Heights University Hospital

All Charges

Charge

Type

Setting

Price

BARIUM ENEMA DBL CONT

Facility

$1,528.00

Service Code	HCPCS 74280
Hospital Charge Code	94061147
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$458.40
Rate for Payer: Aetna Medicare Advantage	$458.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.64
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

BARIUM ENEMA DBL CONT

Facility

$1,528.00

Service Code	HCPCS 74280
Hospital Charge Code	94061147
Hospital Revenue Code	320
Min. Negotiated Rate	$229.20
Max. Negotiated Rate	$229.20
Rate for Payer: Qualcare PPO/HMO/WC	$229.20

BARIUM SULFATE 6GM/VL 1730

Facility

$380.00

Hospital Charge Code	270615177
Hospital Revenue Code	272
Min. Negotiated Rate	$49.40
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.40
Rate for Payer: Oxford Commercial	$190.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$190.00

BARIUM SULFATE 6GM/VL 1730

Facility

$380.00

Hospital Charge Code	270615177
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

BARIUM SULFATE LIQUID POLIBAR

Facility

$72.89

Hospital Charge Code	270651458
Hospital Revenue Code	270
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$36.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$36.45

BARIUM SULFATE LIQUID POLIBAR

Facility

$72.89

Hospital Charge Code	270651458
Hospital Revenue Code	270
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

BARIUM SULFATE SUSP

Facility

$451.78

Service Code	NDC 32909016802
Hospital Charge Code	606390050
Hospital Revenue Code	250
Min. Negotiated Rate	$58.73
Max. Negotiated Rate	$225.89
Rate for Payer: Aetna Commercial	$135.53
Rate for Payer: Aetna Medicare Advantage	$135.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.20
Rate for Payer: Cigna Commercial	$225.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.73
Rate for Payer: Oxford Commercial	$225.89
Rate for Payer: Qualcare PPO/HMO/WC	$67.77
Rate for Payer: UnitedHealthcare Commercial	$225.89

BARIUM SULFATE SUSP

Facility

$451.78

Service Code	NDC 32909016802
Hospital Charge Code	606390050
Hospital Revenue Code	250
Min. Negotiated Rate	$67.77
Max. Negotiated Rate	$67.77
Rate for Payer: Qualcare PPO/HMO/WC	$67.77

BARIUM SULFATE SUSPENSION 450M

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60631127
Hospital Revenue Code	250
Min. Negotiated Rate	$94.65
Max. Negotiated Rate	$364.05
Rate for Payer: Aetna Commercial	$218.43
Rate for Payer: Aetna Medicare Advantage	$218.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.66
Rate for Payer: Cigna Commercial	$364.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.65
Rate for Payer: Oxford Commercial	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$109.21
Rate for Payer: UnitedHealthcare Commercial	$364.05

BARIUM SULFATE SUSPENSION 450M

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60631127
Hospital Revenue Code	250
Min. Negotiated Rate	$109.21
Max. Negotiated Rate	$109.21
Rate for Payer: Qualcare PPO/HMO/WC	$109.21

BAR KLS ERICH ARCH 38-690-00

Facility

$178.45

Hospital Charge Code	270612047
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

BAR KLS ERICH ARCH 38-690-00

Facility

$178.45

Hospital Charge Code	270612047
Hospital Revenue Code	272
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$53.53
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.20
Rate for Payer: Oxford Commercial	$89.22
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$89.22

BARLEY (F6) IGE

Facility

$35.85

Service Code	HCPCS 86003
Hospital Charge Code	39900187
Hospital Revenue Code	305
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

BARLEY (F6) IGE

Facility

$35.85

Service Code	HCPCS 86003
Hospital Charge Code	39900187
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

BARREL BUR 5.0MM 12 FLUTE

Facility

$190.00

Hospital Charge Code	270657642
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

BARREL BUR 5.0MM 12 FLUTE

Facility

$190.00

Hospital Charge Code	270657642
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

BARREL BUR 5.5MM

Facility

$200.00

Hospital Charge Code	270668405
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

BARREL BUR 5.5MM

Facility

$200.00

Hospital Charge Code	270668405
Hospital Revenue Code	272
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$100.00

BARRICAID DEVICE

Facility

$30,000.00

Service Code	HCPCS C9757
Hospital Charge Code	270705080
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

BARRICAID DEVICE

Facility

$30,000.00

Service Code	HCPCS C9757
Hospital Charge Code	270507018
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

BARRICAID DEVICE

Facility

$30,000.00

Service Code	HCPCS C9757
Hospital Charge Code	270705080
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

BARRICAID DEVICE

Facility

$30,000.00

Service Code	HCPCS C9757
Hospital Charge Code	270507018
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

BARRIER ABSOR ADHES 3X4 4350**

Facility

$476.00

Hospital Charge Code	1604701
Hospital Revenue Code	272
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$71.40

BARRIER ABSOR ADHES 3X4 4350**

Facility

$476.00

Hospital Charge Code	1604701
Hospital Revenue Code	272
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$238.00
Rate for Payer: Aetna Commercial	$142.80
Rate for Payer: Aetna Medicare Advantage	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.38
Rate for Payer: Cigna Commercial	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.88
Rate for Payer: Oxford Commercial	$238.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Commercial	$238.00

BARRIER INCISE DRAPE 10 x 16

Facility

$48.00

Hospital Charge Code	270331785
Hospital Revenue Code	272
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

Know your out-of-pocket cost for care.

All Charges