Heights University Hospital

All Charges

Charge

Type

Setting

Price

BASIC METABOLIC

Facility

$365.40

Service Code	HCPCS 80048
Hospital Charge Code	38472014
Hospital Revenue Code	301
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.00
Rate for Payer: Cigna Commercial	$8.46
Rate for Payer: Cigna Medicare Advantage	$4.23
Rate for Payer: Clover Medicare Advantage	$8.04
Rate for Payer: EmblemHealth Commercial	$25.38
Rate for Payer: Humana Medicare Advantage	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.81
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.97
Rate for Payer: Wellcare Medicare Advantage	$8.46

BASIC METABOLIC

Facility

$365.40

Service Code	HCPCS 80048
Hospital Charge Code	38472014
Hospital Revenue Code	301
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$54.81
Rate for Payer: Qualcare PPO/HMO/WC	$54.81

BASIC METABOLIC PANEL 8

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	402080048
Hospital Revenue Code	301
Min. Negotiated Rate	$72.54
Max. Negotiated Rate	$72.54
Rate for Payer: Qualcare PPO/HMO/WC	$72.54

BASIC METABOLIC PANEL 8

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	402080048
Hospital Revenue Code	301
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.00
Rate for Payer: Cigna Commercial	$8.46
Rate for Payer: Cigna Medicare Advantage	$4.23
Rate for Payer: Clover Medicare Advantage	$8.04
Rate for Payer: EmblemHealth Commercial	$25.38
Rate for Payer: Humana Medicare Advantage	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.97
Rate for Payer: Wellcare Medicare Advantage	$8.46

BASIC METABOLIC PROFILE

Facility

$697.90

Service Code	HCPCS 80048
Hospital Charge Code	3004877
Hospital Revenue Code	301
Min. Negotiated Rate	$104.69
Max. Negotiated Rate	$104.69
Rate for Payer: Qualcare PPO/HMO/WC	$104.69

BASIC METABOLIC PROFILE

Facility

$697.90

Service Code	HCPCS 80048
Hospital Charge Code	3004877
Hospital Revenue Code	301
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.00
Rate for Payer: Cigna Commercial	$8.46
Rate for Payer: Cigna Medicare Advantage	$4.23
Rate for Payer: Clover Medicare Advantage	$8.04
Rate for Payer: EmblemHealth Commercial	$25.38
Rate for Payer: Humana Medicare Advantage	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.97
Rate for Payer: Wellcare Medicare Advantage	$8.46

BASIN EMESIS 9 DISP

Facility

$4.00

Hospital Charge Code	270300261
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BASIN EMESIS 9 DISP

Facility

$4.00

Hospital Charge Code	270300261
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

BASIN FOOT **********

Facility

$55.00

Hospital Charge Code	8000721
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

BASIN FOOT **********

Facility

$55.00

Hospital Charge Code	8000721
Hospital Revenue Code	279
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

BASKET 2.4 SEGURA TIP 120 CM 1

Facility

$1,585.55

Hospital Charge Code	270684766
Hospital Revenue Code	272
Min. Negotiated Rate	$206.12
Max. Negotiated Rate	$792.77
Rate for Payer: Aetna Commercial	$475.67
Rate for Payer: Aetna Medicare Advantage	$475.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.32
Rate for Payer: Cigna Commercial	$792.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.12
Rate for Payer: Oxford Commercial	$792.77
Rate for Payer: Qualcare PPO/HMO/WC	$237.83
Rate for Payer: UnitedHealthcare Commercial	$792.77

BASKET 2.4 SEGURA TIP 120 CM 1

Facility

$1,585.55

Hospital Charge Code	270684766
Hospital Revenue Code	272
Min. Negotiated Rate	$237.83
Max. Negotiated Rate	$237.83
Rate for Payer: Qualcare PPO/HMO/WC	$237.83

Basket 3.0F x 120cm x 4

Facility

$1,585.55

Hospital Charge Code	270645386
Hospital Revenue Code	272
Min. Negotiated Rate	$206.12
Max. Negotiated Rate	$792.77
Rate for Payer: Aetna Commercial	$475.67
Rate for Payer: Aetna Medicare Advantage	$475.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.32
Rate for Payer: Cigna Commercial	$792.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.12
Rate for Payer: Oxford Commercial	$792.77
Rate for Payer: Qualcare PPO/HMO/WC	$237.83
Rate for Payer: UnitedHealthcare Commercial	$792.77

