Heights University Hospital

All Charges

Charge

Type

Setting

Price

CASE V6.6 GENERIC ATO MODEL

Facility

$550.00

Hospital Charge Code	270648533
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CASHEW NUT (F202) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900356
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CASHEW NUT (F202) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900356
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
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	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

CASPOFUNGIN 50 MG INJ

Facility

$2,232.05

Hospital Charge Code	60629259
Hospital Revenue Code	636
Min. Negotiated Rate	$334.81
Max. Negotiated Rate	$540.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.16
Rate for Payer: Qualcare PPO/HMO/WC	$334.81

CASPOFUNGIN 50 MG INJ

Facility

$2,232.05

Hospital Charge Code	60629259
Hospital Revenue Code	636
Min. Negotiated Rate	$334.81
Max. Negotiated Rate	$1,116.03
Rate for Payer: Aetna Commercial	$669.62
Rate for Payer: Aetna Medicare Advantage	$669.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.17
Rate for Payer: Cigna Commercial	$1,116.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.16
Rate for Payer: Qualcare PPO/HMO/WC	$334.81

CASPR2 ANTIBODY

Facility

$2,525.00

Service Code	HCPCS 86255
Hospital Charge Code	3038552
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$378.75
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$328.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$378.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

CASPR2 ANTIBODY

Facility

$2,525.00

Service Code	HCPCS 86255
Hospital Charge Code	3038552
Hospital Revenue Code	302
Min. Negotiated Rate	$378.75
Max. Negotiated Rate	$378.75
Rate for Payer: Qualcare PPO/HMO/WC	$378.75

CASSETTE MICRODEBRIDER 2 DISP

Facility

$1,651.00

Hospital Charge Code	270658055
Hospital Revenue Code	272
Min. Negotiated Rate	$214.63
Max. Negotiated Rate	$825.50
Rate for Payer: Aetna Commercial	$495.30
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$421.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$421.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$421.00
Rate for Payer: Cigna Commercial	$825.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.63
Rate for Payer: Oxford Commercial	$825.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.65
Rate for Payer: UnitedHealthcare Commercial	$825.50

CASSETTE MICRODEBRIDER 2 DISP

Facility

$1,651.00

Hospital Charge Code	270658055
Hospital Revenue Code	272
Min. Negotiated Rate	$247.65
Max. Negotiated Rate	$247.65
Rate for Payer: Qualcare PPO/HMO/WC	$247.65

CASSETTE PRUGE

Facility

$4,875.00

Hospital Charge Code	270681572
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

CASSETTE PRUGE

Facility

$4,875.00

Hospital Charge Code	270681572
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

CAST AIR RT STS ANKLE BRACE

Facility

$328.85

Hospital Charge Code	270602912
Hospital Revenue Code	270
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$98.66
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: Oxford Commercial	$164.43
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Commercial	$164.43

CAST AIR RT STS ANKLE BRACE

Facility

$328.85

Hospital Charge Code	270602912
Hospital Revenue Code	270
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$49.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

CAST ARM APPLICATION OF

Facility

$374.45

Hospital Charge Code	4000022
Hospital Revenue Code	270
Min. Negotiated Rate	$48.68
Max. Negotiated Rate	$187.22
Rate for Payer: Aetna Commercial	$112.33
Rate for Payer: Aetna Medicare Advantage	$112.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.48
Rate for Payer: Cigna Commercial	$187.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.68
Rate for Payer: Oxford Commercial	$187.22
Rate for Payer: Qualcare PPO/HMO/WC	$56.17
Rate for Payer: UnitedHealthcare Commercial	$187.22

CAST ARM APPLICATION OF

Facility

$374.45

Hospital Charge Code	4000022
Hospital Revenue Code	270
Min. Negotiated Rate	$56.17
Max. Negotiated Rate	$56.17
Rate for Payer: Qualcare PPO/HMO/WC	$56.17

CAST BOOT **********

Facility

$219.00

Hospital Charge Code	8001927
Hospital Revenue Code	279
Min. Negotiated Rate	$28.47
Max. Negotiated Rate	$109.50
Rate for Payer: Aetna Commercial	$65.70
Rate for Payer: Aetna Medicare Advantage	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.84
Rate for Payer: Cigna Commercial	$109.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.47
Rate for Payer: Oxford Commercial	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.85
Rate for Payer: UnitedHealthcare Commercial	$109.50

CAST BOOT **********

Facility

$219.00

Hospital Charge Code	8001927
Hospital Revenue Code	279
Min. Negotiated Rate	$32.85
Max. Negotiated Rate	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$32.85

CAST FINGER APPLICATION OF****

Facility

$122.00

Hospital Charge Code	4000014
Hospital Revenue Code	279
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

CAST FINGER APPLICATION OF****

Facility

$122.00

Hospital Charge Code	4000014
Hospital Revenue Code	279
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

CASTING TAPE 3 4YD DELTA

Facility

$162.85

Hospital Charge Code	270651747
Hospital Revenue Code	272
Min. Negotiated Rate	$24.43
Max. Negotiated Rate	$24.43
Rate for Payer: Qualcare PPO/HMO/WC	$24.43

CASTING TAPE 3 4YD DELTA

Facility

$162.85

Hospital Charge Code	270651747
Hospital Revenue Code	272
Min. Negotiated Rate	$21.17
Max. Negotiated Rate	$81.42
Rate for Payer: Aetna Commercial	$48.85
Rate for Payer: Aetna Medicare Advantage	$48.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.53
Rate for Payer: Cigna Commercial	$81.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.17
Rate for Payer: Oxford Commercial	$81.42
Rate for Payer: Qualcare PPO/HMO/WC	$24.43
Rate for Payer: UnitedHealthcare Commercial	$81.42

CASTING TAPE 5INX4YRD DELTA LT

Facility

$21.26

Hospital Charge Code	270651748
Hospital Revenue Code	270
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$10.63
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna Medicare Advantage	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.42
Rate for Payer: Cigna Commercial	$10.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.76
Rate for Payer: Oxford Commercial	$10.63
Rate for Payer: Qualcare PPO/HMO/WC	$3.19
Rate for Payer: UnitedHealthcare Commercial	$10.63

CASTING TAPE 5INX4YRD DELTA LT

Facility

$21.26

Hospital Charge Code	270651748
Hospital Revenue Code	270
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

CAST LONG LEG APPLICATION OF

Facility

$688.85

Hospital Charge Code	4000030
Hospital Revenue Code	270
Min. Negotiated Rate	$103.33
Max. Negotiated Rate	$103.33
Rate for Payer: Qualcare PPO/HMO/WC	$103.33

CAST LONG LEG APPLICATION OF

Facility

$688.85

Hospital Charge Code	4000030
Hospital Revenue Code	270
Min. Negotiated Rate	$89.55
Max. Negotiated Rate	$344.43
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$206.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.66
Rate for Payer: Cigna Commercial	$344.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.55
Rate for Payer: Oxford Commercial	$344.43
Rate for Payer: Qualcare PPO/HMO/WC	$103.33
Rate for Payer: UnitedHealthcare Commercial	$344.43

Know your out-of-pocket cost for care.

All Charges