Heights University Hospital

All Charges

Charge

Type

Setting

Price

TREPHINE BLADES

Facility

$300.00

Hospital Charge Code	270332558
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

TREPHINE MRI 11.5MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675771
Hospital Revenue Code	272
Min. Negotiated Rate	$331.50
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$765.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.50
Rate for Payer: Oxford Commercial	$1,275.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$1,275.00

TREPHINE MRI 11.5MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675771
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

TREPHINE MRI 11MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675770
Hospital Revenue Code	272
Min. Negotiated Rate	$331.50
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$765.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.50
Rate for Payer: Oxford Commercial	$1,275.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$1,275.00

TREPHINE MRI 11MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675770
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

TREPHINE MRI 21 MM

Facility

$2,350.00

Hospital Charge Code	270690279
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

TREPHINE MRI 21 MM

Facility

$2,350.00

Hospital Charge Code	270690279
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 VACUUM BARRON 2056

Facility

$593.65

Hospital Charge Code	270600211
Hospital Revenue Code	272
Min. Negotiated Rate	$77.17
Max. Negotiated Rate	$296.82
Rate for Payer: Aetna Commercial	$178.09
Rate for Payer: Aetna Medicare Advantage	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.38
Rate for Payer: Cigna Commercial	$296.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.17
Rate for Payer: Oxford Commercial	$296.82
Rate for Payer: Qualcare PPO/HMO/WC	$89.05
Rate for Payer: UnitedHealthcare Commercial	$296.82

TREPHINE VACUUM BARRON 2056

Facility

$593.65

Hospital Charge Code	270600211
Hospital Revenue Code	272
Min. Negotiated Rate	$89.05
Max. Negotiated Rate	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.05

TREPHINE VACUUM BARRON 2058

Facility

$593.65

Hospital Charge Code	270600212
Hospital Revenue Code	272
Min. Negotiated Rate	$77.17
Max. Negotiated Rate	$296.82
Rate for Payer: Aetna Commercial	$178.09
Rate for Payer: Aetna Medicare Advantage	$178.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.38
Rate for Payer: Cigna Commercial	$296.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.17
Rate for Payer: Oxford Commercial	$296.82
Rate for Payer: Qualcare PPO/HMO/WC	$89.05
Rate for Payer: UnitedHealthcare Commercial	$296.82

TREPHINE VACUUM BARRON 2058

Facility

$593.65

Hospital Charge Code	270600212
Hospital Revenue Code	272
Min. Negotiated Rate	$89.05
Max. Negotiated Rate	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.05

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$42.48
Max. Negotiated Rate	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: Qualcare PPO/HMO/WC	$42.48

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$42.48
Max. Negotiated Rate	$141.60
Rate for Payer: Aetna Commercial	$84.96
Rate for Payer: Aetna Medicare Advantage	$84.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.22
Rate for Payer: Cigna Commercial	$141.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: Qualcare PPO/HMO/WC	$42.48

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
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	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TRETINOIN CRM .05% 15GM

Facility

$227.85

Hospital Charge Code	6005391
Hospital Revenue Code	252
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$34.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.18

TRETINOIN CRM .05% 15GM

Facility

$227.85

Hospital Charge Code	6005391
Hospital Revenue Code	252
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$113.92
Rate for Payer: Aetna Commercial	$68.36
Rate for Payer: Aetna Medicare Advantage	$68.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.10
Rate for Payer: Cigna Commercial	$113.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.62
Rate for Payer: Oxford Commercial	$113.92
Rate for Payer: Qualcare PPO/HMO/WC	$34.18
Rate for Payer: UnitedHealthcare Commercial	$113.92

TRETINOIN GEL .01% 15GM

Facility

$213.80

Hospital Charge Code	6005375
Hospital Revenue Code	252
Min. Negotiated Rate	$32.07
Max. Negotiated Rate	$32.07
Rate for Payer: Qualcare PPO/HMO/WC	$32.07

TRETINOIN GEL .01% 15GM

Facility

$213.80

Hospital Charge Code	6005375
Hospital Revenue Code	252
Min. Negotiated Rate	$27.79
Max. Negotiated Rate	$106.90
Rate for Payer: Aetna Commercial	$64.14
Rate for Payer: Aetna Medicare Advantage	$64.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.52
Rate for Payer: Cigna Commercial	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Oxford Commercial	$106.90
Rate for Payer: Qualcare PPO/HMO/WC	$32.07
Rate for Payer: UnitedHealthcare Commercial	$106.90

TRETINOIN GEL .025% 15GM

Facility

$181.15

Hospital Charge Code	6005383
Hospital Revenue Code	252
Min. Negotiated Rate	$27.17
Max. Negotiated Rate	$27.17
Rate for Payer: Qualcare PPO/HMO/WC	$27.17

TRETINOIN GEL .025% 15GM

Facility

$181.15

Hospital Charge Code	6005383
Hospital Revenue Code	252
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$90.58
Rate for Payer: Aetna Commercial	$54.34
Rate for Payer: Aetna Medicare Advantage	$54.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.19
Rate for Payer: Cigna Commercial	$90.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.55
Rate for Payer: Oxford Commercial	$90.58
Rate for Payer: Qualcare PPO/HMO/WC	$27.17
Rate for Payer: UnitedHealthcare Commercial	$90.58

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$5,196.75
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$11,992.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,196.75
Rate for Payer: Oxford Commercial	$19,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$19,987.50

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$5,196.75
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$11,992.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,196.75
Rate for Payer: Oxford Commercial	$19,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$19,987.50

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

Know your out-of-pocket cost for care.

All Charges