Heights University Hospital

All Charges

Charge

Type

Setting

Price

THERAPEUTIC PLASMA APHERESIS

Facility

$5,065.00

Service Code	HCPCS 36514
Hospital Charge Code	3300021
Hospital Revenue Code	361
Min. Negotiated Rate	$658.45
Max. Negotiated Rate	$3,708.85
Rate for Payer: Aetna Commercial	$1,519.50
Rate for Payer: Aetna Medicare Advantage	$1,519.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,291.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,291.58
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	$1,291.58
Rate for Payer: Cigna Commercial	$3,708.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.45
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$759.75
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

THERAPEUTIC PUTTY 4 OZ

Facility

$10.45

Hospital Charge Code	270613438
Hospital Revenue Code	279
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$5.22

THERAPEUTIC PUTTY 4 OZ

Facility

$10.45

Hospital Charge Code	270613438
Hospital Revenue Code	279
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

THERAPEUTIC ROCKER KNIFE

Facility

$105.65

Hospital Charge Code	270608449
Hospital Revenue Code	270
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

THERAPEUTIC ROCKER KNIFE

Facility

$105.65

Hospital Charge Code	270608449
Hospital Revenue Code	270
Min. Negotiated Rate	$13.73
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$31.70
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.73
Rate for Payer: Oxford Commercial	$52.83
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$52.83

THERAPEUTIC SCOOP DISH

Facility

$43.25

Hospital Charge Code	270608451
Hospital Revenue Code	279
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$12.97
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$21.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$21.62

THERAPEUTIC SCOOP DISH

Facility

$43.25

Hospital Charge Code	270608451
Hospital Revenue Code	279
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

THERAPEUTIC TABLESPOON

Facility

$37.65

Hospital Charge Code	270613436
Hospital Revenue Code	279
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

THERAPEUTIC TABLESPOON

Facility

$37.65

Hospital Charge Code	270613436
Hospital Revenue Code	279
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

THERAPEUTIC TEASPOON

Facility

$37.65

Hospital Charge Code	270613435
Hospital Revenue Code	279
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

THERAPEUTIC TEASPOON

Facility

$37.65

Hospital Charge Code	270613435
Hospital Revenue Code	279
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

THERAPEUTIC THERABAND PT

Facility

$12.85

Hospital Charge Code	270613440
Hospital Revenue Code	279
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$6.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$6.42

THERAPEUTIC THERABAND PT

Facility

$12.85

Hospital Charge Code	270613440
Hospital Revenue Code	279
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

THERAPEUTIC UTENSIL CLIP

Facility

$37.65

Hospital Charge Code	270608448
Hospital Revenue Code	279
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

THERAPEUTIC UTENSIL CLIP

Facility

$37.65

Hospital Charge Code	270608448
Hospital Revenue Code	279
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

THERAPEUTIC VITAMIN/5ML

Facility

$3.00

Hospital Charge Code	60634015
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

THERAPEUTIC VITAMIN/5ML

Facility

$3.00

Hospital Charge Code	60634015
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

THERAPEUTIC VITAMIN W/MIN

Facility

$3.00

Hospital Charge Code	60634016
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

THERAPEUTIC VITAMIN W/MIN

Facility

$3.00

Hospital Charge Code	60634016
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

THERAPY SESSION KIT

Facility

$50.00

Hospital Charge Code	270682400
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

THERAPY SESSION KIT

Facility

$50.00

Hospital Charge Code	270682400
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

THERAPY SESSION KIT

Facility

$50.00

Hospital Charge Code	270682400N
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

THERAPY SESSION KIT

Facility

$50.00

Hospital Charge Code	270682400N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

THERASKIN LARGE 2X3IN 102TSL

Facility

$6,375.00

Service Code	HCPCS Q4121
Hospital Charge Code	270646972
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

THERASKIN LARGE 2X3IN 102TSL

Facility

$6,375.00

Service Code	HCPCS Q4121
Hospital Charge Code	270646972
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,912.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

Know your out-of-pocket cost for care.

All Charges