Heights University Hospital

All Charges

Charge

Type

Setting

Price

BENDING TEMPLATE 7 HOLES

Facility

$136.50

Hospital Charge Code	270675506
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$40.95
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

BENDING TEMPLATE 7 HOLES

Facility

$136.50

Hospital Charge Code	270675506
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

BENDINI ROD DIGITIZER ARRAY

Facility

$12,350.00

Hospital Charge Code	270696804
Hospital Revenue Code	272
Min. Negotiated Rate	$1,852.50
Max. Negotiated Rate	$1,852.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,852.50

BENDINI ROD DIGITIZER ARRAY

Facility

$12,350.00

Hospital Charge Code	270696804
Hospital Revenue Code	272
Min. Negotiated Rate	$1,605.50
Max. Negotiated Rate	$6,175.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$3,705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,149.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,149.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,149.25
Rate for Payer: Cigna Commercial	$6,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.50
Rate for Payer: Oxford Commercial	$6,175.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,852.50
Rate for Payer: UnitedHealthcare Commercial	$6,175.00

BENEDRYL, SERUM***

Facility

$200.00

Service Code	HCPCS 80290
Hospital Charge Code	3032349
Hospital Revenue Code	309
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

BENEDRYL, SERUM***

Facility

$200.00

Service Code	HCPCS 80290
Hospital Charge Code	3032349
Hospital Revenue Code	309
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

BENEDRYL, URINE***

Facility

$141.00

Service Code	HCPCS 80101
Hospital Charge Code	3032356
Hospital Revenue Code	309
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

BENEDRYL, URINE***

Facility

$141.00

Service Code	HCPCS 80101
Hospital Charge Code	3032356
Hospital Revenue Code	309
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.30
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

BENEMID/0.5GM/TAB

Facility

$18.00

Hospital Charge Code	60632541
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

BENEMID/0.5GM/TAB

Facility

$18.00

Hospital Charge Code	60632541
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

Benicar 20mg

Facility

$14.07

Service Code	NDC 63629339001
Hospital Charge Code	6063943278
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$4.22
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$7.04

Benicar 20mg

Facility

$14.07

Service Code	NDC 63629339001
Hospital Charge Code	6063943278
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

Benicar 40mg

Facility

$16.35

Service Code	NDC 65597010430
Hospital Charge Code	6063943279
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Qualcare PPO/HMO/WC	$2.45

Benicar 40mg

Facility

$16.35

Service Code	NDC 65597010430
Hospital Charge Code	6063943279
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$8.18
Rate for Payer: Aetna Commercial	$4.91
Rate for Payer: Aetna Medicare Advantage	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.17
Rate for Payer: Cigna Commercial	$8.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$8.18
Rate for Payer: Qualcare PPO/HMO/WC	$2.45
Rate for Payer: UnitedHealthcare Commercial	$8.18

Benicar 5mg

Facility

$156.04

Service Code	NDC 35356028720
Hospital Charge Code	6063943277
Hospital Revenue Code	250
Min. Negotiated Rate	$20.29
Max. Negotiated Rate	$78.02
Rate for Payer: Aetna Commercial	$46.81
Rate for Payer: Aetna Medicare Advantage	$46.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.79
Rate for Payer: Cigna Commercial	$78.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.29
Rate for Payer: Oxford Commercial	$78.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.41
Rate for Payer: UnitedHealthcare Commercial	$78.02

Benicar 5mg

Facility

$156.04

Service Code	NDC 35356028720
Hospital Charge Code	6063943277
Hospital Revenue Code	250
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$23.41
Rate for Payer: Qualcare PPO/HMO/WC	$23.41

BENIGN PROSTATIC HYPERTROPHY WITH MCC

Facility

$45,788.13

Service Code	MSDRG 725
Min. Negotiated Rate	$12,769.90
Max. Negotiated Rate	$45,788.13
Rate for Payer: Aetna Commercial	$39,458.99
Rate for Payer: Aetna Medicare Advantage	$12,769.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,183.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,183.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,262.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,183.08
Rate for Payer: Cigna Commercial	$25,183.87
Rate for Payer: Cigna Medicare Advantage	$15,262.71
Rate for Payer: Clover Medicare Advantage	$14,499.57
Rate for Payer: EmblemHealth Commercial	$45,788.13
Rate for Payer: Humana Medicare Advantage	$15,720.59
Rate for Payer: Oxford Commercial	$15,739.19
Rate for Payer: UnitedHealthcare Commercial	$17,865.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,262.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16,178.47
Rate for Payer: Wellcare Medicare Advantage	$15,262.71

BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC

Facility

$32,778.81

Service Code	MSDRG 726
Min. Negotiated Rate	$7,878.88
Max. Negotiated Rate	$32,778.81
Rate for Payer: Aetna Commercial	$24,345.74
Rate for Payer: Aetna Medicare Advantage	$7,878.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,123.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,123.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,926.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,123.91
Rate for Payer: Cigna Commercial	$15,538.16
Rate for Payer: Cigna Medicare Advantage	$10,926.27
Rate for Payer: Clover Medicare Advantage	$10,379.96
Rate for Payer: EmblemHealth Commercial	$32,778.81
Rate for Payer: Humana Medicare Advantage	$11,254.06
Rate for Payer: Oxford Commercial	$9,710.90
Rate for Payer: UnitedHealthcare Commercial	$11,022.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,926.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,581.85
Rate for Payer: Wellcare Medicare Advantage	$10,926.27

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079S
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079N
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079N
Hospital Revenue Code	272
Min. Negotiated Rate	$84.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079S
Hospital Revenue Code	272
Min. Negotiated Rate	$84.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079
Hospital Revenue Code	272
Min. Negotiated Rate	$84.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

BENTSON WIRE GUIGE 80CM

Facility

$132.45

Hospital Charge Code	270704889
Hospital Revenue Code	279
Min. Negotiated Rate	$19.87
Max. Negotiated Rate	$19.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.87

Know your out-of-pocket cost for care.

All Charges