Basket 3.0F x 120cm x 4

Facility

$1,585.55

Hospital Charge Code	270645386
Hospital Revenue Code	272
Min. Negotiated Rate	$237.83
Max. Negotiated Rate	$237.83
Rate for Payer: Qualcare PPO/HMO/WC	$237.83

BASKET CAPTURA HELICAL 1.7FR

Facility

$883.05

Hospital Charge Code	270647886
Hospital Revenue Code	272
Min. Negotiated Rate	$132.46
Max. Negotiated Rate	$132.46
Rate for Payer: Qualcare PPO/HMO/WC	$132.46

BASKET CAPTURA HELICAL 1.7FR

Facility

$883.05

Hospital Charge Code	270647886
Hospital Revenue Code	272
Min. Negotiated Rate	$114.80
Max. Negotiated Rate	$441.52
Rate for Payer: Aetna Commercial	$264.92
Rate for Payer: Aetna Medicare Advantage	$264.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.18
Rate for Payer: Cigna Commercial	$441.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.80
Rate for Payer: Oxford Commercial	$441.52
Rate for Payer: Qualcare PPO/HMO/WC	$132.46
Rate for Payer: UnitedHealthcare Commercial	$441.52

BASKET ENGAGE 2.8FRx115cm

Facility

$918.40

Hospital Charge Code	270650763
Hospital Revenue Code	272
Min. Negotiated Rate	$119.39
Max. Negotiated Rate	$459.20
Rate for Payer: Aetna Commercial	$275.52
Rate for Payer: Aetna Medicare Advantage	$275.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.19
Rate for Payer: Cigna Commercial	$459.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.39
Rate for Payer: Oxford Commercial	$459.20
Rate for Payer: Qualcare PPO/HMO/WC	$137.76
Rate for Payer: UnitedHealthcare Commercial	$459.20

BASKET ENGAGE 2.8FRx115cm

Facility

$918.40

Hospital Charge Code	270650763
Hospital Revenue Code	272
Min. Negotiated Rate	$137.76
Max. Negotiated Rate	$137.76
Rate for Payer: Qualcare PPO/HMO/WC	$137.76

BASKET GEMINI

Facility

$1,315.00

Hospital Charge Code	270651472
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

BASKET GEMINI

Facility

$1,315.00

Hospital Charge Code	270651472
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$394.50
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

BASKET GRASPIT GEMINI

Facility

$1,488.75

Hospital Charge Code	270651298
Hospital Revenue Code	270
Min. Negotiated Rate	$223.31
Max. Negotiated Rate	$223.31
Rate for Payer: Qualcare PPO/HMO/WC	$223.31

BASKET GRASPIT GEMINI

Facility

$1,488.75

Hospital Charge Code	270651298
Hospital Revenue Code	270
Min. Negotiated Rate	$193.54
Max. Negotiated Rate	$744.38
Rate for Payer: Aetna Commercial	$446.62
Rate for Payer: Aetna Medicare Advantage	$446.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.63
Rate for Payer: Cigna Commercial	$744.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.54
Rate for Payer: Oxford Commercial	$744.38
Rate for Payer: Qualcare PPO/HMO/WC	$223.31
Rate for Payer: UnitedHealthcare Commercial	$744.38

BASKET LARGE 9040-08

Facility

$2,010.00

Hospital Charge Code	270638008
Hospital Revenue Code	278
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$486.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

BASKET LARGE 9040-08

Facility

$2,010.00

Hospital Charge Code	270638008
Hospital Revenue Code	278
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$1,005.00
Rate for Payer: Aetna Commercial	$603.00
Rate for Payer: Aetna Medicare Advantage	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.55
Rate for Payer: Cigna Commercial	$1,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

BASKET MCV COLON 1058

Facility

$1,168.85

Hospital Charge Code	270606079
Hospital Revenue Code	272
Min. Negotiated Rate	$151.95
Max. Negotiated Rate	$584.42
Rate for Payer: Aetna Commercial	$350.65
Rate for Payer: Aetna Medicare Advantage	$350.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.06
Rate for Payer: Cigna Commercial	$584.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.95
Rate for Payer: Oxford Commercial	$584.42
Rate for Payer: Qualcare PPO/HMO/WC	$175.33
Rate for Payer: UnitedHealthcare Commercial	$584.42

Know your out-of-pocket cost for care.

All Charges