Heights University Hospital

All Charges

Charge

Type

Setting

Price

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132C
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132D
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

TPMT GENOTYPE

Facility

$390.00

Service Code	HCPCS 81335
Hospital Charge Code	3035132A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132E
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132D
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132E
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TPMT GENOTYPE

Facility

$390.00

Service Code	HCPCS 81335
Hospital Charge Code	3035132A
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$640.50
Rate for Payer: Aetna Commercial	$566.38
Rate for Payer: Aetna Medicare Advantage	$174.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$174.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$640.50
Rate for Payer: Cigna Commercial	$174.81
Rate for Payer: Cigna Medicare Advantage	$87.41
Rate for Payer: Clover Medicare Advantage	$166.07
Rate for Payer: EmblemHealth Commercial	$524.43
Rate for Payer: Humana Medicare Advantage	$180.05
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	$174.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$185.30
Rate for Payer: Wellcare Medicare Advantage	$174.81

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TPMT GENOTYPE

Facility

$390.00

Hospital Charge Code	3035132B
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

TPN

Facility

$886.00

Hospital Charge Code	60635155
Hospital Revenue Code	250
Min. Negotiated Rate	$132.90
Max. Negotiated Rate	$132.90
Rate for Payer: Qualcare PPO/HMO/WC	$132.90

TPN

Facility

$886.00

Hospital Charge Code	60635155
Hospital Revenue Code	250
Min. Negotiated Rate	$115.18
Max. Negotiated Rate	$443.00
Rate for Payer: Aetna Commercial	$265.80
Rate for Payer: Aetna Medicare Advantage	$265.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.93
Rate for Payer: Cigna Commercial	$443.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.18
Rate for Payer: Oxford Commercial	$443.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.90
Rate for Payer: UnitedHealthcare Commercial	$443.00

TPN

Facility

$886.00

Hospital Charge Code	60634760
Hospital Revenue Code	250
Min. Negotiated Rate	$132.90
Max. Negotiated Rate	$132.90
Rate for Payer: Qualcare PPO/HMO/WC	$132.90

TPN

Facility

$886.00

Hospital Charge Code	60634760
Hospital Revenue Code	250
Min. Negotiated Rate	$115.18
Max. Negotiated Rate	$443.00
Rate for Payer: Aetna Commercial	$265.80
Rate for Payer: Aetna Medicare Advantage	$265.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.93
Rate for Payer: Cigna Commercial	$443.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.18
Rate for Payer: Oxford Commercial	$443.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.90
Rate for Payer: UnitedHealthcare Commercial	$443.00

TPRLC 133 FP FTYPE PPS SO 6.0

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685253
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 FP FTYPE PPS SO 6.0

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685253
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 FP TYPE1 PPS SO 8.0

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 FP TYPE1 PPS SO 8.0

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1PPS HO 11 X 142MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680825
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1PPS HO 11 X 142MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680825
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1 PPS HO 12 X 144MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686369
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1 PPS HO 12 X 144MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686369
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1 PPS SO 10X140MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1 PPS SO 10X140MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

TPRLC 133 T1 PPS SO 20X160MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695711
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

Know your out-of-pocket cost for care.

All Charges