Heights University Hospital

All Charges

Charge

Type

Setting

Price

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000544
Hospital Revenue Code	272
Min. Negotiated Rate	$57.32
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$220.45
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$220.45

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000546
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000546
Hospital Revenue Code	272
Min. Negotiated Rate	$57.32
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$220.45
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$220.45

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000544
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396N
Hospital Revenue Code	272
Min. Negotiated Rate	$52.16
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.16
Rate for Payer: Oxford Commercial	$200.62
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Commercial	$200.62

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396N
Hospital Revenue Code	272
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$60.19
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396
Hospital Revenue Code	272
Min. Negotiated Rate	$52.16
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.16
Rate for Payer: Oxford Commercial	$200.62
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Commercial	$200.62

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396
Hospital Revenue Code	272
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$60.19
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

BILIARY STENT 7FR-11CM

Facility

$642.00

Hospital Charge Code	270332260
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$192.60
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT 7FR-11CM

Facility

$642.00

Hospital Charge Code	270332260
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT 7FR-6CM

Facility

$642.00

Hospital Charge Code	270332258
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT 7FR-6CM

Facility

$642.00

Hospital Charge Code	270332258
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$192.60
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT SET 8.5FR-5CM

Facility

$642.00

Hospital Charge Code	270332255
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$192.60
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT SET 8.5FR-5CM

Facility

$642.00

Hospital Charge Code	270332255
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$75,019.95

Service Code	MSDRG 409
Min. Negotiated Rate	$23,756.32
Max. Negotiated Rate	$75,019.95
Rate for Payer: Aetna Commercial	$73,418.31
Rate for Payer: Aetna Medicare Advantage	$23,759.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,031.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,031.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,006.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,031.32
Rate for Payer: Cigna Commercial	$46,857.67
Rate for Payer: Cigna Medicare Advantage	$25,006.65
Rate for Payer: Clover Medicare Advantage	$23,756.32
Rate for Payer: EmblemHealth Commercial	$75,019.95
Rate for Payer: Humana Medicare Advantage	$25,756.85
Rate for Payer: Oxford Commercial	$29,284.69
Rate for Payer: UnitedHealthcare Commercial	$33,240.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,006.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26,507.05
Rate for Payer: Wellcare Medicare Advantage	$25,006.65

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$120,231.62

Service Code	MSDRG 408
Min. Negotiated Rate	$36,516.86
Max. Negotiated Rate	$120,231.62
Rate for Payer: Aetna Commercial	$120,231.62
Rate for Payer: Aetna Medicare Advantage	$38,909.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102,549.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102,549.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,438.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102,549.24
Rate for Payer: Cigna Commercial	$76,735.28
Rate for Payer: Cigna Medicare Advantage	$38,438.80
Rate for Payer: Clover Medicare Advantage	$36,516.86
Rate for Payer: EmblemHealth Commercial	$115,316.40
Rate for Payer: Humana Medicare Advantage	$39,591.96
Rate for Payer: Oxford Commercial	$47,957.32
Rate for Payer: UnitedHealthcare Commercial	$54,436.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,438.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$40,745.13
Rate for Payer: Wellcare Medicare Advantage	$38,438.80

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$57,906.39

Service Code	MSDRG 410
Min. Negotiated Rate	$17,325.91
Max. Negotiated Rate	$57,906.39
Rate for Payer: Aetna Commercial	$53,537.06
Rate for Payer: Aetna Medicare Advantage	$17,325.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,280.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,280.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,302.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,280.19
Rate for Payer: Cigna Commercial	$34,168.89
Rate for Payer: Cigna Medicare Advantage	$19,302.13
Rate for Payer: Clover Medicare Advantage	$18,337.02
Rate for Payer: EmblemHealth Commercial	$57,906.39
Rate for Payer: Humana Medicare Advantage	$19,881.19
Rate for Payer: Oxford Commercial	$21,354.56
Rate for Payer: UnitedHealthcare Commercial	$24,239.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,302.13
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20,460.26
Rate for Payer: Wellcare Medicare Advantage	$19,302.13

BILIRUBIN, AMNIOTIC FLUID

Facility

$54.45

Service Code	HCPCS 82143
Hospital Charge Code	3030970
Hospital Revenue Code	301
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.29
Rate for Payer: Aetna Medicare Advantage	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.26
Rate for Payer: Cigna Commercial	$9.35
Rate for Payer: Cigna Medicare Advantage	$4.67
Rate for Payer: Clover Medicare Advantage	$8.88
Rate for Payer: EmblemHealth Commercial	$28.05
Rate for Payer: Humana Medicare Advantage	$9.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.91
Rate for Payer: Wellcare Medicare Advantage	$9.35

BILIRUBIN, AMNIOTIC FLUID

Facility

$54.45

Service Code	HCPCS 82143
Hospital Charge Code	3030970
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

BILIRUBIN CONJUGATED

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3000440
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

BILIRUBIN CONJUGATED

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3000440
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.26
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.39
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: Cigna Medicare Advantage	$2.51
Rate for Payer: Clover Medicare Advantage	$4.77
Rate for Payer: EmblemHealth Commercial	$15.06
Rate for Payer: Humana Medicare Advantage	$5.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.32
Rate for Payer: Wellcare Medicare Advantage	$5.02

BILIRUBIN, DIRECT

Facility

$400.40

Service Code	HCPCS 82248
Hospital Charge Code	38472143
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.26
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.02
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	$18.39
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: Cigna Medicare Advantage	$2.51
Rate for Payer: Clover Medicare Advantage	$4.77
Rate for Payer: EmblemHealth Commercial	$15.06
Rate for Payer: Humana Medicare Advantage	$5.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.06
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.32
Rate for Payer: Wellcare Medicare Advantage	$5.02

BILIRUBIN, DIRECT

Facility

$400.40

Service Code	HCPCS 82248
Hospital Charge Code	38472143
Hospital Revenue Code	301
Min. Negotiated Rate	$60.06
Max. Negotiated Rate	$60.06
Rate for Payer: Qualcare PPO/HMO/WC	$60.06

BILIRUBIN, DIRECT

Facility

$667.59

Service Code	HCPCS 82248
Hospital Charge Code	3000445
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.26
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.02
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	$18.39
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: Cigna Medicare Advantage	$2.51
Rate for Payer: Clover Medicare Advantage	$4.77
Rate for Payer: EmblemHealth Commercial	$15.06
Rate for Payer: Humana Medicare Advantage	$5.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.32
Rate for Payer: Wellcare Medicare Advantage	$5.02

BILIRUBIN, DIRECT

Facility

$667.59

Service Code	HCPCS 82248
Hospital Charge Code	3000445
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges