Heights University Hospital

All Charges

Charge

Type

Setting

Price

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$9,612.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$19,860.00
Rate for Payer: Aetna Commercial	$11,916.00
Rate for Payer: Aetna Medicare Advantage	$11,916.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,128.60
Rate for Payer: Cigna Commercial	$19,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,415.00
Max. Negotiated Rate	$8,736.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,415.00
Max. Negotiated Rate	$18,050.00
Rate for Payer: Aetna Commercial	$10,830.00
Rate for Payer: Aetna Medicare Advantage	$10,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,205.50
Rate for Payer: Cigna Commercial	$18,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$175.63
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$405.30
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.63
Rate for Payer: Oxford Commercial	$675.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$675.50

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$175.63
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$405.30
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.63
Rate for Payer: Oxford Commercial	$675.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$675.50

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$201.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$775.00

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

BROMFENAL CAP 25MG

Facility

$5.15

Hospital Charge Code	60628743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

BROMFENAL CAP 25MG

Facility

$5.15

Hospital Charge Code	60628743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$2.58
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.31
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$2.58

BROMIDE (SERUM)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007226
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

BROMIDE (SERUM)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007226
Hospital Revenue Code	301
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$22.34
Rate for Payer: Cigna Commercial	$22.34
Rate for Payer: Aetna Commercial	$13.41
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.81
Rate for Payer: Oxford Commercial	$22.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.70
Rate for Payer: UnitedHealthcare Commercial	$22.34

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$6.70
Rate for Payer: Qualcare PPO/HMO/WC	$6.70

BROMPHENIRAMINE-PPA TAB CR

Facility

$3.85

Hospital Charge Code	60627217
Hospital Revenue Code	251
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

BROMPHENIRAMINE-PPA TAB CR

Facility

$3.85

Hospital Charge Code	60627217
Hospital Revenue Code	251
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

BROMPHEN PHENYL ELX 4OZ

Facility

$34.60

Hospital Charge Code	6000749
Hospital Revenue Code	251
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

BROMPHEN PHENYL ELX 4OZ

Facility

$34.60

Hospital Charge Code	6000749
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,878.66
Rate for Payer: Aetna Commercial	$6,512.95
Rate for Payer: Aetna Medicare Advantage	$6,512.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,536.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,536.01
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	$5,536.01
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.28
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$3,256.48
Max. Negotiated Rate	$3,256.48
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$3,930.84

Service Code	APR-DRG 1381
Min. Negotiated Rate	$2,835.25
Max. Negotiated Rate	$3,930.84
Rate for Payer: Aetna Better Health Medicaid	$3,853.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,930.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2,835.25

Know your out-of-pocket cost for care.

All Charges