Heights University Hospital

All Charges

Charge

Type

Setting

Price

BIOTINIDASE SERUM

Facility

$390.00

Service Code	HCPCS 82261
Hospital Charge Code	39708051
Hospital Revenue Code	301
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.66
Rate for Payer: Aetna Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.81
Rate for Payer: Cigna Commercial	$16.87
Rate for Payer: Cigna Medicare Advantage	$8.44
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
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	$16.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.88
Rate for Payer: Wellcare Medicare Advantage	$16.87

BIOTINIDASE SERUM

Facility

$390.00

Service Code	HCPCS 82261
Hospital Charge Code	39708051
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BIOTIN LEVEL

Facility

$80.40

Service Code	HCPCS 84591
Hospital Charge Code	3007789
Hospital Revenue Code	301
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$114.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: Aetna Commercial	$55.27
Rate for Payer: Aetna Medicare Advantage	$17.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.51
Rate for Payer: Cigna Commercial	$17.06
Rate for Payer: Cigna Medicare Advantage	$8.53
Rate for Payer: Clover Medicare Advantage	$16.21
Rate for Payer: EmblemHealth Commercial	$51.18
Rate for Payer: Humana Medicare Advantage	$17.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.08
Rate for Payer: Wellcare Medicare Advantage	$17.06

BIOTIN LEVEL

Facility

$80.40

Service Code	HCPCS 84591
Hospital Charge Code	3007789
Hospital Revenue Code	301
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$12.06
Rate for Payer: Qualcare PPO/HMO/WC	$12.06

BIOXPRESS GRAFT DELIVERY SYSTE

Facility

$750.00

Service Code	HCPCS C1762
Hospital Charge Code	270705016
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BIOXPRESS GRAFT DELIVERY SYSTE

Facility

$750.00

Service Code	HCPCS C1762
Hospital Charge Code	270705016
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BIPAP CIRCUIT W/ACCESSO

Facility

$862.45

Hospital Charge Code	270606307
Hospital Revenue Code	272
Min. Negotiated Rate	$112.12
Max. Negotiated Rate	$431.23
Rate for Payer: Aetna Commercial	$258.74
Rate for Payer: Aetna Medicare Advantage	$258.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.92
Rate for Payer: Cigna Commercial	$431.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.12
Rate for Payer: Oxford Commercial	$431.23
Rate for Payer: Qualcare PPO/HMO/WC	$129.37
Rate for Payer: UnitedHealthcare Commercial	$431.23

BIPAP CIRCUIT W/ACCESSO

Facility

$862.45

Hospital Charge Code	270606307
Hospital Revenue Code	272
Min. Negotiated Rate	$129.37
Max. Negotiated Rate	$129.37
Rate for Payer: Qualcare PPO/HMO/WC	$129.37

BIPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500175
Hospital Revenue Code	410
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$180.85
Rate for Payer: Qualcare PPO/HMO/WC	$180.85

BIPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500175
Hospital Revenue Code	410
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$361.71
Rate for Payer: Aetna Medicare Advantage	$361.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.45
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.74
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.85
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

BIPAP PROCEDURE*****

Facility

$418.00

Service Code	HCPCS 94660
Hospital Charge Code	9500174
Hospital Revenue Code	419
Min. Negotiated Rate	$54.34
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.59
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.34
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

BIPAP PROCEDURE*****

Facility

$418.00

Service Code	HCPCS 94660
Hospital Charge Code	9500174
Hospital Revenue Code	419
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$62.70
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

BIPOLAR 28 MM 46MM OD

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701914
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

BIPOLAR 28 MM 46MM OD

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701914
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

BIPOLAR COMPONENT

Facility

$7,675.00

Hospital Charge Code	270656481
Hospital Revenue Code	271
Min. Negotiated Rate	$997.75
Max. Negotiated Rate	$3,837.50
Rate for Payer: Aetna Commercial	$2,302.50
Rate for Payer: Aetna Medicare Advantage	$2,302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,957.12
Rate for Payer: Cigna Commercial	$3,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$997.75
Rate for Payer: Oxford Commercial	$3,837.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25
Rate for Payer: UnitedHealthcare Commercial	$3,837.50

BIPOLAR COMPONENT

Facility

$7,675.00

Hospital Charge Code	270656481
Hospital Revenue Code	271
Min. Negotiated Rate	$1,151.25
Max. Negotiated Rate	$1,151.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25

BIPOLAR COMPONENT 25x50mm

Facility

$3,000.00

Hospital Charge Code	270675125
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT 25x50mm

Facility

$3,000.00

Hospital Charge Code	270675125
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT 28x46mm

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270675059
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT 28x46mm

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270675059
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT 28X48MM

Facility

$1,500.00

Hospital Charge Code	270669545
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

BIPOLAR COMPONENT 28X48MM

Facility

$1,500.00

Hospital Charge Code	270669545
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

BIPOLAR COMPONENT 28x49MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674252
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT 28x49MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674252
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIPOLAR COMPONENT-LEFT HIP

Facility

$5,609.50

Service Code	HCPCS C1776
Hospital Charge Code	270676774
Hospital Revenue Code	278
Min. Negotiated Rate	$841.42
Max. Negotiated Rate	$1,357.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,121.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.50
Rate for Payer: Qualcare PPO/HMO/WC	$841.42

Know your out-of-pocket cost for care.

All Charges