Heights University Hospital

All Charges

Charge

Type

Setting

Price

FIBRIN SPLIT PRODUCTS

Facility

$390.00

Service Code	HCPCS 85362
Hospital Charge Code	3002946
Hospital Revenue Code	305
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
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	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
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	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

FIBRIN SPLIT PRODUCTS

Facility

$390.00

Service Code	HCPCS 85362
Hospital Charge Code	3002946
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBROGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85384
Hospital Charge Code	401485384
Hospital Revenue Code	305
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.49
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.61
Rate for Payer: Cigna Commercial	$9.72
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
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	$9.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.30
Rate for Payer: Wellcare Medicare Advantage	$9.72

FIBROGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85384
Hospital Charge Code	401485384
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBULA ANATOMIC LOCK RIGHT 4H

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270681981
Hospital Revenue Code	278
Min. Negotiated Rate	$475.80
Max. Negotiated Rate	$767.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: Qualcare PPO/HMO/WC	$475.80

FIBULA ANATOMIC LOCK RIGHT 4H

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270681981
Hospital Revenue Code	278
Min. Negotiated Rate	$475.80
Max. Negotiated Rate	$1,586.00
Rate for Payer: Aetna Commercial	$951.60
Rate for Payer: Aetna Medicare Advantage	$951.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.86
Rate for Payer: Cigna Commercial	$1,586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: Qualcare PPO/HMO/WC	$475.80

FIBULA COMP LOCK PLATE 10H

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685141
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FIBULA COMP LOCK PLATE 10H

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685141
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FIBULA PLATE 1

Facility

$4,088.25

Hospital Charge Code	270656679
Hospital Revenue Code	278
Min. Negotiated Rate	$613.24
Max. Negotiated Rate	$2,044.12
Rate for Payer: Aetna Commercial	$1,226.47
Rate for Payer: Aetna Medicare Advantage	$1,226.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$817.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.50
Rate for Payer: Cigna Commercial	$2,044.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.36
Rate for Payer: Qualcare PPO/HMO/WC	$613.24

FIBULA PLATE 1

Facility

$4,088.25

Hospital Charge Code	270656679
Hospital Revenue Code	278
Min. Negotiated Rate	$613.24
Max. Negotiated Rate	$989.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$817.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.36
Rate for Payer: Qualcare PPO/HMO/WC	$613.24

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$580.12
Max. Negotiated Rate	$1,933.75
Rate for Payer: Aetna Commercial	$1,160.25
Rate for Payer: Aetna Medicare Advantage	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.21
Rate for Payer: Cigna Commercial	$1,933.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: Qualcare PPO/HMO/WC	$580.12

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$580.12
Max. Negotiated Rate	$935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: Qualcare PPO/HMO/WC	$580.12

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$515.25
Max. Negotiated Rate	$831.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: Qualcare PPO/HMO/WC	$515.25

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$515.25
Max. Negotiated Rate	$1,717.50
Rate for Payer: Aetna Commercial	$1,030.50
Rate for Payer: Aetna Medicare Advantage	$1,030.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$875.92
Rate for Payer: Cigna Commercial	$1,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: Qualcare PPO/HMO/WC	$515.25

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$428.02
Max. Negotiated Rate	$1,646.25
Rate for Payer: Aetna Commercial	$987.75
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.02
Rate for Payer: Oxford Commercial	$1,646.25
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Commercial	$1,646.25

FIBULAR STRUT 8mm 450658

Facility

$4,890.00

Hospital Charge Code	270638883
Hospital Revenue Code	278
Min. Negotiated Rate	$733.50
Max. Negotiated Rate	$1,183.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$978.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,183.38
Rate for Payer: Qualcare PPO/HMO/WC	$733.50

FIBULAR STRUT 8mm 450658

Facility

$4,890.00

Hospital Charge Code	270638883
Hospital Revenue Code	278
Min. Negotiated Rate	$733.50
Max. Negotiated Rate	$2,445.00
Rate for Payer: Aetna Commercial	$1,467.00
Rate for Payer: Aetna Medicare Advantage	$1,467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,246.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,246.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,246.95
Rate for Payer: Cigna Commercial	$2,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,183.38
Rate for Payer: Qualcare PPO/HMO/WC	$733.50

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,056.25
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.25
Rate for Payer: Oxford Commercial	$4,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Commercial	$4,062.50

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$172.86
Max. Negotiated Rate	$664.84
Rate for Payer: Aetna Commercial	$398.90
Rate for Payer: Aetna Medicare Advantage	$398.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.07
Rate for Payer: Cigna Commercial	$664.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.86
Rate for Payer: Oxford Commercial	$664.84
Rate for Payer: Qualcare PPO/HMO/WC	$199.45
Rate for Payer: UnitedHealthcare Commercial	$664.84

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$199.45
Max. Negotiated Rate	$199.45
Rate for Payer: Qualcare PPO/HMO/WC	$199.45

FILAGASTRIM INJ 1ML

Facility

$1,239.70

Hospital Charge Code	6007173
Hospital Revenue Code	636
Min. Negotiated Rate	$185.96
Max. Negotiated Rate	$619.85
Rate for Payer: Aetna Commercial	$371.91
Rate for Payer: Aetna Medicare Advantage	$371.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.12
Rate for Payer: Cigna Commercial	$619.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.01
Rate for Payer: Qualcare PPO/HMO/WC	$185.96

FILAGASTRIM INJ 1ML

Facility

$1,239.70

Hospital Charge Code	6007173
Hospital Revenue Code	636
Min. Negotiated Rate	$185.96
Max. Negotiated Rate	$300.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.01
Rate for Payer: Qualcare PPO/HMO/WC	$185.96

FILARIASIS

Facility

$133.65

Service Code	HCPCS 87207
Hospital Charge Code	3000188
Hospital Revenue Code	309
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

Know your out-of-pocket cost for care.

All Charges