for Payer: Aetna Medicare Advantage	$23.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.07
Rate for Payer: Cigna Commercial	$39.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

BARBITURATES (QUANT URINE)

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3000395
Hospital Revenue Code	301
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

BARBITURATES (QUANT URINE)

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3000395
Hospital Revenue Code	301
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.77
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$114.00

BARBITURATES (QUANT) URINE***

Facility

$57.00

Hospital Charge Code	3010394
Hospital Revenue Code	309
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BARBITURATES (QUANT) URINE***

Facility

$57.00

Hospital Charge Code	3010394
Hospital Revenue Code	309
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$114.00

BARBITURATES, URINE

Facility

$298.20

Service Code	HCPCS 80345
Hospital Charge Code	38472131
Hospital Revenue Code	301
Min. Negotiated Rate	$44.73
Max. Negotiated Rate	$44.73
Rate for Payer: Qualcare PPO/HMO/WC	$44.73

BARBITURATES, URINE

Facility

$298.20

Service Code	HCPCS 80345
Hospital Charge Code	38472131
Hospital Revenue Code	301
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$149.10
Rate for Payer: Aetna Commercial	$89.46
Rate for Payer: Aetna Medicare Advantage	$89.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.04
Rate for Payer: Cigna Commercial	$149.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

BAR CONNECT 5.0X300 39394

Facility

$127.75

Hospital Charge Code	270634839
Hospital Revenue Code	278
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$63.88
Rate for Payer: Aetna Commercial	$38.33
Rate for Payer: Aetna Medicare Advantage	$38.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.58
Rate for Payer: Cigna Commercial	$63.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.92
Rate for Payer: Qualcare PPO/HMO/WC	$19.16

BAR CONNECT 5.0X300 39394

Facility

$127.75

Hospital Charge Code	270634839
Hospital Revenue Code	278
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$30.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.92
Rate for Payer: Qualcare PPO/HMO/WC	$19.16

BAR CONNECTING 4.0 X 220MM

Facility

$225.00

Hospital Charge Code	270661252
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BAR CONNECTING 4.0 X 220MM

Facility

$225.00

Hospital Charge Code	270661252
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

BAR CRBN 11MM X 250MM

Facility

$1,457.50

Service Code	HCPCS C1713
Hospital Charge Code	270704154
Hospital Revenue Code	278
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$728.75
Rate for Payer: Aetna Commercial	$437.25
Rate for Payer: Aetna Medicare Advantage	$437.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.66
Rate for Payer: Cigna Commercial	$728.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

BAR CRBN 11MM X 250MM

Facility

$1,457.50

Service Code	HCPCS C1713
Hospital Charge Code	270704154
Hospital Revenue Code	278
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$352.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.71
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

BARD 3D MAX MESH LARGE

Facility

$1,237.50

Service Code	HCPCS C1781
Hospital Charge Code	270685595
Hospital Revenue Code	278
Min. Negotiated Rate	$185.62
Max. Negotiated Rate	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.48
Rate for Payer: Qualcare PPO/HMO/WC	$185.62

BARD 3D MAX MESH LARGE

Facility

$1,237.50

Service Code	HCPCS C1781
Hospital Charge Code	270685595
Hospital Revenue Code	278
Min. Negotiated Rate	$185.62
Max. Negotiated Rate	$618.75
Rate for Payer: Aetna Commercial	$371.25
Rate for Payer: Aetna Medicare Advantage	$371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.56
Rate for Payer: Cigna Commercial	$618.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.48
Rate for Payer: Qualcare PPO/HMO/WC	$185.62

BARD AET SILICONE PEG GUIDE***

Facility

$531.00

Hospital Charge Code	2300572
Hospital Revenue Code	279
Min. Negotiated Rate	$69.03
Max. Negotiated Rate	$265.50
Rate for Payer: Aetna Commercial	$159.30
Rate for Payer: Aetna Medicare Advantage	$159.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.41
Rate for Payer: Cigna Commercial	$265.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.03
Rate for Payer: Oxford Commercial	$265.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.65
Rate for Payer: UnitedHealthcare Commercial	$265.50

BARD AET SILICONE PEG GUIDE***

Facility

$531.00

Hospital Charge Code	2300572
Hospital Revenue Code	279
Min. Negotiated Rate	$79.65
Max. Negotiated Rate	$79.65
Rate for Payer: Qualcare PPO/HMO/WC	$79.65

BARD MARLEX MESH PLUG

Facility

$489.00

Hospital Charge Code	270335369
Hospital Revenue Code	278
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$118.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.34
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

BARD MARLEX MESH PLUG

Facility

$489.00

Hospital Charge Code	270335369
Hospital Revenue Code	278
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$244.50
Rate for Payer: Aetna Commercial	$146.70
Rate for Payer: Aetna Medicare Advantage	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.69
Rate for Payer: Cigna Commercial	$244.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.34
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

BARD MESH 2X4

Facility

$309.50

Service Code	HCPCS C1781
Hospital Charge Code	270691387
Hospital Revenue Code	278
Min. Negotiated Rate	$46.42
Max. Negotiated Rate	$154.75
Rate for Payer: Aetna Commercial	$92.85
Rate for Payer: Aetna Medicare Advantage	$92.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.92
Rate for Payer: Cigna Commercial	$154.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.90
Rate for Payer: Qualcare PPO/HMO/WC	$46.42

Know your out-of-pocket cost for care.

All Charges