Heights University Hospital

All Charges

Charge

Type

Setting

Price

TA LONG 90-4.8 STAPLER GREEN

Facility

$597.00

Hospital Charge Code	270334731
Hospital Revenue Code	272
Min. Negotiated Rate	$89.55
Max. Negotiated Rate	$89.55
Rate for Payer: Qualcare PPO/HMO/WC	$89.55

TALUS SZ 5 ANKLE TOTAL

Facility

$29,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697284
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$14,500.00
Rate for Payer: Aetna Commercial	$8,700.00
Rate for Payer: Aetna Medicare Advantage	$8,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,395.00
Rate for Payer: Cigna Commercial	$14,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

TALUS SZ 5 ANKLE TOTAL

Facility

$29,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697284
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$7,018.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

TALUS TOTAL ANKLE SZ2 RT

Facility

$25,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677295
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

TALUS TOTAL ANKLE SZ2 RT

Facility

$25,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677295
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

TALUS TOTAL ANKLE SZ4 RT

Facility

$25,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678162
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

TALUS TOTAL ANKLE SZ4 RT

Facility

$25,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678162
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

TALWIN/30MG/ML

Facility

$53.00

Hospital Charge Code	60634415
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

TALWIN/30MG/ML

Facility

$53.00

Hospital Charge Code	60634415
Hospital Revenue Code	250
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$15.90
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.89
Rate for Payer: Oxford Commercial	$26.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$26.50

TALWIN NX/TAB

Facility

$3.00

Hospital Charge Code	60633963
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

TALWIN NX/TAB

Facility

$3.00

Hospital Charge Code	60633963
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TAMIFLU 12MG/ML

Facility

$215.00

Hospital Charge Code	60635729
Hospital Revenue Code	250
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$107.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$107.50
Rate for Payer: Aetna Commercial	$64.50
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Oxford Commercial	$107.50

TAMIFLU 12MG/ML

Facility

$215.00

Hospital Charge Code	60635729
Hospital Revenue Code	250
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

TAMIFLU ORAL SUSP

Facility

$16.15

Service Code	NDC 4082205
Hospital Charge Code	60635754
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$8.07

TAMIFLU ORAL SUSP

Facility

$16.15

Service Code	NDC 4082205
Hospital Charge Code	60635754
Hospital Revenue Code	250
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$2.42

TAMOXIFEN 10 MG TAB

Facility

$15.88

Service Code	NDC 63739026910
Hospital Charge Code	6010086
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.38

TAMOXIFEN 10 MG TAB

Facility

$15.88

Service Code	NDC 63739026910
Hospital Charge Code	6010086
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$7.94
Rate for Payer: Aetna Commercial	$4.76
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.05
Rate for Payer: Cigna Commercial	$7.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$7.94
Rate for Payer: Qualcare PPO/HMO/WC	$2.38
Rate for Payer: UnitedHealthcare Commercial	$7.94

TAMOXIFEN TAB 10MG

Facility

$15.40

Hospital Charge Code	6008692
Hospital Revenue Code	251
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

TAMOXIFEN TAB 10MG

Facility

$15.40

Hospital Charge Code	6008692
Hospital Revenue Code	251
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

TAMP BONE INFLATABLE

Facility

$6,475.00

Hospital Charge Code	270636280
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

TAMP BONE INFLATABLE

Facility

$6,475.00

Hospital Charge Code	270636280
Hospital Revenue Code	272
Min. Negotiated Rate	$841.75
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$1,942.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$841.75
Rate for Payer: Oxford Commercial	$3,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$3,237.50

TAMP BONE INFLATABLE 10/2 K15A

Facility

$5,975.00

Hospital Charge Code	270637758
Hospital Revenue Code	272
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$896.25
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

TAMP BONE INFLATABLE 10/2 K15A

Facility

$5,975.00

Hospital Charge Code	270637758
Hospital Revenue Code	272
Min. Negotiated Rate	$776.75
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$1,792.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$776.75
Rate for Payer: Oxford Commercial	$2,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Commercial	$2,987.50

TAMP BONE INFLATABLE 10/3

Facility

$6,475.00

Hospital Charge Code	270640794
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

TAMP BONE INFLATABLE 10/3

Facility

$6,475.00

Hospital Charge Code	270640794
Hospital Revenue Code	272
Min. Negotiated Rate	$841.75
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$1,942.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$841.75
Rate for Payer: Oxford Commercial	$3,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$3,237.50

Know your out-of-pocket cost for care.

All Charges