Heights University Hospital

All Charges

Charge

Type

Setting

Price

STREPTOKINASE INJ 750,000U

Facility

$1,471.55

Hospital Charge Code	60627540
Hospital Revenue Code	636
Min. Negotiated Rate	$220.73
Max. Negotiated Rate	$735.77
Rate for Payer: Aetna Commercial	$441.46
Rate for Payer: Aetna Medicare Advantage	$441.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.25
Rate for Payer: Cigna Commercial	$735.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.12
Rate for Payer: Qualcare PPO/HMO/WC	$220.73

STREPTOKINASE INJ 750,000U

Facility

$1,471.55

Hospital Charge Code	60627540
Hospital Revenue Code	636
Min. Negotiated Rate	$220.73
Max. Negotiated Rate	$356.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.12
Rate for Payer: Qualcare PPO/HMO/WC	$220.73

STREPTOMYCIN SULFATE/1G

Facility

$131.00

Hospital Charge Code	60634822
Hospital Revenue Code	250
Min. Negotiated Rate	$17.03
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$65.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$65.50

STREPTOMYCIN SULFATE/1G

Facility

$131.00

Hospital Charge Code	60634822
Hospital Revenue Code	250
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

STREPTOMYCIN SULFATE 1 GM VIAL

Facility

$150.75

Service Code	HCPCS J3000
Hospital Charge Code	6063943246
Hospital Revenue Code	636
Min. Negotiated Rate	$22.61
Max. Negotiated Rate	$36.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

STREPTOMYCIN SULFATE 1 GM VIAL

Facility

$150.75

Service Code	HCPCS J3000
Hospital Charge Code	6063943246
Hospital Revenue Code	636
Min. Negotiated Rate	$22.61
Max. Negotiated Rate	$45.23
Rate for Payer: Aetna Commercial	$45.23
Rate for Payer: Aetna Medicare Advantage	$45.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.44
Rate for Payer: Cigna Commercial	$40.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

STREPTOZOCIN 10 MG INJ

Facility

$293.00

Hospital Charge Code	60634187
Hospital Revenue Code	636
Min. Negotiated Rate	$43.95
Max. Negotiated Rate	$146.50
Rate for Payer: Aetna Commercial	$87.90
Rate for Payer: Aetna Medicare Advantage	$87.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.72
Rate for Payer: Cigna Commercial	$146.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.91
Rate for Payer: Qualcare PPO/HMO/WC	$43.95

STREPTOZOCIN 10 MG INJ

Facility

$293.00

Hospital Charge Code	60634187
Hospital Revenue Code	636
Min. Negotiated Rate	$43.95
Max. Negotiated Rate	$70.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.91
Rate for Payer: Qualcare PPO/HMO/WC	$43.95

STREPTOZOCIN 1 G INJ

Facility

$744.60

Hospital Charge Code	60627407
Hospital Revenue Code	636
Min. Negotiated Rate	$111.69
Max. Negotiated Rate	$372.30
Rate for Payer: Aetna Commercial	$223.38
Rate for Payer: Aetna Medicare Advantage	$223.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.87
Rate for Payer: Cigna Commercial	$372.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.69

STREPTOZOCIN 1 G INJ

Facility

$744.60

Hospital Charge Code	60627407
Hospital Revenue Code	636
Min. Negotiated Rate	$111.69
Max. Negotiated Rate	$180.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.69

STREPTOZOCIN 1GM

Facility

$612.50

Hospital Charge Code	6000228
Hospital Revenue Code	636
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$306.25
Rate for Payer: Aetna Commercial	$183.75
Rate for Payer: Aetna Medicare Advantage	$183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.19
Rate for Payer: Cigna Commercial	$306.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$91.88

STREPTOZOCIN 1GM

Facility

$612.50

Hospital Charge Code	6000228
Hospital Revenue Code	636
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$148.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$91.88

STREPTOZYME

Facility

$141.65

Service Code	HCPCS 86403
Hospital Charge Code	3006731
Hospital Revenue Code	302
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.23
Rate for Payer: Wellcare Medicare Advantage	$11.54

STREPTOZYME

Facility

$141.65

Service Code	HCPCS 86403
Hospital Charge Code	3006731
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

STREPTOZYME SCR W/REFL(SERUM)

Facility

$16.83

Service Code	HCPCS 86403
Hospital Charge Code	397080018
Hospital Revenue Code	302
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.52
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.23
Rate for Payer: Wellcare Medicare Advantage	$11.54

STREPTOZYME SCR W/REFL(SERUM)

Facility

$16.83

Service Code	HCPCS 86403
Hospital Charge Code	397080018
Hospital Revenue Code	302
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.52

STRESS 600/TAB

Facility

$3.00

Hospital Charge Code	60633923
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

STRESS 600/TAB

Facility

$3.00

Hospital Charge Code	60633923
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	5307010
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74117026
Hospital Revenue Code	483
Min. Negotiated Rate	$572.70
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74115026
Hospital Revenue Code	483
Min. Negotiated Rate	$572.70
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74116026
Hospital Revenue Code	483
Min. Negotiated Rate	$572.70
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

STRESS ECHO

Facility

$2,389.00

Service Code	HCPCS 93350
Hospital Charge Code	36540012
Hospital Revenue Code	483
Min. Negotiated Rate	$358.35
Max. Negotiated Rate	$358.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.35

STRESS ECHO

Facility

$2,389.00

Service Code	HCPCS 93350
Hospital Charge Code	36540012
Hospital Revenue Code	483
Min. Negotiated Rate	$310.57
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$716.70
Rate for Payer: Aetna Medicare Advantage	$716.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.20
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.57
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$358.35
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	5307010
Hospital Revenue Code	483
Min. Negotiated Rate	$572.70
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

Know your out-of-pocket cost for care.

All Charges