Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

BARD MESH 3X6

Facility

$285.50

Service Code	HCPCS C1781
Hospital Charge Code	270600193
Hospital Revenue Code	278
Min. Negotiated Rate	$42.83
Max. Negotiated Rate	$69.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.09
Rate for Payer: Qualcare PPO/HMO/WC	$42.83

BARD MESH 3X6

Facility

$285.50

Service Code	HCPCS C1781
Hospital Charge Code	270600193
Hospital Revenue Code	278
Min. Negotiated Rate	$42.83
Max. Negotiated Rate	$142.75
Rate for Payer: Aetna Commercial	$85.65
Rate for Payer: Aetna Medicare Advantage	$85.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.80
Rate for Payer: Cigna Commercial	$142.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.09
Rate for Payer: Qualcare PPO/HMO/WC	$42.83

BARD MESH 6X6

Facility

$394.50

Service Code	HCPCS C1781
Hospital Charge Code	270691390
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$197.25
Rate for Payer: Aetna Commercial	$118.35
Rate for Payer: Aetna Medicare Advantage	$118.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.60
Rate for Payer: Cigna Commercial	$197.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.47
Rate for Payer: Qualcare PPO/HMO/WC	$59.17

BARD MESH 6X6

Facility

$394.50

Service Code	HCPCS C1781
Hospital Charge Code	270691390
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.47
Rate for Payer: Qualcare PPO/HMO/WC	$59.17

BARD SLING ALIGN S SUPRAPUBIC

Facility

$1,597.20

Service Code	HCPCS C1771
Hospital Charge Code	270661718
Hospital Revenue Code	278
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$386.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.52
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

BARD SLING ALIGN S SUPRAPUBIC

Facility

$1,597.20

Service Code	HCPCS C1771
Hospital Charge Code	270661718
Hospital Revenue Code	278
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$798.60
Rate for Payer: Aetna Commercial	$479.16
Rate for Payer: Aetna Medicare Advantage	$479.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.29
Rate for Payer: Cigna Commercial	$798.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.52
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

BARD TUBING

Facility

$459.00

Hospital Charge Code	60635887
Hospital Revenue Code	272
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$68.85
Rate for Payer: Qualcare PPO/HMO/WC	$68.85

BARD TUBING

Facility

$459.00

Hospital Charge Code	60635887
Hospital Revenue Code	272
Min. Negotiated Rate	$59.67
Max. Negotiated Rate	$229.50
Rate for Payer: Aetna Commercial	$137.70
Rate for Payer: Aetna Medicare Advantage	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.05
Rate for Payer: Cigna Commercial	$229.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.67
Rate for Payer: Oxford Commercial	$229.50
Rate for Payer: Qualcare PPO/HMO/WC	$68.85
Rate for Payer: UnitedHealthcare Commercial	$229.50

BARD WOVEN FILIFORM STRAIGHT

Facility

$248.00

Hospital Charge Code	270332491
Hospital Revenue Code	272
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.40
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$124.00

BARD WOVEN FILIFORM STRAIGHT

Facility

$248.00

Hospital Charge Code	270332491
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

BARE WIRE FILT DEL 315 2244031

Facility

$800.00

Hospital Charge Code	270643423V
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

BARE WIRE FILT DEL 315 2244031

Facility

$800.00

Hospital Charge Code	270643423V
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

BARE WIRE FILT DEL 315 244031

Facility

$800.00

Hospital Charge Code	270643423C
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

BARE WIRE FILT DEL 315 244031

Facility

$800.00

Hospital Charge Code	270643423C
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

BARIATRIC BACK AND SEAT EXT (S

Facility

$21,852.90

Hospital Charge Code	270663230
Hospital Revenue Code	270
Min. Negotiated Rate	$3,277.93
Max. Negotiated Rate	$3,277.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,277.93

BARIATRIC BACK AND SEAT EXT (S

Facility

$21,852.90

Hospital Charge Code	270663230
Hospital Revenue Code	270
Min. Negotiated Rate	$2,840.88
Max. Negotiated Rate	$10,926.45
Rate for Payer: Aetna Commercial	$6,555.87
Rate for Payer: Aetna Medicare Advantage	$6,555.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,572.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,572.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,572.49
Rate for Payer: Cigna Commercial	$10,926.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,840.88
Rate for Payer: Oxford Commercial	$10,926.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,277.93
Rate for Payer: UnitedHealthcare Commercial	$10,926.45

BARIATRIC PADS

Facility

$875.00

Hospital Charge Code	270692091
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

BARIATRIC PADS

Facility

$875.00

Hospital Charge Code	270692091
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BARICITINIB 2MG TABLET

Facility

$494.46

Service Code	NDC 2418230
Hospital Charge Code	606390390
Hospital Revenue Code	250
Min. Negotiated Rate	$64.28
Max. Negotiated Rate	$247.23
Rate for Payer: Aetna Commercial	$148.34
Rate for Payer: Aetna Medicare Advantage	$148.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.09
Rate for Payer: Cigna Commercial	$247.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.28
Rate for Payer: Oxford Commercial	$247.23
Rate for Payer: Qualcare PPO/HMO/WC	$74.17
Rate for Payer: UnitedHealthcare Commercial	$247.23

BARICITINIB 2MG TABLET

Facility

$494.46

Service Code	NDC 2418230
Hospital Charge Code	606390390
Hospital Revenue Code	250
Min. Negotiated Rate	$74.17
Max. Negotiated Rate	$74.17
Rate for Payer: Qualcare PPO/HMO/WC	$74.17

BARIUM ENEMA

Facility

$1,041.00

Service Code	HCPCS 74270
Hospital Charge Code	94061145
Hospital Revenue Code	320
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$312.30
Rate for Payer: Aetna Medicare Advantage	$312.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.45
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.33
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.15
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

BARIUM ENEMA

Facility

$1,041.00

Service Code	HCPCS 74270
Hospital Charge Code	94061145
Hospital Revenue Code	320
Min. Negotiated Rate	$156.15
Max. Negotiated Rate	$156.15
Rate for Payer: Qualcare PPO/HMO/WC	$156.15

BARIUM ENEMA (BARIUMKIT)

Facility

$95.14

Service Code	NDC 32909080401
Hospital Charge Code	606380032
Hospital Revenue Code	250
Min. Negotiated Rate	$12.37
Max. Negotiated Rate	$47.57
Rate for Payer: Aetna Commercial	$28.54
Rate for Payer: Aetna Medicare Advantage	$28.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.26
Rate for Payer: Cigna Commercial	$47.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.37
Rate for Payer: Oxford Commercial	$47.57
Rate for Payer: Qualcare PPO/HMO/WC	$14.27
Rate for Payer: UnitedHealthcare Commercial	$47.57

BARIUM ENEMA (BARIUMKIT)

Facility

$95.14

Service Code	NDC 32909080401
Hospital Charge Code	606380032
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$14.27
Rate for Payer: Qualcare PPO/HMO/WC	$14.27

Know your out-of-pocket cost for care.

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