Heights University Hospital

All Charges

Charge

Type

Setting

Price

Abilify Maintena 300mg/ml inj

Facility

$9,554.27

Service Code	HCPCS J0401
Hospital Charge Code	606390240
Hospital Revenue Code	636
Min. Negotiated Rate	$1,433.14
Max. Negotiated Rate	$2,312.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.14

Abilify Maintena 300mg/ml inj

Facility

$9,554.27

Service Code	HCPCS J0401
Hospital Charge Code	606390240
Hospital Revenue Code	636
Min. Negotiated Rate	$1,433.14
Max. Negotiated Rate	$2,866.28
Rate for Payer: Aetna Commercial	$2,866.28
Rate for Payer: Aetna Medicare Advantage	$2,866.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,436.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,436.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,436.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.14

Abilify Maintena 400mg/ml inj

Facility

$12,739.05

Service Code	HCPCS J0401
Hospital Charge Code	606390241
Hospital Revenue Code	636
Min. Negotiated Rate	$1,910.86
Max. Negotiated Rate	$3,821.72
Rate for Payer: Aetna Commercial	$3,821.72
Rate for Payer: Aetna Medicare Advantage	$3,821.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,082.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,910.86

Abilify Maintena 400mg/ml inj

Facility

$12,739.05

Service Code	HCPCS J0401
Hospital Charge Code	606390241
Hospital Revenue Code	636
Min. Negotiated Rate	$1,910.86
Max. Negotiated Rate	$3,082.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,082.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,910.86

ABILIFY ORAL 1MG/ML SOL

Facility

$47.37

Service Code	NDC 60505040405
Hospital Charge Code	6063943045
Hospital Revenue Code	250
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$23.68
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.08
Rate for Payer: Cigna Commercial	$23.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.16
Rate for Payer: Oxford Commercial	$23.68
Rate for Payer: Qualcare PPO/HMO/WC	$7.11
Rate for Payer: UnitedHealthcare Commercial	$23.68

ABILIFY ORAL 1MG/ML SOL

Facility

$47.37

Service Code	NDC 60505040405
Hospital Charge Code	6063943045
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$7.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.11

ABLATE HEART DYSRHYTHM FOCUS

Facility

$34,545.48

Service Code	HCPCS 93650
Hospital Charge Code	69008136
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$18,574.08
Rate for Payer: Aetna Commercial	$10,363.64
Rate for Payer: Aetna Medicare Advantage	$10,363.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,809.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,809.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,809.10
Rate for Payer: Cigna Commercial	$18,574.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,490.91
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,181.82
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

ABLATE HEART DYSRHYTHM FOCUS

Facility

$34,545.48

Service Code	HCPCS 93650
Hospital Charge Code	69008136
Hospital Revenue Code	481
Min. Negotiated Rate	$5,181.82
Max. Negotiated Rate	$5,181.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,181.82

ABLATE INF TURBINATE SUBMUC BL

Facility

$16,164.25

Service Code	HCPCS 30802
Hospital Charge Code	1600000517
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,849.27
Rate for Payer: Aetna Commercial	$4,849.27
Rate for Payer: Aetna Medicare Advantage	$4,849.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,121.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,121.88
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	$4,121.88
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,101.35
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,424.64
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

ABLATE INF TURBINATE SUBMUC BL

Facility

$16,164.25

Service Code	HCPCS 30802
Hospital Charge Code	1600000517
Hospital Revenue Code	360
Min. Negotiated Rate	$2,424.64
Max. Negotiated Rate	$2,424.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,424.64

ABLATE INF TURBINATE SUPERF

Facility

$6,474.80

Service Code	HCPCS 30801
Hospital Charge Code	1600000315
Hospital Revenue Code	360
Min. Negotiated Rate	$841.72
Max. Negotiated Rate	$3,694.94
Rate for Payer: Aetna Commercial	$1,942.44
Rate for Payer: Aetna Medicare Advantage	$1,942.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.07
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	$1,651.07
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$841.72
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

ABLATE INF TURBINATE SUPERF

Facility

$6,474.80

Service Code	HCPCS 30801
Hospital Charge Code	1600000315
Hospital Revenue Code	360
Min. Negotiated Rate	$971.22
Max. Negotiated Rate	$971.22
Rate for Payer: Qualcare PPO/HMO/WC	$971.22

ABLATION INSTRUMENT 10/15MM

Facility

$15,975.00

Hospital Charge Code	270670689
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

ABLATION INSTRUMENT 10/15MM

Facility

$15,975.00

Hospital Charge Code	270670689
Hospital Revenue Code	272
Min. Negotiated Rate	$2,076.75
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$4,792.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.75
Rate for Payer: Oxford Commercial	$7,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$7,987.50

ABLATION INSTRUMENT 5/10MM

Facility

$15,975.00

Hospital Charge Code	270670690
Hospital Revenue Code	272
Min. Negotiated Rate	$2,076.75
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$4,792.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.75
Rate for Payer: Oxford Commercial	$7,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$7,987.50

ABLATION INSTRUMENT 5/10MM

Facility

$15,975.00

Hospital Charge Code	270670690
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

ABLATOR 50 APOLLO

Facility

$1,300.00

Hospital Charge Code	270687981
Hospital Revenue Code	272
Min. Negotiated Rate	$169.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$650.00

ABLATOR 50 APOLLO

Facility

$1,300.00

Hospital Charge Code	270687981
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

ABLATOR 50D APOLLO RF

Facility

$1,250.00

Hospital Charge Code	270693449
Hospital Revenue Code	272
Min. Negotiated Rate	$162.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$625.00

ABLATOR 50D APOLLO RF

Facility

$1,250.00

Hospital Charge Code	270693449
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ABLATOR ASPIRATING 3MM 50DEG

Facility

$875.00

Hospital Charge Code	270671807
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ABLATOR ASPIRATING 3MM 50DEG

Facility

$875.00

Hospital Charge Code	270671807
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

ABLATOR ASPIRATING 3MM 90DEG

Facility

$875.00

Hospital Charge Code	270671806
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

ABLATOR ASPIRATING 3MM 90DEG

Facility

$875.00

Hospital Charge Code	270671806
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ABLATOR HOOK 90DEG

Facility

$575.00

Hospital Charge Code	270671808
Hospital Revenue Code	272
Min. Negotiated Rate	$74.75
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.75
Rate for Payer: Oxford Commercial	$287.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$287.50

Know your out-of-pocket cost for care.

All Charges