Heights University Hospital

All Charges

Charge

Type

Setting

Price

TUNNELLED ASCITES DRAIN

Facility

$211.99

Service Code	HCPCS 49418
Hospital Charge Code	2200403
Hospital Revenue Code	350
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$31.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

TUNNELLED ASCITES DRAIN

Facility

$211.99

Service Code	HCPCS 49418
Hospital Charge Code	2200403
Hospital Revenue Code	350
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$779.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

TUNNELLER IVS

Facility

$2,951.25

Hospital Charge Code	270630518
Hospital Revenue Code	272
Min. Negotiated Rate	$442.69
Max. Negotiated Rate	$442.69
Rate for Payer: Qualcare PPO/HMO/WC	$442.69

TUNNELLER IVS

Facility

$2,951.25

Hospital Charge Code	270630518
Hospital Revenue Code	272
Min. Negotiated Rate	$383.66
Max. Negotiated Rate	$1,475.62
Rate for Payer: Aetna Commercial	$885.38
Rate for Payer: Aetna Medicare Advantage	$885.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.57
Rate for Payer: Cigna Commercial	$1,475.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.66
Rate for Payer: Oxford Commercial	$1,475.62
Rate for Payer: Qualcare PPO/HMO/WC	$442.69
Rate for Payer: UnitedHealthcare Commercial	$1,475.62

TUOHY EPIDURAL NEEDLE 17G X 6

Facility

$120.00

Hospital Charge Code	270331713
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

TUOHY EPIDURAL NEEDLE 17G X 6

Facility

$120.00

Hospital Charge Code	270331713
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

TURBINATE GYR SOMNUS 112041105

Facility

$719.25

Hospital Charge Code	270628502
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

TURBINATE GYR SOMNUS 112041105

Facility

$719.25

Hospital Charge Code	270628502
Hospital Revenue Code	272
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$215.78
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.50
Rate for Payer: Oxford Commercial	$359.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.89
Rate for Payer: UnitedHealthcare Commercial	$359.62

TURBINATE HP 1120411001

Facility

$719.25

Hospital Charge Code	270629508
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

TURBINATE HP 1120411001

Facility

$719.25

Hospital Charge Code	270629508
Hospital Revenue Code	272
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$215.78
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.50
Rate for Payer: Oxford Commercial	$359.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.89
Rate for Payer: UnitedHealthcare Commercial	$359.62

TUTOPLAST/ALLOGRAFT

Facility

$1,325.00

Hospital Charge Code	270663906
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

TUTOPLAST/ALLOGRAFT

Facility

$1,325.00

Hospital Charge Code	270663906
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

TUTOPLAST DERMIS 2X2cm 93-9212

Facility

$3,521.65

Hospital Charge Code	270630854
Hospital Revenue Code	272
Min. Negotiated Rate	$528.25
Max. Negotiated Rate	$528.25
Rate for Payer: Qualcare PPO/HMO/WC	$528.25

TUTOPLAST DERMIS 2X2cm 93-9212

Facility

$3,521.65

Hospital Charge Code	270630854
Hospital Revenue Code	272
Min. Negotiated Rate	$457.81
Max. Negotiated Rate	$1,760.83
Rate for Payer: Aetna Commercial	$1,056.49
Rate for Payer: Aetna Medicare Advantage	$1,056.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.02
Rate for Payer: Cigna Commercial	$1,760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.81
Rate for Payer: Oxford Commercial	$1,760.83
Rate for Payer: Qualcare PPO/HMO/WC	$528.25
Rate for Payer: UnitedHealthcare Commercial	$1,760.83

TUTOPLAST FASCA LATA4x7 937201

Facility

$3,968.00

Hospital Charge Code	270630172
Hospital Revenue Code	272
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$595.20
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

TUTOPLAST FASCA LATA4x7 937201

Facility

$3,968.00

Hospital Charge Code	270630172
Hospital Revenue Code	272
Min. Negotiated Rate	$515.84
Max. Negotiated Rate	$1,984.00
Rate for Payer: Aetna Commercial	$1,190.40
Rate for Payer: Aetna Medicare Advantage	$1,190.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,011.84
Rate for Payer: Cigna Commercial	$1,984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.84
Rate for Payer: Oxford Commercial	$1,984.00
Rate for Payer: Qualcare PPO/HMO/WC	$595.20
Rate for Payer: UnitedHealthcare Commercial	$1,984.00

TUTOPLAST PERICARDIUM PATCH

Facility

$702.00

Hospital Charge Code	270335537
Hospital Revenue Code	278
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$169.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.88
Rate for Payer: Qualcare PPO/HMO/WC	$105.30

TUTOPLAST PERICARDIUM PATCH

Facility

$702.00

Hospital Charge Code	270335537
Hospital Revenue Code	278
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$351.00
Rate for Payer: Aetna Commercial	$210.60
Rate for Payer: Aetna Medicare Advantage	$210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.01
Rate for Payer: Cigna Commercial	$351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.88
Rate for Payer: Qualcare PPO/HMO/WC	$105.30

TUTOPLAST SCLERA

Facility

$1,450.00

Service Code	HCPCS L8610
Hospital Charge Code	270688403
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

TUTOPLAST SCLERA

Facility

$1,450.00

Service Code	HCPCS L8610
Hospital Charge Code	270688403
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$848.70
Rate for Payer: Aetna Commercial	$435.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$848.70
Rate for Payer: Cigna Medicare Advantage	$509.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

T.VAGINALIS CULTURE

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39900530
Hospital Revenue Code	309
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.48
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.29
Rate for Payer: Cigna Commercial	$6.63
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.03
Rate for Payer: Wellcare Medicare Advantage	$6.63

T.VAGINALIS CULTURE

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39900530
Hospital Revenue Code	309
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Qualcare PPO/HMO/WC	$6.84

TVT-O SLING W/OBTURATOR 810081

Facility

$4,975.00

Hospital Charge Code	270638390
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

TVT-O SLING W/OBTURATOR 810081

Facility

$4,975.00

Hospital Charge Code	270638390
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

T WHIPPLEI DNA QUAL RTPCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3000376
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

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