Heights University Hospital

All Charges

Charge

Type

Setting

Price

CASCADE 910046

Facility

$750.00

Hospital Charge Code	270646505
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

CASCADE 910046

Facility

$750.00

Hospital Charge Code	270646505
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

CASCADE PLATELET SYST PRFM KIT

Facility

$1,750.00

Hospital Charge Code	270678210
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CASCADE PLATELET SYST PRFM KIT

Facility

$1,750.00

Hospital Charge Code	270678210
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CASCADE PLATELET SYST PRP MEMB

Facility

$3,300.00

Hospital Charge Code	270678212
Hospital Revenue Code	272
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.00
Rate for Payer: Oxford Commercial	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Commercial	$1,650.00

CASCADE PLATELET SYST PRP MEMB

Facility

$3,300.00

Hospital Charge Code	270678212
Hospital Revenue Code	272
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

CASCADE PLATELET SYST PRP x2

Facility

$2,625.00

Hospital Charge Code	270678211
Hospital Revenue Code	272
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.25
Rate for Payer: Oxford Commercial	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$1,312.50

CASCADE PLATELET SYST PRP x2

Facility

$2,625.00

Hospital Charge Code	270678211
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

CASCARA AROMATIC 4 OZ

Facility

$1.95

Hospital Charge Code	6006258
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

CASCARA AROMATIC 4 OZ

Facility

$1.95

Hospital Charge Code	6006258
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

CASCARA LQ 120ML

Facility

$9.00

Hospital Charge Code	60628587
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

CASCARA LQ 120ML

Facility

$9.00

Hospital Charge Code	60628587
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CASCARA SAGRADA 5ML U/D CUP

Facility

$1.60

Hospital Charge Code	60629313
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.80
Rate for Payer: Aetna Commercial	$0.48
Rate for Payer: Aetna Medicare Advantage	$0.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.41
Rate for Payer: Cigna Commercial	$0.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.21
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.24
Rate for Payer: UnitedHealthcare Commercial	$0.80

CASCARA SAGRADA 5ML U/D CUP

Facility

$1.60

Hospital Charge Code	60629313
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.24

CASCARA SAGRADA AROMATIC

Facility

$1.00

Hospital Charge Code	60632641
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

CASCARA SAGRADA AROMATIC

Facility

$1.00

Hospital Charge Code	60632641
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

CASCARA SAGRADA AROMATIC

Facility

$3.00

Hospital Charge Code	60632642
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CASCARA SAGRADA AROMATIC

Facility

$3.00

Hospital Charge Code	60632642
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

CASE 2.7/3.5MM VA-LCP ELBW SYS

Facility

$6,201.65

Hospital Charge Code	270677662
Hospital Revenue Code	272
Min. Negotiated Rate	$806.21
Max. Negotiated Rate	$3,100.82
Rate for Payer: Aetna Commercial	$1,860.49
Rate for Payer: Aetna Medicare Advantage	$1,860.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.42
Rate for Payer: Cigna Commercial	$3,100.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.21
Rate for Payer: Oxford Commercial	$3,100.82
Rate for Payer: Qualcare PPO/HMO/WC	$930.25
Rate for Payer: UnitedHealthcare Commercial	$3,100.82

CASE 2.7/3.5MM VA-LCP ELBW SYS

Facility

$6,201.65

Hospital Charge Code	270677662
Hospital Revenue Code	272
Min. Negotiated Rate	$930.25
Max. Negotiated Rate	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$930.25

CASE SURGICAL W/O BRACKETS 11

Facility

$3,495.00

Hospital Charge Code	270665199
Hospital Revenue Code	270
Min. Negotiated Rate	$454.35
Max. Negotiated Rate	$1,747.50
Rate for Payer: Aetna Commercial	$1,048.50
Rate for Payer: Aetna Medicare Advantage	$1,048.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$891.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$891.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$891.23
Rate for Payer: Cigna Commercial	$1,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.35
Rate for Payer: Oxford Commercial	$1,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$524.25
Rate for Payer: UnitedHealthcare Commercial	$1,747.50

CASE SURGICAL W/O BRACKETS 11

Facility

$3,495.00

Hospital Charge Code	270665199
Hospital Revenue Code	270
Min. Negotiated Rate	$524.25
Max. Negotiated Rate	$524.25
Rate for Payer: Qualcare PPO/HMO/WC	$524.25

CASE TRIMANO

Facility

$1,850.00

Hospital Charge Code	270676551
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

CASE TRIMANO

Facility

$1,850.00

Hospital Charge Code	270676551
Hospital Revenue Code	272
Min. Negotiated Rate	$240.50
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$555.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.50
Rate for Payer: Oxford Commercial	$925.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$925.00

CASE V6.6 GENERIC ATO MODEL

Facility

$550.00

Hospital Charge Code	270648533
Hospital Revenue Code	272
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$275.00

Know your out-of-pocket cost for care.

All Charges