Heights University Hospital

All Charges

Charge

Type

Setting

Price

CALCIUM WITH MODIFIER CD

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	8200303RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$5.16
Rate for Payer: Cigna Medicare Advantage	$2.58
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.47
Rate for Payer: Wellcare Medicare Advantage	$5.16

CALCIUM WITH MODIFIER CD

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	8200303RS
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

CALCIUM WITH MODIFIER CE

Facility

$54.45

Service Code	HCPCS 82310CE
Hospital Charge Code	8200304RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.88
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00

CALCIUM WITH MODIFIER CE

Facility

$54.45

Service Code	HCPCS 82310CE
Hospital Charge Code	8200304RS
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

CALCULUS QUANT CHEMICAL

Facility

$91.00

Service Code	HCPCS 82360
Hospital Charge Code	38477109
Hospital Revenue Code	301
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

CALCULUS QUANT CHEMICAL

Facility

$91.00

Service Code	HCPCS 82360
Hospital Charge Code	38477109
Hospital Revenue Code	301
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

CALIBRATED DRILL 4.3MM SHORT

Facility

$800.00

Hospital Charge Code	270663170
Hospital Revenue Code	270
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CALIBRATED DRILL 4.3MM SHORT

Facility

$800.00

Hospital Charge Code	270663170
Hospital Revenue Code	270
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

CALIBRATED DRILL BIT 4.2X145MM

Facility

$2,270.00

Hospital Charge Code	270703862
Hospital Revenue Code	272
Min. Negotiated Rate	$340.50
Max. Negotiated Rate	$340.50
Rate for Payer: Qualcare PPO/HMO/WC	$340.50

CALIBRATED DRILL BIT 4.2X145MM

Facility

$2,270.00

Hospital Charge Code	270703862
Hospital Revenue Code	272
Min. Negotiated Rate	$295.10
Max. Negotiated Rate	$1,135.00
Rate for Payer: Aetna Commercial	$681.00
Rate for Payer: Aetna Medicare Advantage	$681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.85
Rate for Payer: Cigna Commercial	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.10
Rate for Payer: Oxford Commercial	$1,135.00
Rate for Payer: Qualcare PPO/HMO/WC	$340.50
Rate for Payer: UnitedHealthcare Commercial	$1,135.00

CALIBRATED DRILL BIT 4.3

Facility

$1,550.00

Hospital Charge Code	270657812
Hospital Revenue Code	272
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

CALIBRATED DRILL BIT 4.3

Facility

$1,550.00

Hospital Charge Code	270657812
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

CALIBRATION VALIDATION PRODUCT

Facility

$24.00

Hospital Charge Code	270658860
Hospital Revenue Code	270
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CALIBRATION VALIDATION PRODUCT

Facility

$24.00

Hospital Charge Code	270658860
Hospital Revenue Code	270
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

CALOTTE FULL DUR SHP-555-CLT12

Facility

$6,200.00

Hospital Charge Code	270620695
Hospital Revenue Code	272
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$930.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

CALOTTE FULL DUR SHP-555-CLT12

Facility

$6,200.00

Hospital Charge Code	270620695
Hospital Revenue Code	272
Min. Negotiated Rate	$806.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.00
Rate for Payer: Oxford Commercial	$3,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00
Rate for Payer: UnitedHealthcare Commercial	$3,100.00

CALPORTECTIN, STOOL

Facility

$134.90

Service Code	HCPCS 83993
Hospital Charge Code	39900117
Hospital Revenue Code	301
Min. Negotiated Rate	$20.23
Max. Negotiated Rate	$20.23
Rate for Payer: Qualcare PPO/HMO/WC	$20.23

CALPORTECTIN, STOOL

Facility

$134.90

Service Code	HCPCS 83993
Hospital Charge Code	39900117
Hospital Revenue Code	301
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.92
Rate for Payer: Cigna Commercial	$19.63
Rate for Payer: Cigna Medicare Advantage	$9.81
Rate for Payer: Clover Medicare Advantage	$18.65
Rate for Payer: EmblemHealth Commercial	$58.89
Rate for Payer: Humana Medicare Advantage	$20.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.23
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.81
Rate for Payer: Wellcare Medicare Advantage	$19.63

CALPROTECTIN, FECAL

Facility

$390.00

Service Code	HCPCS 83993
Hospital Charge Code	3038141
Hospital Revenue Code	301
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.92
Rate for Payer: Cigna Commercial	$19.63
Rate for Payer: Cigna Medicare Advantage	$9.81
Rate for Payer: Clover Medicare Advantage	$18.65
Rate for Payer: EmblemHealth Commercial	$58.89
Rate for Payer: Humana Medicare Advantage	$20.22
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	$19.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.81
Rate for Payer: Wellcare Medicare Advantage	$19.63

CALPROTECTIN, FECAL

Facility

$390.00

Service Code	HCPCS 83993
Hospital Charge Code	3038141
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CALTRATE-600/1.5GM/TAB

Facility

$1.00

Hospital Charge Code	60632607
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

CALTRATE-600/1.5GM/TAB

Facility

$1.00

Hospital Charge Code	60632607
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

CAMALOX/12OZ

Facility

$61.00

Hospital Charge Code	60634584
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

CAMALOX/12OZ

Facility

$61.00

Hospital Charge Code	60634584
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

CAMERA SOAKER CAP 1488/1288

Facility

$240.55

Hospital Charge Code	270688264
Hospital Revenue Code	272
Min. Negotiated Rate	$31.27
Max. Negotiated Rate	$120.28
Rate for Payer: Aetna Commercial	$72.17
Rate for Payer: Aetna Medicare Advantage	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.34
Rate for Payer: Cigna Commercial	$120.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.27
Rate for Payer: Oxford Commercial	$120.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.08
Rate for Payer: UnitedHealthcare Commercial	$120.28

Know your out-of-pocket cost for care.

All Charges