Heights University Hospital

All Charges

Charge

Type

Setting

Price

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .018 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683675S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$1,584.00
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$1,584.00
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$1,584.00
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 150

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683677S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 90

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$1,584.00
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 90

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 90

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676N
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$2,640.00
Rate for Payer: Aetna Commercial	$1,584.00
Rate for Payer: Aetna Medicare Advantage	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.40
Rate for Payer: Cigna Commercial	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

Trailblazer Angle .035 x 90

Facility

$5,280.00

Service Code	HCPCS C1887
Hospital Charge Code	270683676S
Hospital Revenue Code	278
Min. Negotiated Rate	$792.00
Max. Negotiated Rate	$1,277.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.76
Rate for Payer: Qualcare PPO/HMO/WC	$792.00

TRAMADOL 50MG

Facility

$3.00

Hospital Charge Code	60635624
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRAMADOL 50MG

Facility

$3.00

Hospital Charge Code	60635624
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

TRAMADOL 50 MG TAB

Facility

$5.36

Service Code	NDC 51079099120
Hospital Charge Code	60627720
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

TRAMADOL 50 MG TAB

Facility

$5.36

Service Code	NDC 51079099120
Hospital Charge Code	60627720
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.68
Rate for Payer: Aetna Commercial	$1.61
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$2.68

TRAMADOL SCREENW REF/CONF URIN

Facility

$399.05

Service Code	HCPCS 80307
Hospital Charge Code	39708045
Hospital Revenue Code	306
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$59.86
Rate for Payer: Qualcare PPO/HMO/WC	$59.86

TRAMADOL SCREENW REF/CONF URIN

Facility

$399.05

Service Code	HCPCS 80307
Hospital Charge Code	39708045
Hospital Revenue Code	306
Min. Negotiated Rate	$31.07
Max. Negotiated Rate	$227.68
Rate for Payer: Aetna Commercial	$201.33
Rate for Payer: Aetna Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$62.14
Rate for Payer: Cigna Medicare Advantage	$31.07
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.86
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$65.87
Rate for Payer: Wellcare Medicare Advantage	$62.14

TRANDATE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634403
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

TRANDATE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634403
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRANDATE/5MG/1ML

Facility

$183.00

Hospital Charge Code	60634047
Hospital Revenue Code	250
Min. Negotiated Rate	$23.79
Max. Negotiated Rate	$91.50
Rate for Payer: Aetna Commercial	$54.90
Rate for Payer: Aetna Medicare Advantage	$54.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.66
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.79
Rate for Payer: Oxford Commercial	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Commercial	$91.50

TRANDATE/5MG/1ML

Facility

$183.00

Hospital Charge Code	60634047
Hospital Revenue Code	250
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

TRANEXAMIC ACID

Facility

$16.75

Service Code	NDC 517096010
Hospital Charge Code	606380005
Hospital Revenue Code	250
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$8.38
Rate for Payer: Aetna Commercial	$5.03
Rate for Payer: Aetna Medicare Advantage	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.18
Rate for Payer: Oxford Commercial	$8.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$8.38

TRANEXAMIC ACID

Facility

$16.75

Service Code	NDC 517096010
Hospital Charge Code	606380005
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

TRANEXAMIC ACID 1000MG/100ML

Facility

$169.18

Service Code	NDC 51754010803
Hospital Charge Code	606390297
Hospital Revenue Code	250
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$84.59
Rate for Payer: Aetna Commercial	$50.75
Rate for Payer: Aetna Medicare Advantage	$50.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.14
Rate for Payer: Cigna Commercial	$84.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.99
Rate for Payer: Oxford Commercial	$84.59
Rate for Payer: Qualcare PPO/HMO/WC	$25.38
Rate for Payer: UnitedHealthcare Commercial	$84.59

TRANEXAMIC ACID 1000MG/100ML

Facility

$169.18

Service Code	NDC 51754010803
Hospital Charge Code	606390297
Hospital Revenue Code	250
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$25.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.38

Know your out-of-pocket cost for care.

All Charges