Heights University Hospital

All Charges

Charge

Type

Setting

Price

BILL RHOGAM PRODUCT

Facility

$587.25

Hospital Charge Code	3100633
Hospital Revenue Code	636
Min. Negotiated Rate	$88.09
Max. Negotiated Rate	$293.62
Rate for Payer: Aetna Commercial	$176.18
Rate for Payer: Aetna Medicare Advantage	$176.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.75
Rate for Payer: Cigna Commercial	$293.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.11
Rate for Payer: Qualcare PPO/HMO/WC	$88.09

BILL RHOGAM PRODUCT

Facility

$587.25

Hospital Charge Code	3100633
Hospital Revenue Code	636
Min. Negotiated Rate	$88.09
Max. Negotiated Rate	$142.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.11
Rate for Payer: Qualcare PPO/HMO/WC	$88.09

BILL RHO IMMUNE/GLOBULIN

Facility

$139.25

Hospital Charge Code	3100450
Hospital Revenue Code	636
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

BILL RHO IMMUNE/GLOBULIN

Facility

$139.25

Hospital Charge Code	3100450
Hospital Revenue Code	636
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$33.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

BILL SDP PLASMA

Facility

$484.00

Hospital Charge Code	3109010
Hospital Revenue Code	399
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

BILL SDP PLASMA

Facility

$484.00

Hospital Charge Code	3109010
Hospital Revenue Code	399
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$756.00

BIL RENAL ANGIO W CARD CATH

Facility

$2,132.50

Hospital Charge Code	74110049
Hospital Revenue Code	323
Min. Negotiated Rate	$319.88
Max. Negotiated Rate	$319.88
Rate for Payer: Qualcare PPO/HMO/WC	$319.88

BIL RENAL ANGIO W CARD CATH

Facility

$2,132.50

Hospital Charge Code	5100436
Hospital Revenue Code	323
Min. Negotiated Rate	$277.23
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$639.75
Rate for Payer: Aetna Medicare Advantage	$639.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.79
Rate for Payer: Cigna Commercial	$1,066.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.23
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.88
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

BIL RENAL ANGIO W CARD CATH

Facility

$2,132.50

Hospital Charge Code	5100436
Hospital Revenue Code	323
Min. Negotiated Rate	$319.88
Max. Negotiated Rate	$319.88
Rate for Payer: Qualcare PPO/HMO/WC	$319.88

BIL RENAL ANGIO W CARD CATH

Facility

$2,132.50

Hospital Charge Code	74110049
Hospital Revenue Code	323
Min. Negotiated Rate	$277.23
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$639.75
Rate for Payer: Aetna Medicare Advantage	$639.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.79
Rate for Payer: Cigna Commercial	$1,066.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.23
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.88
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

BILRY DUCT TRNSHPTIC DLATON

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	5100832
Hospital Revenue Code	320
Min. Negotiated Rate	$333.23
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

BILRY DUCT TRNSHPTIC DLATON

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	5100832
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BILTRICIDE 600MG TAB

Facility

$66.00

Hospital Charge Code	60635241
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

BILTRICIDE 600MG TAB

Facility

$66.00

Hospital Charge Code	60635241
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

BIMATOPROST OPHT .03% SOL

Facility

$697.65

Hospital Charge Code	60629889
Hospital Revenue Code	250
Min. Negotiated Rate	$104.65
Max. Negotiated Rate	$104.65
Rate for Payer: Qualcare PPO/HMO/WC	$104.65

BIMATOPROST OPHT .03% SOL

Facility

$697.65

Hospital Charge Code	60629889
Hospital Revenue Code	250
Min. Negotiated Rate	$90.69
Max. Negotiated Rate	$348.82
Rate for Payer: Aetna Commercial	$209.29
Rate for Payer: Aetna Medicare Advantage	$209.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.90
Rate for Payer: Cigna Commercial	$348.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.69
Rate for Payer: Oxford Commercial	$348.82
Rate for Payer: Qualcare PPO/HMO/WC	$104.65
Rate for Payer: UnitedHealthcare Commercial	$348.82

BI-MENTUM ALTRX LINER 53/28

Facility

$22,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270700358
Hospital Revenue Code	278
Min. Negotiated Rate	$3,429.00
Max. Negotiated Rate	$11,430.00
Rate for Payer: Aetna Commercial	$6,858.00
Rate for Payer: Aetna Medicare Advantage	$6,858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,829.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,829.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,829.30
Rate for Payer: Cigna Commercial	$11,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,532.12
Rate for Payer: Qualcare PPO/HMO/WC	$3,429.00

BI-MENTUM ALTRX LINER 53/28

Facility

$22,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270700358
Hospital Revenue Code	278
Min. Negotiated Rate	$3,429.00
Max. Negotiated Rate	$5,532.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,532.12
Rate for Payer: Qualcare PPO/HMO/WC	$3,429.00

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$6,394.50
Max. Negotiated Rate	$21,315.00
Rate for Payer: Aetna Commercial	$12,789.00
Rate for Payer: Aetna Medicare Advantage	$12,789.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,870.65
Rate for Payer: Cigna Commercial	$21,315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$6,394.50
Max. Negotiated Rate	$10,316.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50

BIMTRC STEM 13X34-150 12162382

Facility

$20,955.00

Hospital Charge Code	270639189
Hospital Revenue Code	278
Min. Negotiated Rate	$3,143.25
Max. Negotiated Rate	$10,477.50
Rate for Payer: Aetna Commercial	$6,286.50
Rate for Payer: Aetna Medicare Advantage	$6,286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,343.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,343.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,343.52
Rate for Payer: Cigna Commercial	$10,477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,071.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,143.25

BIMTRC STEM 13X34-150 12162382

Facility

$20,955.00

Hospital Charge Code	270639189
Hospital Revenue Code	278
Min. Negotiated Rate	$3,143.25
Max. Negotiated Rate	$5,071.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,071.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,143.25

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$31.04
Rate for Payer: Qualcare PPO/HMO/WC	$31.04

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$20.69
Max. Negotiated Rate	$151.62
Rate for Payer: Aetna Commercial	$134.07
Rate for Payer: Aetna Medicare Advantage	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.62
Rate for Payer: Cigna Commercial	$41.38
Rate for Payer: Cigna Medicare Advantage	$20.69
Rate for Payer: Clover Medicare Advantage	$39.31
Rate for Payer: EmblemHealth Commercial	$124.14
Rate for Payer: Humana Medicare Advantage	$42.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.04
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$43.86
Rate for Payer: Wellcare Medicare Advantage	$41.38

BIN BREA LIN 2XL 45-49 S-XL/L

Facility

$110.00

Hospital Charge Code	270637535
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

Know your out-of-pocket cost for care.

All Charges