Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRANSURETHRAL RSCTN BLDDR NECK

Facility

$23,841.70

Service Code	HCPCS 52500
Hospital Charge Code	1600000310
Hospital Revenue Code	360
Min. Negotiated Rate	$3,576.26
Max. Negotiated Rate	$3,576.26
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26

TRANSVAGINAL

Facility

$6,700.00

Service Code	HCPCS 76830
Hospital Charge Code	94061177
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

TRANSVAGINAL

Facility

$6,700.00

Service Code	HCPCS 76830
Hospital Charge Code	94061177
Hospital Revenue Code	402
Min. Negotiated Rate	$137.82
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

TRANSVAGINAL US, OBSTETRIC

Facility

$2,298.80

Service Code	HCPCS 76817
Hospital Charge Code	83653080
Hospital Revenue Code	402
Min. Negotiated Rate	$344.82
Max. Negotiated Rate	$344.82
Rate for Payer: Qualcare PPO/HMO/WC	$344.82

TRANSVAGINAL US, OBSTETRIC

Facility

$2,298.80

Service Code	HCPCS 76817
Hospital Charge Code	83653080
Hospital Revenue Code	402
Min. Negotiated Rate	$151.47
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$689.64
Rate for Payer: Aetna Medicare Advantage	$689.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.84
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.82
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

TRANXENE T-TAB/15MG/TAB

Facility

$6.00

Hospital Charge Code	60634053
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

TRANXENE T-TAB/15MG/TAB

Facility

$6.00

Hospital Charge Code	60634053
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRANXENE T-TAB/3.75MG/TAB

Facility

$6.00

Hospital Charge Code	60634051
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRANXENE T-TAB/3.75MG/TAB

Facility

$6.00

Hospital Charge Code	60634051
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

TRANXENE T-TAB/3.75MG/TAB

Facility

$6.00

Hospital Charge Code	60634049
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRANXENE T-TAB/3.75MG/TAB

Facility

$6.00

Hospital Charge Code	60634049
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

TRANXENE T-TAB/7.5MG/TAB

Facility

$5.00

Hospital Charge Code	60634050
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

TRANXENE T-TAB/7.5MG/TAB

Facility

$5.00

Hospital Charge Code	60634050
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TRANXENE T-TAB/7.5MG/TAB

Facility

$6.00

Hospital Charge Code	60634052
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

TRANXENE T-TAB/7.5MG/TAB

Facility

$6.00

Hospital Charge Code	60634052
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRANYLCYPROMINE 10 MG TAB

Facility

$8.05

Hospital Charge Code	60627782
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

TRANYLCYPROMINE 10 MG TAB

Facility

$8.05

Hospital Charge Code	60627782
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.03
Rate for Payer: Aetna Commercial	$2.42
Rate for Payer: Aetna Medicare Advantage	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.03

TRAPEASE VENACAVA FILTER

Facility

$5,913.70

Hospital Charge Code	270CH0137
Hospital Revenue Code	278
Min. Negotiated Rate	$887.05
Max. Negotiated Rate	$1,431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,182.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,431.12
Rate for Payer: Qualcare PPO/HMO/WC	$887.05

TRAPEASE VENACAVA FILTER

Facility

$5,913.70

Hospital Charge Code	270CH0137
Hospital Revenue Code	278
Min. Negotiated Rate	$887.05
Max. Negotiated Rate	$2,956.85
Rate for Payer: Aetna Commercial	$1,774.11
Rate for Payer: Aetna Medicare Advantage	$1,774.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,507.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,507.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,182.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,507.99
Rate for Payer: Cigna Commercial	$2,956.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,431.12
Rate for Payer: Qualcare PPO/HMO/WC	$887.05

TRAPEASE VENACAVA FLITER

Facility

$5,913.70

Hospital Charge Code	2703111106
Hospital Revenue Code	272
Min. Negotiated Rate	$887.05
Max. Negotiated Rate	$887.05
Rate for Payer: Qualcare PPO/HMO/WC	$887.05

TRAPEASE VENACAVA FLITER

Facility

$5,913.70

Hospital Charge Code	2703111106
Hospital Revenue Code	272
Min. Negotiated Rate	$768.78
Max. Negotiated Rate	$2,956.85
Rate for Payer: Aetna Commercial	$1,774.11
Rate for Payer: Aetna Medicare Advantage	$1,774.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,507.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,507.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,507.99
Rate for Payer: Cigna Commercial	$2,956.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.78
Rate for Payer: Oxford Commercial	$2,956.85
Rate for Payer: Qualcare PPO/HMO/WC	$887.05
Rate for Payer: UnitedHealthcare Commercial	$2,956.85

TRAPEZOID 2cm

Facility

$2,743.10

Hospital Charge Code	270674941
Hospital Revenue Code	272
Min. Negotiated Rate	$356.60
Max. Negotiated Rate	$1,371.55
Rate for Payer: Aetna Commercial	$822.93
Rate for Payer: Aetna Medicare Advantage	$822.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.49
Rate for Payer: Cigna Commercial	$1,371.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.60
Rate for Payer: Oxford Commercial	$1,371.55
Rate for Payer: Qualcare PPO/HMO/WC	$411.46
Rate for Payer: UnitedHealthcare Commercial	$1,371.55

TRAPEZOID 2cm

Facility

$2,743.10

Hospital Charge Code	270674941
Hospital Revenue Code	272
Min. Negotiated Rate	$411.46
Max. Negotiated Rate	$411.46
Rate for Payer: Qualcare PPO/HMO/WC	$411.46

TRAP MUCOUS SPECIMEN 80cc

Facility

$6.54

Hospital Charge Code	270649870
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

TRAP MUCOUS SPECIMEN 80cc

Facility

$6.54

Hospital Charge Code	270649870
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare Advantage	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.67
Rate for Payer: Cigna Commercial	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.85
Rate for Payer: Oxford Commercial	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$3.27

Know your out-of-pocket cost for care.

All Charges