Heights University Hospital

All Charges

Charge

Type

Setting

Price

UROKINASE 5000 UNITS/ML INJ

Facility

$74.50

Hospital Charge Code	6008536
Hospital Revenue Code	250
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$37.25
Rate for Payer: Aetna Commercial	$22.35
Rate for Payer: Aetna Medicare Advantage	$22.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.00
Rate for Payer: Cigna Commercial	$37.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.69
Rate for Payer: Oxford Commercial	$37.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.18
Rate for Payer: UnitedHealthcare Commercial	$37.25

UROKINASE 500 IU

Facility

$255.00

Hospital Charge Code	60634775
Hospital Revenue Code	250
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.15
Rate for Payer: Oxford Commercial	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$127.50

UROKINASE 500 IU

Facility

$255.00

Hospital Charge Code	60634775
Hospital Revenue Code	250
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

UROKINASE INJ 250,000U 5ML

Facility

$3,025.95

Hospital Charge Code	6010201
Hospital Revenue Code	636
Min. Negotiated Rate	$453.89
Max. Negotiated Rate	$732.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.28
Rate for Payer: Qualcare PPO/HMO/WC	$453.89

UROKINASE INJ 250,000U 5ML

Facility

$3,025.95

Hospital Charge Code	6010201
Hospital Revenue Code	636
Min. Negotiated Rate	$453.89
Max. Negotiated Rate	$1,512.97
Rate for Payer: Aetna Commercial	$907.78
Rate for Payer: Aetna Medicare Advantage	$907.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.62
Rate for Payer: Cigna Commercial	$1,512.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.28
Rate for Payer: Qualcare PPO/HMO/WC	$453.89

UROKINASE INJ 5000 IU/ML 1.8ML

Facility

$654.10

Hospital Charge Code	6010219
Hospital Revenue Code	250
Min. Negotiated Rate	$85.03
Max. Negotiated Rate	$327.05
Rate for Payer: Aetna Commercial	$196.23
Rate for Payer: Aetna Medicare Advantage	$196.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.80
Rate for Payer: Cigna Commercial	$327.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.03
Rate for Payer: Oxford Commercial	$327.05
Rate for Payer: Qualcare PPO/HMO/WC	$98.11
Rate for Payer: UnitedHealthcare Commercial	$327.05

UROKINASE INJ 5000 IU/ML 1.8ML

Facility

$654.10

Hospital Charge Code	6010219
Hospital Revenue Code	250
Min. Negotiated Rate	$98.11
Max. Negotiated Rate	$98.11
Rate for Payer: Qualcare PPO/HMO/WC	$98.11

UROKINASE INJ 9,000U/1.8ML

Facility

$519.55

Hospital Charge Code	60627542
Hospital Revenue Code	250
Min. Negotiated Rate	$77.93
Max. Negotiated Rate	$77.93
Rate for Payer: Qualcare PPO/HMO/WC	$77.93

UROKINASE INJ 9,000U/1.8ML

Facility

$519.55

Hospital Charge Code	60627542
Hospital Revenue Code	250
Min. Negotiated Rate	$67.54
Max. Negotiated Rate	$259.77
Rate for Payer: Aetna Commercial	$155.87
Rate for Payer: Aetna Medicare Advantage	$155.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.49
Rate for Payer: Cigna Commercial	$259.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.54
Rate for Payer: Oxford Commercial	$259.77
Rate for Payer: Qualcare PPO/HMO/WC	$77.93
Rate for Payer: UnitedHealthcare Commercial	$259.77

UROLIFT 2 IMPLANT CARTRIDGE

Facility

$23,000.00

Hospital Charge Code	270702038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$6,900.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

UROLIFT 2 IMPLANT CARTRIDGE

Facility

$23,000.00

Hospital Charge Code	270702038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702039
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
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) NJ Health	$1,150.00
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	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702309
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702039
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702309
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
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) NJ Health	$1,150.00
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	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLOME LOANER KIT LK0022

Facility

$11,408.00

Hospital Charge Code	270634331
Hospital Revenue Code	272
Min. Negotiated Rate	$1,483.04
Max. Negotiated Rate	$5,704.00
Rate for Payer: Aetna Commercial	$3,422.40
Rate for Payer: Aetna Medicare Advantage	$3,422.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,909.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,909.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,909.04
Rate for Payer: Cigna Commercial	$5,704.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.04
Rate for Payer: Oxford Commercial	$5,704.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,711.20
Rate for Payer: UnitedHealthcare Commercial	$5,704.00

UROLOME LOANER KIT LK0022

Facility

$11,408.00

Hospital Charge Code	270634331
Hospital Revenue Code	272
Min. Negotiated Rate	$1,711.20
Max. Negotiated Rate	$1,711.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,711.20

URO MAX ULTRA 21FR 75CM ASCEND

Facility

$1,038.70

Hospital Charge Code	270658598
Hospital Revenue Code	278
Min. Negotiated Rate	$155.81
Max. Negotiated Rate	$519.35
Rate for Payer: Aetna Commercial	$311.61
Rate for Payer: Aetna Medicare Advantage	$311.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.87
Rate for Payer: Cigna Commercial	$519.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.37
Rate for Payer: Qualcare PPO/HMO/WC	$155.81

URO MAX ULTRA 21FR 75CM ASCEND

Facility

$1,038.70

Hospital Charge Code	270658598
Hospital Revenue Code	278
Min. Negotiated Rate	$155.81
Max. Negotiated Rate	$251.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.37
Rate for Payer: Qualcare PPO/HMO/WC	$155.81

URO MAX ULTRA BALLOON CATHETER

Facility

$1,741.15

Service Code	HCPCS C1726
Hospital Charge Code	270656990
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$421.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

URO MAX ULTRA BALLOON CATHETER

Facility

$1,741.15

Service Code	HCPCS C1726
Hospital Charge Code	270656990
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$870.58
Rate for Payer: Aetna Commercial	$522.35
Rate for Payer: Aetna Medicare Advantage	$522.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.99
Rate for Payer: Cigna Commercial	$870.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

UROMAX ULTRA BALLOON DILATION

Facility

$1,741.15

Hospital Charge Code	270657032
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$421.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

UROMAX ULTRA BALLOON DILATION

Facility

$1,741.15

Hospital Charge Code	270657032
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$870.58
Rate for Payer: Aetna Commercial	$522.35
Rate for Payer: Aetna Medicare Advantage	$522.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.99
Rate for Payer: Cigna Commercial	$870.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

UROVAC BLADDER EVACUATOR

Facility

$148.00

Hospital Charge Code	270332412
Hospital Revenue Code	272
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

UROVAC BLADDER EVACUATOR

Facility

$148.00

Hospital Charge Code	270332412
Hospital Revenue Code	272
Min. Negotiated Rate	$19.24
Max. Negotiated Rate	$74.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.24
Rate for Payer: Oxford Commercial	$74.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$74.00

Know your out-of-pocket cost for care.

All Charges