Heights University Hospital

All Charges

Charge

Type

Setting

Price

TREAT UTERUS INFECTION

Facility

$48,126.45

Service Code	HCPCS 59830
Hospital Charge Code	1600000321
Hospital Revenue Code	360
Min. Negotiated Rate	$459.09
Max. Negotiated Rate	$14,437.93
Rate for Payer: Aetna Commercial	$14,437.93
Rate for Payer: Aetna Medicare Advantage	$14,437.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,272.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,272.24
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	$12,272.24
Rate for Payer: Cigna Commercial	$459.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,256.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,218.97
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TREAT UTERUS INFECTION

Facility

$48,126.45

Service Code	HCPCS 59830
Hospital Charge Code	1600000321
Hospital Revenue Code	360
Min. Negotiated Rate	$7,218.97
Max. Negotiated Rate	$7,218.97
Rate for Payer: Qualcare PPO/HMO/WC	$7,218.97

TRECATOR-SC/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634054
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

TRECATOR-SC/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634054
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TREK/MINI TREK 1.20MM X06MM

Facility

$500.00

Hospital Charge Code	270666645
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TREK/MINI TREK 1.20MM X06MM

Facility

$500.00

Hospital Charge Code	270666645
Hospital Revenue Code	279
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

TREL-XPRESS 300C DMB

Facility

$4,465.00

Hospital Charge Code	270660818
Hospital Revenue Code	278
Min. Negotiated Rate	$669.75
Max. Negotiated Rate	$2,232.50
Rate for Payer: Aetna Commercial	$1,339.50
Rate for Payer: Aetna Medicare Advantage	$1,339.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.58
Rate for Payer: Cigna Commercial	$2,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.53
Rate for Payer: Qualcare PPO/HMO/WC	$669.75

TREL-XPRESS 300C DMB

Facility

$4,465.00

Hospital Charge Code	270660818
Hospital Revenue Code	278
Min. Negotiated Rate	$669.75
Max. Negotiated Rate	$1,080.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.53
Rate for Payer: Qualcare PPO/HMO/WC	$669.75

TRENTAL/400MG/TAB

Facility

$3.00

Hospital Charge Code	60634055
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

TRENTAL/400MG/TAB

Facility

$3.00

Hospital Charge Code	60634056
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

TRENTAL/400MG/TAB

Facility

$3.00

Hospital Charge Code	60634056
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRENTAL/400MG/TAB

Facility

$3.00

Hospital Charge Code	60634055
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TREPH11.5mIDx8 MRI NON99864015

Facility

$2,095.00

Hospital Charge Code	270638896
Hospital Revenue Code	272
Min. Negotiated Rate	$272.35
Max. Negotiated Rate	$1,047.50
Rate for Payer: Aetna Commercial	$628.50
Rate for Payer: Aetna Medicare Advantage	$628.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.23
Rate for Payer: Cigna Commercial	$1,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.35
Rate for Payer: Oxford Commercial	$1,047.50
Rate for Payer: Qualcare PPO/HMO/WC	$314.25
Rate for Payer: UnitedHealthcare Commercial	$1,047.50

TREPH11.5mIDx8 MRI NON99864015

Facility

$2,095.00

Hospital Charge Code	270638896
Hospital Revenue Code	272
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$314.25
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

TREPH13.5mIDx8 MRI NON99864019

Facility

$2,095.00

Hospital Charge Code	270638897
Hospital Revenue Code	272
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$314.25
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

TREPH13.5mIDx8 MRI NON99864019

Facility

$2,095.00

Hospital Charge Code	270638897
Hospital Revenue Code	272
Min. Negotiated Rate	$272.35
Max. Negotiated Rate	$1,047.50
Rate for Payer: UnitedHealthcare Commercial	$1,047.50
Rate for Payer: Aetna Commercial	$628.50
Rate for Payer: Aetna Medicare Advantage	$628.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.23
Rate for Payer: Cigna Commercial	$1,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.35
Rate for Payer: Oxford Commercial	$1,047.50
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

TREPH14.5mIDx8 MRI NON99864021

Facility

$2,095.00

Hospital Charge Code	270638898
Hospital Revenue Code	272
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$314.25
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

TREPH14.5mIDx8 MRI NON99864021

Facility

$2,095.00

Hospital Charge Code	270638898
Hospital Revenue Code	272
Min. Negotiated Rate	$272.35
Max. Negotiated Rate	$1,047.50
Rate for Payer: Aetna Commercial	$628.50
Rate for Payer: Aetna Medicare Advantage	$628.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.23
Rate for Payer: Cigna Commercial	$1,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.35
Rate for Payer: Oxford Commercial	$1,047.50
Rate for Payer: Qualcare PPO/HMO/WC	$314.25
Rate for Payer: UnitedHealthcare Commercial	$1,047.50

TREPHINE 20.5MM

Facility

$2,350.00

Hospital Charge Code	270690278
Hospital Revenue Code	272
Min. Negotiated Rate	$305.50
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$705.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.50
Rate for Payer: Oxford Commercial	$1,175.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$1,175.00

TREPHINE 20.5MM

Facility

$2,350.00

Hospital Charge Code	270690278
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

TREPHINE 21.50 MM MRI

Facility

$2,350.00

Hospital Charge Code	270690280
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

TREPHINE 21.50 MM MRI

Facility

$2,350.00

Hospital Charge Code	270690280
Hospital Revenue Code	272
Min. Negotiated Rate	$305.50
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$705.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.50
Rate for Payer: Oxford Commercial	$1,175.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$1,175.00

TREPHINE 8.5MM

Facility

$1,483.75

Hospital Charge Code	270691602
Hospital Revenue Code	272
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$222.56
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

TREPHINE 8.5MM

Facility

$1,483.75

Hospital Charge Code	270691602
Hospital Revenue Code	272
Min. Negotiated Rate	$192.89
Max. Negotiated Rate	$741.88
Rate for Payer: Aetna Commercial	$445.12
Rate for Payer: Aetna Medicare Advantage	$445.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.36
Rate for Payer: Cigna Commercial	$741.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.89
Rate for Payer: Oxford Commercial	$741.88
Rate for Payer: Qualcare PPO/HMO/WC	$222.56
Rate for Payer: UnitedHealthcare Commercial	$741.88

TREPHINE BLADES

Facility

$300.00

Hospital Charge Code	270332558
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

Know your out-of-pocket cost for care.

All Charges