Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRANSFORMER FOR VAGINAL LIGHT

Facility

$340.00

Hospital Charge Code	270332049
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

TRANSFORMER FOR VAGINAL LIGHT

Facility

$340.00

Hospital Charge Code	270332049
Hospital Revenue Code	272
Min. Negotiated Rate	$44.20
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$170.00

TRANSF REACTION INVESTIGATION

Facility

$390.00

Service Code	HCPCS 86078
Hospital Charge Code	3100203
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TRANSF REACTION INVESTIGATION

Facility

$390.00

Service Code	HCPCS 86078
Hospital Charge Code	3100203
Hospital Revenue Code	302
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$405.73
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) NJ Health	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$21.48
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

TRANSFSN BLD/BLD COMPONENTS

Facility

$3,556.46

Service Code	HCPCS 36430
Hospital Charge Code	1600000658
Hospital Revenue Code	360
Min. Negotiated Rate	$533.47
Max. Negotiated Rate	$533.47
Rate for Payer: Qualcare PPO/HMO/WC	$533.47

TRANSFSN BLD/BLD COMPONENTS

Facility

$3,556.46

Service Code	HCPCS 36430
Hospital Charge Code	1600000658
Hospital Revenue Code	360
Min. Negotiated Rate	$462.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,066.94
Rate for Payer: Aetna Medicare Advantage	$1,066.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$906.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$906.90
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	$906.90
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.34
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$533.47
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TRANSFUSION REACTION

Facility

$249.00

Service Code	HCPCS 86078
Hospital Charge Code	38471064
Hospital Revenue Code	302
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$74.70
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$21.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

TRANSFUSION REACTION

Facility

$249.00

Service Code	HCPCS 86078
Hospital Charge Code	38471064
Hospital Revenue Code	302
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

TRANSFUSION REACTION, URINE

Facility

$100.00

Service Code	HCPCS 86999
Hospital Charge Code	3100435
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

TRANSFUSION REACTION, URINE

Facility

$100.00

Service Code	HCPCS 86999
Hospital Charge Code	3100435
Hospital Revenue Code	300
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

TRANSFUSION TX ADMIN > 4HRS

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	3401040
Hospital Revenue Code	391
Min. Negotiated Rate	$182.49
Max. Negotiated Rate	$1,050.61
Rate for Payer: Aetna Commercial	$421.12
Rate for Payer: Aetna Medicare Advantage	$421.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.96
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.49
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$756.00

TRANSFUSION TX ADMIN > 4HRS

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	3401040
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

TRANSFUSION TX ADMIN UP TO 4HR

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	3400074
Hospital Revenue Code	391
Min. Negotiated Rate	$182.49
Max. Negotiated Rate	$1,050.61
Rate for Payer: Aetna Commercial	$421.12
Rate for Payer: Aetna Medicare Advantage	$421.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.96
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.49
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$756.00

TRANSFUSION TX ADMIN UP TO 4HR

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	3400074
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

TRANSGLUTAMINASE AB (IGA)

Facility

$75.65

Service Code	HCPCS 83516
Hospital Charge Code	39900096
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

TRANSGLUTAMINASE AB (IGA)

Facility

$75.65

Service Code	HCPCS 83516
Hospital Charge Code	39900096
Hospital Revenue Code	301
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

TRANSHEPATIC CHOLANGIOGRAM

Facility

$331.55

Service Code	HCPCS 47500
Hospital Charge Code	5100521
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

TRANSHEPATIC CHOLANGIOGRAM

Facility

$331.55

Service Code	HCPCS 47500
Hospital Charge Code	5100521
Hospital Revenue Code	361
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

TRANSHEPATIC CHOLANGIOGRAM S&I

Facility

$1,305.00

Service Code	HCPCS 74320
Hospital Charge Code	5100520
Hospital Revenue Code	320
Min. Negotiated Rate	$195.75
Max. Negotiated Rate	$195.75
Rate for Payer: Qualcare PPO/HMO/WC	$195.75

TRANSHEPATIC CHOLANGIOGRAM S&I

Facility

$1,305.00

Service Code	HCPCS 74320
Hospital Charge Code	5100520
Hospital Revenue Code	320
Min. Negotiated Rate	$169.65
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$391.50
Rate for Payer: Aetna Medicare Advantage	$391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.77
Rate for Payer: Cigna Commercial	$652.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.75
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

TRANSIENT ISCHEMIA

Facility

$10,267.44

Service Code	APR-DRG 0472
Min. Negotiated Rate	$6,340.63
Max. Negotiated Rate	$10,267.44
Rate for Payer: Aetna Better Health Medicaid	$10,066.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,267.44
Rate for Payer: Wellpoint Medicaid Managed Care	$6,340.63

TRANSIENT ISCHEMIA

Facility

$8,957.11

Service Code	APR-DRG 0471
Min. Negotiated Rate	$5,840.92
Max. Negotiated Rate	$8,957.11
Rate for Payer: Aetna Better Health Medicaid	$8,781.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,957.11
Rate for Payer: Wellpoint Medicaid Managed Care	$5,840.92

TRANSIENT ISCHEMIA

Facility

$21,970.14

Service Code	APR-DRG 0474
Min. Negotiated Rate	$15,741.81
Max. Negotiated Rate	$21,970.14
Rate for Payer: Aetna Better Health Medicaid	$21,539.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,970.14
Rate for Payer: Wellpoint Medicaid Managed Care	$15,741.81

TRANSIENT ISCHEMIA

Facility

$12,953.98

Service Code	APR-DRG 0473
Min. Negotiated Rate	$7,919.27
Max. Negotiated Rate	$12,953.98
Rate for Payer: Aetna Better Health Medicaid	$12,699.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,953.98
Rate for Payer: Wellpoint Medicaid Managed Care	$7,919.27

TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$35,007.99

Service Code	MSDRG 069
Min. Negotiated Rate	$8,716.97
Max. Negotiated Rate	$35,007.99
Rate for Payer: Aetna Commercial	$26,935.44
Rate for Payer: Aetna Medicare Advantage	$8,716.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,669.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,053.60
Rate for Payer: Cigna Medicare Advantage	$11,669.33
Rate for Payer: Clover Medicare Advantage	$11,085.86
Rate for Payer: EmblemHealth Commercial	$35,007.99
Rate for Payer: Humana Medicare Advantage	$12,019.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,669.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,369.49
Rate for Payer: Wellcare Medicare Advantage	$11,669.33

Know your out-of-pocket cost for care.

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