Heights University Hospital

All Charges

Charge

Type

Setting

Price

BUPROPION XL 300MG

Facility

$19.07

Hospital Charge Code	60635738
Hospital Revenue Code	250
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$9.54
Rate for Payer: Aetna Commercial	$5.72
Rate for Payer: Aetna Medicare Advantage	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.48
Rate for Payer: Oxford Commercial	$9.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$9.54

BUPROPION XL 300MG

Facility

$19.07

Hospital Charge Code	60635738
Hospital Revenue Code	250
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

BUPROPION XL(WELLBUTRIN)300

Facility

$204.02

Service Code	NDC 904657304
Hospital Charge Code	60630150
Hospital Revenue Code	250
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$102.01
Rate for Payer: Aetna Commercial	$61.21
Rate for Payer: Aetna Medicare Advantage	$61.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.03
Rate for Payer: Cigna Commercial	$102.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$102.01
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$102.01

BUPROPION XL(WELLBUTRIN)300

Facility

$204.02

Service Code	NDC 904657304
Hospital Charge Code	60630150
Hospital Revenue Code	250
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

BUR 1.6MMX9CM MIDAS REX MR8

Facility

$1,660.00

Hospital Charge Code	270696446
Hospital Revenue Code	272
Min. Negotiated Rate	$249.00
Max. Negotiated Rate	$249.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.00

BUR 1.6MMX9CM MIDAS REX MR8

Facility

$1,660.00

Hospital Charge Code	270696446
Hospital Revenue Code	272
Min. Negotiated Rate	$215.80
Max. Negotiated Rate	$830.00
Rate for Payer: Aetna Commercial	$498.00
Rate for Payer: Aetna Medicare Advantage	$498.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.30
Rate for Payer: Cigna Commercial	$830.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.80
Rate for Payer: Oxford Commercial	$830.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.00
Rate for Payer: UnitedHealthcare Commercial	$830.00

BUR 2.3 MM TAPERED ROUTER

Facility

$577.55

Hospital Charge Code	270683609
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$173.26
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$288.77
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$288.77

BUR 2.3 MM TAPERED ROUTER

Facility

$577.55

Hospital Charge Code	270683609
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

BUR 25.4MMX9CM MIDAS REX MR8

Facility

$1,385.00

Hospital Charge Code	270696447
Hospital Revenue Code	272
Min. Negotiated Rate	$180.05
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$415.50
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Oxford Commercial	$692.50
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Commercial	$692.50

BUR 25.4MMX9CM MIDAS REX MR8

Facility

$1,385.00

Hospital Charge Code	270696447
Hospital Revenue Code	272
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$207.75
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

BUR 3MMX9CM MIDAS REX MR8

Facility

$1,660.00

Hospital Charge Code	270696448
Hospital Revenue Code	272
Min. Negotiated Rate	$215.80
Max. Negotiated Rate	$830.00
Rate for Payer: Aetna Commercial	$498.00
Rate for Payer: Aetna Medicare Advantage	$498.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.30
Rate for Payer: Cigna Commercial	$830.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.80
Rate for Payer: Oxford Commercial	$830.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.00
Rate for Payer: UnitedHealthcare Commercial	$830.00

BUR 3MMX9CM MIDAS REX MR8

Facility

$1,660.00

Hospital Charge Code	270696448
Hospital Revenue Code	272
Min. Negotiated Rate	$249.00
Max. Negotiated Rate	$249.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.00

BUR 4.0MM ROUND CUTTING

Facility

$274.00

Hospital Charge Code	270696474
Hospital Revenue Code	272
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$137.00
Rate for Payer: Aetna Commercial	$82.20
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.87
Rate for Payer: Cigna Commercial	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$137.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$137.00

BUR 4.0MM ROUND CUTTING

Facility

$274.00

Hospital Charge Code	270696474
Hospital Revenue Code	272
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

BUR 4mm CUTTING 31314065UE

Facility

$175.00

Hospital Charge Code	270639699
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

BUR 4mm CUTTING 31314065UE

Facility

$175.00

Hospital Charge Code	270639699
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

BUR 6.0 ACORN MM

Facility

$1,125.00

Hospital Charge Code	270683985
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.25
Rate for Payer: Oxford Commercial	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$562.50

BUR 6.0 ACORN MM

Facility

$1,125.00

Hospital Charge Code	270683985
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BUR 6mm CUTTING 31316058UE

Facility

$325.00

Hospital Charge Code	270639698
Hospital Revenue Code	272
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

BUR 6mm CUTTING 31316058UE

Facility

$325.00

Hospital Charge Code	270639698
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

BUR ACORN 6.0MM

Facility

$621.00

Hospital Charge Code	270675182
Hospital Revenue Code	272
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$93.15

BUR ACORN 6.0MM

Facility

$621.00

Hospital Charge Code	270675182
Hospital Revenue Code	272
Min. Negotiated Rate	$80.73
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$186.30
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.73
Rate for Payer: Oxford Commercial	$310.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$310.50

BUR ACORN 6.0MM LONG

Facility

$440.00

Hospital Charge Code	270676377
Hospital Revenue Code	272
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

BUR ACORN 6.0MM LONG

Facility

$440.00

Hospital Charge Code	270676377
Hospital Revenue Code	272
Min. Negotiated Rate	$57.20
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.20
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$220.00

BUR ACORN EXTRA LONG

Facility

$580.75

Hospital Charge Code	270675302
Hospital Revenue Code	272
Min. Negotiated Rate	$75.50
Max. Negotiated Rate	$290.38
Rate for Payer: Aetna Commercial	$174.22
Rate for Payer: Aetna Medicare Advantage	$174.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.09
Rate for Payer: Cigna Commercial	$290.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.50
Rate for Payer: Oxford Commercial	$290.38
Rate for Payer: Qualcare PPO/HMO/WC	$87.11
Rate for Payer: UnitedHealthcare Commercial	$290.38

Know your out-of-pocket cost for care.

All Charges