Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRYPTICASE KIT

Facility

$147.85

Hospital Charge Code	60628555
Hospital Revenue Code	250
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$22.18
Rate for Payer: Qualcare PPO/HMO/WC	$22.18

TRYPTOPHAN

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39900455
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

TRYPTOPHAN

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39900455
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

TRYPTOPHAN (SERUM)***

Facility

$58.00

Service Code	HCPCS 82131
Hospital Charge Code	3007713
Hospital Revenue Code	301
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

TRYPTOPHAN (SERUM)***

Facility

$58.00

Service Code	HCPCS 82131
Hospital Charge Code	3007713
Hospital Revenue Code	301
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

TRY VRTBRL BLLN 11Gx15 VBT1115

Facility

$5,750.00

Hospital Charge Code	270650185
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

TRY VRTBRL BLLN 11Gx15 VBT1115

Facility

$5,750.00

Hospital Charge Code	270650185
Hospital Revenue Code	272
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

TRYX ENVELOPE ANTIBACT ABOSRB

Facility

$9,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270690980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

TRYX ENVELOPE ANTIBACT ABOSRB

Facility

$9,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270690980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

TSH

Facility

$115.50

Service Code	HCPCS 84443
Hospital Charge Code	39900141
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.56
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.32
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

TSH

Facility

$115.50

Service Code	HCPCS 84443
Hospital Charge Code	39900141
Hospital Revenue Code	301
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$17.32
Rate for Payer: Qualcare PPO/HMO/WC	$17.32

TSH RECEPTOR AB

Facility

$1,204.00

Service Code	HCPCS 84235
Hospital Charge Code	38472036
Hospital Revenue Code	301
Min. Negotiated Rate	$180.60
Max. Negotiated Rate	$180.60
Rate for Payer: Qualcare PPO/HMO/WC	$180.60

TSH RECEPTOR AB

Facility

$1,204.00

Service Code	HCPCS 84235
Hospital Charge Code	38472036
Hospital Revenue Code	301
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$260.99
Rate for Payer: Aetna Commercial	$230.79
Rate for Payer: Aetna Medicare Advantage	$71.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$71.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.99
Rate for Payer: Cigna Commercial	$71.23
Rate for Payer: Cigna Medicare Advantage	$35.62
Rate for Payer: Clover Medicare Advantage	$67.67
Rate for Payer: EmblemHealth Commercial	$213.69
Rate for Payer: Humana Medicare Advantage	$73.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$71.23
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$75.50
Rate for Payer: Wellcare Medicare Advantage	$71.23

TSH RECEPTOR AB (RIA)

Facility

$585.17

Service Code	HCPCS 83520
Hospital Charge Code	3009032
Hospital Revenue Code	301
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$87.78
Rate for Payer: Qualcare PPO/HMO/WC	$87.78

TSH RECEPTOR AB (RIA)

Facility

$585.17

Service Code	HCPCS 83520
Hospital Charge Code	3009032
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

TSH WITH FREE T4 REFLEX

Facility

$244.26

Service Code	HCPCS 84443
Hospital Charge Code	3000706
Hospital Revenue Code	301
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$36.64
Rate for Payer: Qualcare PPO/HMO/WC	$36.64

TSH WITH FREE T4 REFLEX

Facility

$244.26

Service Code	HCPCS 84443
Hospital Charge Code	3000706
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.56
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.64
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

TSI

Facility

$390.00

Service Code	HCPCS 84445
Hospital Charge Code	39900142
Hospital Revenue Code	301
Min. Negotiated Rate	$25.43
Max. Negotiated Rate	$186.35
Rate for Payer: Aetna Commercial	$164.79
Rate for Payer: Aetna Medicare Advantage	$50.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$50.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.35
Rate for Payer: Cigna Commercial	$50.86
Rate for Payer: Cigna Medicare Advantage	$25.43
Rate for Payer: Clover Medicare Advantage	$48.32
Rate for Payer: EmblemHealth Commercial	$152.58
Rate for Payer: Humana Medicare Advantage	$52.39
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	$50.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$53.91
Rate for Payer: Wellcare Medicare Advantage	$50.86

TSI

Facility

$390.00

Service Code	HCPCS 84445
Hospital Charge Code	39900142
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TSI-THYROID STIMUL IMMUNOGLBN

Facility

$438.00

Hospital Charge Code	3010527
Hospital Revenue Code	301
Min. Negotiated Rate	$56.94
Max. Negotiated Rate	$219.00
Rate for Payer: Aetna Commercial	$131.40
Rate for Payer: Aetna Medicare Advantage	$131.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.69
Rate for Payer: Cigna Commercial	$219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

TSI-THYROID STIMUL IMMUNOGLBN

Facility

$438.00

Hospital Charge Code	3010527
Hospital Revenue Code	301
Min. Negotiated Rate	$65.70
Max. Negotiated Rate	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.70

T-SLING 45X1.1cm W/SLV CALTS10

Facility

$3,825.00

Hospital Charge Code	270632449
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,147.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

T-SLING 45X1.1cm W/SLV CALTS10

Facility

$3,825.00

Hospital Charge Code	270632449
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

T-SLING W/ CENSORB 1.1x45 TS05

Facility

$17,236.00

Hospital Charge Code	270632403
Hospital Revenue Code	278
Min. Negotiated Rate	$2,585.40
Max. Negotiated Rate	$4,171.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,447.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,171.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,585.40

T-SLING W/ CENSORB 1.1x45 TS05

Facility

$17,236.00

Hospital Charge Code	270632403
Hospital Revenue Code	278
Min. Negotiated Rate	$2,585.40
Max. Negotiated Rate	$8,618.00
Rate for Payer: Aetna Commercial	$5,170.80
Rate for Payer: Aetna Medicare Advantage	$5,170.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,395.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,395.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,395.18
Rate for Payer: Cigna Commercial	$8,618.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,171.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,585.40

Know your out-of-pocket cost for care.

All Charges