Heights University Hospital

All Charges

Charge

Type

Setting

Price

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,645.37
Max. Negotiated Rate	$2,654.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,645.37
Max. Negotiated Rate	$5,484.55
Rate for Payer: Aetna Commercial	$3,290.73
Rate for Payer: Aetna Medicare Advantage	$3,290.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,797.12
Rate for Payer: Cigna Commercial	$5,484.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$197.60
Max. Negotiated Rate	$760.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$456.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.60
Rate for Payer: Cigna Commercial	$760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.60
Rate for Payer: Oxford Commercial	$760.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00
Rate for Payer: UnitedHealthcare Commercial	$760.00

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00

THALLIUM, 24 HOUR URINE

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000362
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

THALLIUM, 24 HOUR URINE

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000362
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THALLIUM BLOOD

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000364
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

THALLIUM BLOOD

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000364
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLOUS CHLORIDE FLOOD

Facility

$51.45

Hospital Charge Code	270658186
Hospital Revenue Code	270
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$25.73
Rate for Payer: Aetna Commercial	$15.44
Rate for Payer: Aetna Medicare Advantage	$15.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.12
Rate for Payer: Cigna Commercial	$25.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.69
Rate for Payer: Oxford Commercial	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$25.73

THALLOUS CHLORIDE FLOOD

Facility

$51.45

Hospital Charge Code	270658186
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

T-HANDLE DRIVER

Facility

$7,220.00

Hospital Charge Code	270690628
Hospital Revenue Code	272
Min. Negotiated Rate	$938.60
Max. Negotiated Rate	$3,610.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$2,166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.10
Rate for Payer: Cigna Commercial	$3,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$938.60
Rate for Payer: Oxford Commercial	$3,610.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.00
Rate for Payer: UnitedHealthcare Commercial	$3,610.00

T-HANDLE DRIVER

Facility

$7,220.00

Hospital Charge Code	270690628
Hospital Revenue Code	272
Min. Negotiated Rate	$1,083.00
Max. Negotiated Rate	$1,083.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.00

T HANDLE SCREW DRIVER 6MM

Facility

$2,990.00

Hospital Charge Code	270686004
Hospital Revenue Code	272
Min. Negotiated Rate	$448.50
Max. Negotiated Rate	$448.50
Rate for Payer: Qualcare PPO/HMO/WC	$448.50

T HANDLE SCREW DRIVER 6MM

Facility

$2,990.00

Hospital Charge Code	270686004
Hospital Revenue Code	272
Min. Negotiated Rate	$388.70
Max. Negotiated Rate	$1,495.00
Rate for Payer: Aetna Commercial	$897.00
Rate for Payer: Aetna Medicare Advantage	$897.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$762.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$762.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$762.45
Rate for Payer: Cigna Commercial	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.70
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$448.50
Rate for Payer: UnitedHealthcare Commercial	$1,495.00

THAWING PROC, FROZEN BLD PROD

Facility

$100.00

Service Code	HCPCS 86927
Hospital Charge Code	3100153
Hospital Revenue Code	300
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

THAWING PROC, FROZEN BLD PROD

Facility

$100.00

Service Code	HCPCS 86927
Hospital Charge Code	3100153
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

The Captivator COLD Single-use

Facility

$75.00

Hospital Charge Code	270688073
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

Know your out-of-pocket cost for care.

All Charges