Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLOCADREN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634354
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

BLOCADREN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634354
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BLOCADREN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634353
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BLOCADREN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634353
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

BLOCK BD BITE LG 000428

Facility

$46.68

Hospital Charge Code	270617369
Hospital Revenue Code	270
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.00

BLOCK BD BITE LG 000428

Facility

$46.68

Hospital Charge Code	270617369
Hospital Revenue Code	270
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$23.34
Rate for Payer: Aetna Commercial	$14.00
Rate for Payer: Aetna Medicare Advantage	$14.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.90
Rate for Payer: Cigna Commercial	$23.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.07
Rate for Payer: Oxford Commercial	$23.34
Rate for Payer: Qualcare PPO/HMO/WC	$7.00
Rate for Payer: UnitedHealthcare Commercial	$23.34

BLOCKER

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691011
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

BLOCKER

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691011
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

BLOCKERS

Facility

$500.00

Hospital Charge Code	270701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BLOCKERS

Facility

$500.00

Hospital Charge Code	270701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BLOCK FEM AUGMENT 6x60 145341

Facility

$4,226.00

Hospital Charge Code	270635588
Hospital Revenue Code	278
Min. Negotiated Rate	$633.90
Max. Negotiated Rate	$2,113.00
Rate for Payer: Aetna Commercial	$1,267.80
Rate for Payer: Aetna Medicare Advantage	$1,267.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.63
Rate for Payer: Cigna Commercial	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.69
Rate for Payer: Qualcare PPO/HMO/WC	$633.90

BLOCK FEM AUGMENT 6x60 145341

Facility

$4,226.00

Hospital Charge Code	270635588
Hospital Revenue Code	278
Min. Negotiated Rate	$633.90
Max. Negotiated Rate	$1,022.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.69
Rate for Payer: Qualcare PPO/HMO/WC	$633.90

BLOCK INJ PLANTAR DIGIT

Facility

$1,227.12

Service Code	HCPCS 64455
Hospital Charge Code	16001034
Hospital Revenue Code	360
Min. Negotiated Rate	$159.53
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$819.40
Rate for Payer: Aetna Commercial	$368.14
Rate for Payer: Aetna Medicare Advantage	$368.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.92
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.53
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$184.07
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$835.79
Rate for Payer: Wellpoint Medicaid Managed Care	$819.40

BLOCK INJ PLANTAR DIGIT

Facility

$1,227.12

Service Code	HCPCS 64455
Hospital Charge Code	16001034
Hospital Revenue Code	360
Min. Negotiated Rate	$184.07
Max. Negotiated Rate	$184.07
Rate for Payer: Qualcare PPO/HMO/WC	$184.07

BLOCK PROPHECY 2R ALIGN GD

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697279
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

BLOCK PROPHECY 2R ALIGN GD

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697279
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

BLOCKS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	201701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00

BLOCKS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	201701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$832.50
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$1,665.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$832.50
Max. Negotiated Rate	$1,343.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$2,062.50
Rate for Payer: Oxford Commercial	$2,062.50
Rate for Payer: Aetna Commercial	$1,237.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$2,062.50

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

BLOCK ZIM 13/15 20 7871-01-20

Facility

$1,656.85

Hospital Charge Code	270622362
Hospital Revenue Code	278
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$828.42
Rate for Payer: Aetna Commercial	$497.06
Rate for Payer: Aetna Medicare Advantage	$497.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.50
Rate for Payer: Cigna Commercial	$828.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.96
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

BLOCK ZIM 13/15 20 7871-01-20

Facility

$1,656.85

Hospital Charge Code	270622362
Hospital Revenue Code	278
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$400.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.96
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

BLOOD - ADM

Facility

$20.00

Hospital Charge Code	3200011
Hospital Revenue Code	391
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$756.00

Know your out-of-pocket cost for care.

All Charges