Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRIGLYCERIDES

Facility

$306.00

Service Code	HCPCS 84478
Hospital Charge Code	38472654
Hospital Revenue Code	301
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Qualcare PPO/HMO/WC	$45.90

TRIGLYCERIDES PERITONEAL

Facility

$39.50

Service Code	HCPCS 84478
Hospital Charge Code	39900144
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.92
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

TRIGLYCERIDES PERITONEAL

Facility

$39.50

Service Code	HCPCS 84478
Hospital Charge Code	39900144
Hospital Revenue Code	301
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.92

TRIGLYCERIDES, SERUM

Facility

$667.59

Service Code	HCPCS 84478
Hospital Charge Code	3002615
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

TRIGLYCERIDES, SERUM

Facility

$667.59

Service Code	HCPCS 84478
Hospital Charge Code	3002615
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
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	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

TRIGLYCERIDES SERUM PANEL***

Facility

$6.00

Service Code	HCPCS 84478
Hospital Charge Code	3002615P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

TRIGLYCERIDES SERUM PANEL***

Facility

$6.00

Service Code	HCPCS 84478
Hospital Charge Code	3002615P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRIGLYCERIDE, SYNOVIAL FLUID

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3002613
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

TRIGLYCERIDE, SYNOVIAL FLUID

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3002613
Hospital Revenue Code	301
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

TRIGLYCRIDE, PERITONEAL FLUID

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3002612
Hospital Revenue Code	301
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

TRIGLYCRIDE, PERITONEAL FLUID

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3002612
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

TRIHEMIC-600/TAB

Facility

$3.00

Hospital Charge Code	60634072
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

TRIHEMIC-600/TAB

Facility

$3.00

Hospital Charge Code	60634072
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRIHEXPHENIDYL HCL ELX 2MG

Facility

$57.00

Hospital Charge Code	6011050
Hospital Revenue Code	251
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$28.50

TRIHEXPHENIDYL HCL ELX 2MG

Facility

$57.00

Hospital Charge Code	6011050
Hospital Revenue Code	251
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

TRIHEXYPHENIDYL 2 MG TAB

Facility

$4.00

Service Code	NDC 591533501
Hospital Charge Code	60627420
Hospital Revenue Code	251
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

TRIHEXYPHENIDYL 2 MG TAB

Facility

$4.00

Service Code	NDC 591533501
Hospital Charge Code	60627420
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TRIHEXYPHENIDYL 5 MG TAB

Facility

$4.85

Hospital Charge Code	60627421
Hospital Revenue Code	251
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

TRIHEXYPHENIDYL 5 MG TAB

Facility

$4.85

Hospital Charge Code	60627421
Hospital Revenue Code	251
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.63
Rate for Payer: Oxford Commercial	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$2.42

TRIIODOTHYRONINE FREE

Facility

$103.25

Service Code	HCPCS 84481
Hospital Charge Code	3002585
Hospital Revenue Code	301
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.89
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Cigna Commercial	$16.94
Rate for Payer: Cigna Medicare Advantage	$8.47
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.96
Rate for Payer: Wellcare Medicare Advantage	$16.94

TRIIODOTHYRONINE FREE

Facility

$103.25

Service Code	HCPCS 84481
Hospital Charge Code	3002585
Hospital Revenue Code	301
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

TRIIODOTHYRONINE T3;REVERSE

Facility

$111.64

Service Code	HCPCS 84482
Hospital Charge Code	38477132
Hospital Revenue Code	301
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$16.75
Rate for Payer: Qualcare PPO/HMO/WC	$16.75

TRIIODOTHYRONINE T3;REVERSE

Facility

$111.64

Service Code	HCPCS 84482
Hospital Charge Code	38477132
Hospital Revenue Code	301
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.06
Rate for Payer: Aetna Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$15.76
Rate for Payer: Cigna Medicare Advantage	$7.88
Rate for Payer: Clover Medicare Advantage	$14.97
Rate for Payer: EmblemHealth Commercial	$47.28
Rate for Payer: Humana Medicare Advantage	$16.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.71
Rate for Payer: Wellcare Medicare Advantage	$15.76

TRILAFON/2MG/TAB

Facility

$3.00

Hospital Charge Code	60634892
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRILAFON/2MG/TAB

Facility

$3.00

Hospital Charge Code	60634892
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

Know your out-of-pocket cost for care.

All Charges