Heights University Hospital

All Charges

Charge

Type

Setting

Price

DYNANITE STAPLE9WX10L

Facility

$7,475.00

Hospital Charge Code	270686092
Hospital Revenue Code	272
Min. Negotiated Rate	$971.75
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.75
Rate for Payer: Oxford Commercial	$3,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$3,737.50

DYNANITE STR 12MM W/INSTR

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690882
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$2,292.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

DYNANITE STR 12MM W/INSTR

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690882
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$4,737.50
Rate for Payer: Aetna Commercial	$2,842.50
Rate for Payer: Aetna Medicare Advantage	$2,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.12
Rate for Payer: Cigna Commercial	$4,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

DYNANITE STR 14MM W/INSTR

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$4,737.50
Rate for Payer: Aetna Commercial	$2,842.50
Rate for Payer: Aetna Medicare Advantage	$2,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.12
Rate for Payer: Cigna Commercial	$4,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

DYNANITE STR 14MM W/INSTR

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$2,292.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

DYNAPEN/250MG/CAP

Facility

$7.00

Hospital Charge Code	60632920
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

DYNAPEN/250MG/CAP

Facility

$7.00

Hospital Charge Code	60632920
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

DYNAPEN/500MG/TAB

Facility

$18.29

Service Code	NDC 93312501
Hospital Charge Code	60634758
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$9.14
Rate for Payer: Aetna Commercial	$5.49
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.66
Rate for Payer: Cigna Commercial	$9.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.38
Rate for Payer: Oxford Commercial	$9.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.74
Rate for Payer: UnitedHealthcare Commercial	$9.14

DYNAPEN/500MG/TAB

Facility

$18.29

Service Code	NDC 93312501
Hospital Charge Code	60634758
Hospital Revenue Code	250
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$2.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.74

DYNAPEN/62.5MG/5ML

Facility

$61.00

Hospital Charge Code	60632921
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

DYNAPEN/62.5MG/5ML

Facility

$61.00

Hospital Charge Code	60632921
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

DYNAPEN/62.5MG/5ML

Facility

$43.00

Hospital Charge Code	60632919
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

DYNAPEN/62.5MG/5ML

Facility

$43.00

Hospital Charge Code	60632919
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

DYONICS 4.0MM EL ACROMIOBLASTR

Facility

$250.00

Hospital Charge Code	270692788
Hospital Revenue Code	272
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$125.00

DYONICS 4.0MM EL ACROMIOBLASTR

Facility

$250.00

Hospital Charge Code	270692788
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

DYONICS FULL RADIUS 3.5MM

Facility

$616.00

Hospital Charge Code	270601290
Hospital Revenue Code	272
Min. Negotiated Rate	$80.08
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$184.80
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.08
Rate for Payer: Oxford Commercial	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$308.00

DYONICS FULL RADIUS 3.5MM

Facility

$616.00

Hospital Charge Code	270601290
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

DYONICS FULL RADIUS 4.5MM

Facility

$616.00

Hospital Charge Code	270601291
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

DYONICS FULL RADIUS 4.5MM

Facility

$616.00

Hospital Charge Code	270601291
Hospital Revenue Code	272
Min. Negotiated Rate	$80.08
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$184.80
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.08
Rate for Payer: Oxford Commercial	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$308.00

DYRENIUM/100MG

Facility

$3.00

Hospital Charge Code	60634479
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DYRENIUM/100MG

Facility

$3.00

Hospital Charge Code	60634479
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

DYRENIUM/50MG

Facility

$3.00

Hospital Charge Code	60634478
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DYRENIUM/50MG

Facility

$3.00

Hospital Charge Code	60634478
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

DYSEQUILIBRIUM

Facility

$33,637.98

Service Code	MSDRG 149
Min. Negotiated Rate	$8,201.90
Max. Negotiated Rate	$33,637.98
Rate for Payer: Aetna Commercial	$25,343.87
Rate for Payer: Aetna Medicare Advantage	$8,201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,212.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,399.58
Rate for Payer: Cigna Commercial	$16,175.18
Rate for Payer: Cigna Medicare Advantage	$11,212.66
Rate for Payer: Clover Medicare Advantage	$10,652.03
Rate for Payer: EmblemHealth Commercial	$33,637.98
Rate for Payer: Humana Medicare Advantage	$11,549.04
Rate for Payer: Oxford Commercial	$10,109.02
Rate for Payer: UnitedHealthcare Commercial	$11,474.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,212.66
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,885.42
Rate for Payer: Wellcare Medicare Advantage	$11,212.66

E1 VNGD PS+ TIB BRG 63/67X14

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682023
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges