Heights University Hospital

All Charges

Charge

Type

Setting

Price

TULAREMIA AGGLUTININS

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	38472903
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

TULAREMIA AGGLUTININS

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	38472903
Hospital Revenue Code	305
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.62
Rate for Payer: Aetna Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.57
Rate for Payer: Cigna Commercial	$6.98
Rate for Payer: Cigna Medicare Advantage	$3.49
Rate for Payer: Clover Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$20.94
Rate for Payer: Humana Medicare Advantage	$7.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.40
Rate for Payer: Wellcare Medicare Advantage	$6.98

TULIP CREO MIS REDUCTION 30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698437
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

TULIP CREO MIS REDUCTION 30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698437
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

TULIP MAS PLIF

Facility

$6,155.00

Hospital Charge Code	270663767
Hospital Revenue Code	270
Min. Negotiated Rate	$923.25
Max. Negotiated Rate	$923.25
Rate for Payer: Qualcare PPO/HMO/WC	$923.25

TULIP MAS PLIF

Facility

$6,155.00

Hospital Charge Code	270663767
Hospital Revenue Code	270
Min. Negotiated Rate	$800.15
Max. Negotiated Rate	$3,077.50
Rate for Payer: Aetna Commercial	$1,846.50
Rate for Payer: Aetna Medicare Advantage	$1,846.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.53
Rate for Payer: Cigna Commercial	$3,077.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.15
Rate for Payer: Oxford Commercial	$3,077.50
Rate for Payer: Qualcare PPO/HMO/WC	$923.25
Rate for Payer: UnitedHealthcare Commercial	$3,077.50

TULIP MOD POLY REDUCTION 10 MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694880
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TULIP MOD POLY REDUCTION 10 MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694880
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TULIP PRECEPT

Facility

$6,420.00

Hospital Charge Code	270659980
Hospital Revenue Code	270
Min. Negotiated Rate	$963.00
Max. Negotiated Rate	$963.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

TULIP PRECEPT

Facility

$6,420.00

Hospital Charge Code	270659980
Hospital Revenue Code	270
Min. Negotiated Rate	$834.60
Max. Negotiated Rate	$3,210.00
Rate for Payer: Aetna Commercial	$1,926.00
Rate for Payer: Aetna Medicare Advantage	$1,926.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.10
Rate for Payer: Cigna Commercial	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.60
Rate for Payer: Oxford Commercial	$3,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00
Rate for Payer: UnitedHealthcare Commercial	$3,210.00

TULIP REDUCT MOD EXT TAB POLY

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698061
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TULIP REDUCT MOD EXT TAB POLY

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698061
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TULIPS

Facility

$5,920.00

Hospital Charge Code	270657322
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$1,432.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

TULIPS

Facility

$5,920.00

Hospital Charge Code	270657322
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$2,960.00
Rate for Payer: Aetna Commercial	$1,776.00
Rate for Payer: Aetna Medicare Advantage	$1,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,509.60
Rate for Payer: Cigna Commercial	$2,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

TULIPS

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270704681
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

TULIPS

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270704681
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

TULIPS

Facility

$2,000.00

Hospital Charge Code	270702886
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TULIPS

Facility

$2,000.00

Hospital Charge Code	270702886
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TULIP STD TOWER

Facility

$6,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270697212
Hospital Revenue Code	278
Min. Negotiated Rate	$921.00
Max. Negotiated Rate	$1,485.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,485.88
Rate for Payer: Qualcare PPO/HMO/WC	$921.00

TULIP STD TOWER

Facility

$6,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270697212
Hospital Revenue Code	278
Min. Negotiated Rate	$921.00
Max. Negotiated Rate	$3,070.00
Rate for Payer: Aetna Commercial	$1,842.00
Rate for Payer: Aetna Medicare Advantage	$1,842.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,565.70
Rate for Payer: Cigna Commercial	$3,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,485.88
Rate for Payer: Qualcare PPO/HMO/WC	$921.00

TUMARK EVIVA U 271 560

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270669921
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$218.75
Rate for Payer: Aetna Commercial	$131.25
Rate for Payer: Aetna Medicare Advantage	$131.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.56
Rate for Payer: Cigna Commercial	$218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: Qualcare PPO/HMO/WC	$65.62

TUMARK EVIVA U 271 560

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270669921
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$105.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: Qualcare PPO/HMO/WC	$65.62

TUMARK EVIVA X 251 551

Facility

$325.00

Hospital Charge Code	270669922
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

TUMARK EVIVA X 251 551

Facility

$325.00

Hospital Charge Code	270669922
Hospital Revenue Code	272
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

TUMARK EVIVA X 251 551

Facility

$325.00

Hospital Charge Code	270669922R
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

Know your out-of-pocket cost for care.

All Charges