Heights University Hospital

All Charges

Charge

Type

Setting

Price

TAMP OAT SZ 10

Facility

$970.00

Hospital Charge Code	270677743
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 10

Facility

$970.00

Hospital Charge Code	270677743
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMP OAT SZ 5

Facility

$970.00

Hospital Charge Code	270677738
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 5

Facility

$970.00

Hospital Charge Code	270677738
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$126.10
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.10
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$485.00

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

T AND B LYMPHOCYTES

Facility

$177.50

Service Code	HCPCS 86360
Hospital Charge Code	3008707C
Hospital Revenue Code	302
Min. Negotiated Rate	$26.62
Max. Negotiated Rate	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$26.62

T AND B LYMPHOCYTES

Facility

$111.25

Service Code	HCPCS 86359
Hospital Charge Code	3008707A
Hospital Revenue Code	302
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

T AND B LYMPHOCYTES

Facility

$177.50

Service Code	HCPCS 86360
Hospital Charge Code	3008707C
Hospital Revenue Code	302
Min. Negotiated Rate	$23.07
Max. Negotiated Rate	$172.13
Rate for Payer: Aetna Commercial	$152.22
Rate for Payer: Aetna Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.13
Rate for Payer: Cigna Commercial	$46.98
Rate for Payer: Cigna Medicare Advantage	$23.49
Rate for Payer: Clover Medicare Advantage	$44.63
Rate for Payer: EmblemHealth Commercial	$140.94
Rate for Payer: Humana Medicare Advantage	$48.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$49.80
Rate for Payer: Wellcare Medicare Advantage	$46.98

T AND B LYMPHOCYTES

Facility

$120.00

Service Code	HCPCS 86360
Hospital Charge Code	3008707B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$172.13
Rate for Payer: Aetna Commercial	$152.22
Rate for Payer: Aetna Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.13
Rate for Payer: Cigna Commercial	$46.98
Rate for Payer: Cigna Medicare Advantage	$23.49
Rate for Payer: Clover Medicare Advantage	$44.63
Rate for Payer: EmblemHealth Commercial	$140.94
Rate for Payer: Humana Medicare Advantage	$48.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$49.80
Rate for Payer: Wellcare Medicare Advantage	$46.98

T AND B LYMPHOCYTES

Facility

$111.25

Service Code	HCPCS 86359
Hospital Charge Code	3008707A
Hospital Revenue Code	302
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$138.24
Rate for Payer: Aetna Commercial	$122.25
Rate for Payer: Aetna Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.24
Rate for Payer: Cigna Commercial	$37.73
Rate for Payer: Cigna Medicare Advantage	$18.86
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39.99
Rate for Payer: Wellcare Medicare Advantage	$37.73

T AND B LYMPHOCYTES

Facility

$120.00

Service Code	HCPCS 86360
Hospital Charge Code	3008707B
Hospital Revenue Code	302
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$134.48
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$310.35
Rate for Payer: Aetna Medicare Advantage	$310.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.79
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.48
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$66.11
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$310.35
Rate for Payer: Aetna Medicare Advantage	$310.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.79
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.48
Rate for Payer: Oxford Commercial	$517.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$517.25

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$66.11
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$310.35
Rate for Payer: Aetna Medicare Advantage	$310.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.79
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.48
Rate for Payer: Oxford Commercial	$517.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$517.25

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$968.07
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges