Heights University Hospital

All Charges

Charge

Type

Setting

Price

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

TITNUMCOMPRESNTNSIONBANDPLATE

Facility

$2,130.00

Hospital Charge Code	270635602
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$639.00
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

TITNUMCOMPRESNTNSIONBANDPLATE

Facility

$2,130.00

Hospital Charge Code	270635602
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46

TITNUMCRTXSCWSELFTAP2.4MMX14MM

Facility

$2,675.00

Hospital Charge Code	270639270
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TITNUMCRTXSCWSELFTAP2.4MMX14MM

Facility

$2,675.00

Hospital Charge Code	270639270
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$802.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TIZANIDINE 4 MG TAB

Facility

$11.79

Service Code	NDC 904641861
Hospital Charge Code	60629865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

TIZANIDINE 4 MG TAB

Facility

$11.79

Service Code	NDC 904641861
Hospital Charge Code	60629865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$5.89
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna Medicare Advantage	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.01
Rate for Payer: Cigna Commercial	$5.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$5.89

TIZANIDINE (ZANAFLEX) 2MG CAP

Facility

$14.27

Service Code	NDC 378072219
Hospital Charge Code	60630191
Hospital Revenue Code	250
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$7.13
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$7.13
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$7.13

TIZANIDINE (ZANAFLEX) 2MG CAP

Facility

$14.27

Service Code	NDC 378072219
Hospital Charge Code	60630191
Hospital Revenue Code	250
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

TL201 THALLIUM MCI

Facility

$55.00

Hospital Charge Code	74116075
Hospital Revenue Code	343
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Hospital Charge Code	74116075
Hospital Revenue Code	343
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Service Code	HCPCS A9505
Hospital Charge Code	5309025
Hospital Revenue Code	343
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$57.76
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Service Code	HCPCS A9505
Hospital Charge Code	74115075
Hospital Revenue Code	343
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Hospital Charge Code	74117075
Hospital Revenue Code	343
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Service Code	HCPCS A9505
Hospital Charge Code	74115075
Hospital Revenue Code	343
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$57.76
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Hospital Charge Code	74117075
Hospital Revenue Code	343
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL201 THALLIUM MCI

Facility

$55.00

Service Code	HCPCS A9505
Hospital Charge Code	5309025
Hospital Revenue Code	343
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

TL ANGIOPLASTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	5600055
Hospital Revenue Code	323
Min. Negotiated Rate	$1,410.56
Max. Negotiated Rate	$1,410.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56

TL ANGIOPLASTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	5600055
Hospital Revenue Code	323
Min. Negotiated Rate	$1,222.49
Max. Negotiated Rate	$4,701.88
Rate for Payer: Aetna Commercial	$2,821.12
Rate for Payer: Aetna Medicare Advantage	$2,821.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.96
Rate for Payer: Cigna Commercial	$4,701.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.49
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

TLH UTERUS 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58570
Hospital Charge Code	1600000716
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

TLH UTERUS 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58570
Hospital Charge Code	1600000716
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$13,000.38
Rate for Payer: Aetna Medicare Advantage	$13,000.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,050.32
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	$11,050.32
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,633.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TLH W/T/O 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58571
Hospital Charge Code	16000763
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

TLH W/T/O 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58571
Hospital Charge Code	16000763
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$13,000.38
Rate for Payer: Aetna Medicare Advantage	$13,000.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,050.32
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	$11,050.32
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,633.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TLH W/T/O UTERUS OVER 250 G

Facility

$30,381.68

Service Code	HCPCS 58573
Hospital Charge Code	16000764
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$9,114.50
Rate for Payer: Aetna Medicare Advantage	$9,114.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,747.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,747.33
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	$7,747.33
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,949.62
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,557.25
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Know your out-of-pocket cost for care.

All Charges