Heights University Hospital

All Charges

Charge

Type

Setting

Price

TORADOL TABS/10MG/U/D

Facility

$6.00

Hospital Charge Code	60634742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

TORADOL TABS/10MG/U/D

Facility

$6.00

Hospital Charge Code	60634742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TORCH ABS IGG/IGM

Facility

$927.00

Service Code	HCPCS 80090
Hospital Charge Code	3004404
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$463.50
Rate for Payer: Aetna Commercial	$278.10
Rate for Payer: Aetna Medicare Advantage	$278.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.38
Rate for Payer: Cigna Commercial	$463.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

TORCH ABS IGG/IGM

Facility

$927.00

Service Code	HCPCS 80090
Hospital Charge Code	3004404
Hospital Revenue Code	301
Min. Negotiated Rate	$139.05
Max. Negotiated Rate	$139.05
Rate for Payer: Qualcare PPO/HMO/WC	$139.05

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86762
Hospital Charge Code	3004406C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	3004406D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86695
Hospital Charge Code	3004406A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.74
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: Cigna Medicare Advantage	$6.59
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
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	$13.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.98
Rate for Payer: Wellcare Medicare Advantage	$13.19

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86696
Hospital Charge Code	3004406B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86762
Hospital Charge Code	3004406C
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86695
Hospital Charge Code	3004406A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	3004406D
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TORCH IGG

Facility

$390.00

Service Code	HCPCS 86696
Hospital Charge Code	3004406B
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
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	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

TORCH IGM

Facility

$153.65

Service Code	HCPCS 86762
Hospital Charge Code	3004407B
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

TORCH IGM

Facility

$153.65

Service Code	HCPCS 86762
Hospital Charge Code	3004407B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TORCH IGM

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004407C
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

TORCH IGM

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004407C
Hospital Revenue Code	302
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.69
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.80
Rate for Payer: Cigna Commercial	$14.41
Rate for Payer: Cigna Medicare Advantage	$7.21
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.27
Rate for Payer: Wellcare Medicare Advantage	$14.41

TORCH PROFILE IGM

Facility

$138.70

Service Code	HCPCS 86694
Hospital Charge Code	3004407A
Hospital Revenue Code	302
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.80

TORCH PROFILE IGM

Facility

$416.00

Hospital Charge Code	3004407
Hospital Revenue Code	302
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$62.40

TORCH PROFILE IGM

Facility

$138.70

Service Code	HCPCS 86694
Hospital Charge Code	3004407A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TORCH PROFILE IGM

Facility

$416.00

Hospital Charge Code	3004407
Hospital Revenue Code	302
Min. Negotiated Rate	$54.08
Max. Negotiated Rate	$208.00
Rate for Payer: Aetna Commercial	$124.80
Rate for Payer: Aetna Medicare Advantage	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.08
Rate for Payer: Cigna Commercial	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

TORPEDO 3.5 MM X 7 CM

Facility

$505.00

Hospital Charge Code	270690696
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

TORPEDO 3.5 MM X 7 CM

Facility

$505.00

Hospital Charge Code	270690696
Hospital Revenue Code	272
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.65
Rate for Payer: Oxford Commercial	$252.50
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Commercial	$252.50

TORPEDO CURVED 4.0 MM X 13 CM

Facility

$505.00

Hospital Charge Code	270683618
Hospital Revenue Code	272
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.65
Rate for Payer: Oxford Commercial	$252.50
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Commercial	$252.50

TORPEDO CURVED 4.0 MM X 13 CM

Facility

$505.00

Hospital Charge Code	270683618
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

TORPEDO CURVE HL 4.2 X 19CM

Facility

$505.00

Hospital Charge Code	270687987
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

Know your out-of-pocket cost for care.

All Charges