Heights University Hospital

All Charges

Charge

Type

Setting

Price

TA SP BONE AGRFT LOCAL ADD-ONT

Facility

$11,887.22

Service Code	HCPCS 20936
Hospital Charge Code	16000286
Hospital Revenue Code	360
Min. Negotiated Rate	$1,783.08
Max. Negotiated Rate	$1,783.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08

TA THORAX SPINE FUSION

Facility

$14,222.30

Service Code	HCPCS 22610
Hospital Charge Code	16000804
Hospital Revenue Code	360
Min. Negotiated Rate	$1,848.90
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$4,266.69
Rate for Payer: Aetna Medicare Advantage	$4,266.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,626.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,626.69
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	$3,626.69
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.90
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.34
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

TA THORAX SPINE FUSION

Facility

$14,222.30

Service Code	HCPCS 22610
Hospital Charge Code	16000804
Hospital Revenue Code	360
Min. Negotiated Rate	$2,133.34
Max. Negotiated Rate	$2,133.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.34

TAVIST/2.68MG/TAB

Facility

$4.00

Hospital Charge Code	60633966
Hospital Revenue Code	250
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

TAVIST/2.68MG/TAB

Facility

$4.00

Hospital Charge Code	60633966
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TAVIST-D/TAB

Facility

$4.00

Hospital Charge Code	60633967
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TAVIST-D/TAB

Facility

$4.00

Hospital Charge Code	60633967
Hospital Revenue Code	250
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

TAVIST I/TAB

Facility

$1.00

Hospital Charge Code	60634398
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

TAVIST I/TAB

Facility

$1.00

Hospital Charge Code	60634398
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TAXOL 300MG/50ML INJ

Facility

$9,928.00

Hospital Charge Code	60635234
Hospital Revenue Code	636
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$2,402.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,402.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

TAXOL 300MG/50ML INJ

Facility

$9,928.00

Hospital Charge Code	60635234
Hospital Revenue Code	636
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$4,964.00
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,964.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,402.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

TAXOL 30MG VIALS

Facility

$2,407.00

Hospital Charge Code	60635082
Hospital Revenue Code	636
Min. Negotiated Rate	$361.05
Max. Negotiated Rate	$1,203.50
Rate for Payer: Aetna Commercial	$722.10
Rate for Payer: Aetna Medicare Advantage	$722.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.78
Rate for Payer: Cigna Commercial	$1,203.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.49
Rate for Payer: Qualcare PPO/HMO/WC	$361.05

TAXOL 30MG VIALS

Facility

$2,407.00

Hospital Charge Code	60635082
Hospital Revenue Code	636
Min. Negotiated Rate	$361.05
Max. Negotiated Rate	$582.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.49
Rate for Payer: Qualcare PPO/HMO/WC	$361.05

*****TAY SACHS

Facility

$150.00

Service Code	HCPCS 84311
Hospital Charge Code	30006748
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

*****TAY SACHS

Facility

$150.00

Service Code	HCPCS 84311
Hospital Charge Code	30006748
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

TAY-SACHS CAR SCN,LEUK AND DNA

Facility

$193.75

Service Code	HCPCS 83080
Hospital Charge Code	3006745
Hospital Revenue Code	301
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$29.06
Rate for Payer: Qualcare PPO/HMO/WC	$29.06

TAY-SACHS CAR SCN,LEUK AND DNA

Facility

$193.75

Service Code	HCPCS 83080
Hospital Charge Code	3006745
Hospital Revenue Code	301
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.66
Rate for Payer: Aetna Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.81
Rate for Payer: Cigna Commercial	$16.87
Rate for Payer: Cigna Medicare Advantage	$8.44
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.06
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.88
Rate for Payer: Wellcare Medicare Advantage	$16.87

TAY SACHS (SPECT)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3006748
Hospital Revenue Code	301
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

TAY SACHS (SPECT)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3006748
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

TAZIDIME/1GM

Facility

$84.00

Hospital Charge Code	60633969
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

TAZIDIME/1GM

Facility

$84.00

Hospital Charge Code	60633969
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TAZIDIME/500MG

Facility

$48.00

Hospital Charge Code	60633968
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

TAZIDIME/500MG

Facility

$48.00

Hospital Charge Code	60633968
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.00

TAZIDIME/6GM

Facility

$482.00

Hospital Charge Code	60633970
Hospital Revenue Code	250
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$72.30
Rate for Payer: Qualcare PPO/HMO/WC	$72.30

TAZIDIME/6GM

Facility

$482.00

Hospital Charge Code	60633970
Hospital Revenue Code	250
Min. Negotiated Rate	$62.66
Max. Negotiated Rate	$241.00
Rate for Payer: Aetna Commercial	$144.60
Rate for Payer: Aetna Medicare Advantage	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.91
Rate for Payer: Cigna Commercial	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.66
Rate for Payer: Oxford Commercial	$241.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.30
Rate for Payer: UnitedHealthcare Commercial	$241.00

Know your out-of-pocket cost for care.

All Charges