Heights University Hospital

All Charges

Charge

Type

Setting

Price

DAUNORUBICIN INJ 20MG

Facility

$1,220.50

Hospital Charge Code	6000103
Hospital Revenue Code	636
Min. Negotiated Rate	$183.07
Max. Negotiated Rate	$610.25
Rate for Payer: Aetna Commercial	$366.15
Rate for Payer: Aetna Medicare Advantage	$366.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.23
Rate for Payer: Cigna Commercial	$610.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.36
Rate for Payer: Qualcare PPO/HMO/WC	$183.07

DAUNORUBICIN INJ 20MG

Facility

$1,220.50

Hospital Charge Code	6000103
Hospital Revenue Code	636
Min. Negotiated Rate	$183.07
Max. Negotiated Rate	$295.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.36
Rate for Payer: Qualcare PPO/HMO/WC	$183.07

DAV catheter 100cm Beacon

Facility

$550.00

Hospital Charge Code	270624956
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

DAV catheter 100cm Beacon

Facility

$550.00

Hospital Charge Code	270624956N
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

DAV catheter 100cm Beacon

Facility

$550.00

Hospital Charge Code	270624956N
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

DAV catheter 100cm Beacon

Facility

$550.00

Hospital Charge Code	270624956
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

DAVOL SEPRAMESH 4X8

Facility

$660.00

Hospital Charge Code	270339455
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

DAVOL SEPRAMESH 4X8

Facility

$660.00

Hospital Charge Code	270339455
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$198.00
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

DAVOL SORBAFIX

Facility

$945.00

Hospital Charge Code	270339456
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

DAVOL SORBAFIX

Facility

$945.00

Hospital Charge Code	270339456
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

DAYPRO/600MG/U/D

Facility

$7.00

Hospital Charge Code	60634934
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

DAYPRO/600MG/U/D

Facility

$7.00

Hospital Charge Code	60634934
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Hospital Charge Code	24746280
Hospital Revenue Code	915
Min. Negotiated Rate	$104.10
Max. Negotiated Rate	$400.40
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246280
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Hospital Charge Code	24786280
Hospital Revenue Code	915
Min. Negotiated Rate	$104.10
Max. Negotiated Rate	$400.40
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Hospital Charge Code	24786280
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246280
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

DAY TREATMENT < 2.5 HOURS

Facility

$800.80

Hospital Charge Code	24746280
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT > 2.5 HOURS

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246275
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

DAY TREATMENT > 2.5 HOURS

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246275
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

DBL OST BUNION CORRECT

Facility

$31,049.10

Service Code	HCPCS 28299
Hospital Charge Code	16000252
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$9,314.73
Rate for Payer: Aetna Medicare Advantage	$9,314.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,917.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,917.52
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	$7,917.52
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,036.38
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DBL OST BUNION CORRECT

Facility

$31,049.10

Service Code	HCPCS 28299
Hospital Charge Code	16000252
Hospital Revenue Code	360
Min. Negotiated Rate	$4,657.36
Max. Negotiated Rate	$4,657.36
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36

DBM 30CC CANCELLOUS CHIPS

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695305
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

DBM 30CC CANCELLOUS CHIPS

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695305
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

DBM CRUSH MIX 2.5 CC

Facility

$6,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270683202
Hospital Revenue Code	278
Min. Negotiated Rate	$909.00
Max. Negotiated Rate	$3,030.00
Rate for Payer: Aetna Commercial	$1,818.00
Rate for Payer: Aetna Medicare Advantage	$1,818.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,545.30
Rate for Payer: Cigna Commercial	$3,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,466.52
Rate for Payer: Qualcare PPO/HMO/WC	$909.00

Know your out-of-pocket cost for care.

All Charges