Heights University Hospital

All Charges

Charge

Type

Setting

Price

FILTER VACUUM MIXING FUME*****

Facility

$82.00

Hospital Charge Code	1606250
Hospital Revenue Code	279
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

FILTER VENA CAVA FEM 50-501

Facility

$2,252.00

Hospital Charge Code	1608397
Hospital Revenue Code	272
Min. Negotiated Rate	$337.80
Max. Negotiated Rate	$337.80
Rate for Payer: Qualcare PPO/HMO/WC	$337.80

FILTER VENA CAVA FEM 50-501

Facility

$2,252.00

Hospital Charge Code	1608397
Hospital Revenue Code	272
Min. Negotiated Rate	$292.76
Max. Negotiated Rate	$1,126.00
Rate for Payer: Aetna Commercial	$675.60
Rate for Payer: Aetna Medicare Advantage	$675.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$574.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$574.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$574.26
Rate for Payer: Cigna Commercial	$1,126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.76
Rate for Payer: Oxford Commercial	$1,126.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.80
Rate for Payer: UnitedHealthcare Commercial	$1,126.00

FILTER VENA CAVA FEMORAL 12FR

Facility

$4,994.50

Service Code	HCPCS C1880
Hospital Charge Code	270601106
Hospital Revenue Code	278
Min. Negotiated Rate	$749.17
Max. Negotiated Rate	$1,208.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: Qualcare PPO/HMO/WC	$749.17

FILTER VENA CAVA FEMORAL 12FR

Facility

$4,994.50

Service Code	HCPCS C1880
Hospital Charge Code	270601106
Hospital Revenue Code	278
Min. Negotiated Rate	$749.17
Max. Negotiated Rate	$2,497.25
Rate for Payer: Aetna Commercial	$1,498.35
Rate for Payer: Aetna Medicare Advantage	$1,498.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.60
Rate for Payer: Cigna Commercial	$2,497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: Qualcare PPO/HMO/WC	$749.17

FILTER VENA CAVA JUGLR 50300**

Facility

$4,810.00

Hospital Charge Code	1604685
Hospital Revenue Code	279
Min. Negotiated Rate	$625.30
Max. Negotiated Rate	$2,405.00
Rate for Payer: Aetna Commercial	$1,443.00
Rate for Payer: Aetna Medicare Advantage	$1,443.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,226.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,226.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,226.55
Rate for Payer: Cigna Commercial	$2,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.30
Rate for Payer: Oxford Commercial	$2,405.00
Rate for Payer: Qualcare PPO/HMO/WC	$721.50
Rate for Payer: UnitedHealthcare Commercial	$2,405.00

FILTER VENA CAVA JUGLR 50300**

Facility

$4,810.00

Hospital Charge Code	1604685
Hospital Revenue Code	279
Min. Negotiated Rate	$721.50
Max. Negotiated Rate	$721.50
Rate for Payer: Qualcare PPO/HMO/WC	$721.50

FILTER VENA CAVA JUGULAR 12FR

Facility

$4,994.50

Hospital Charge Code	270601105
Hospital Revenue Code	278
Min. Negotiated Rate	$749.17
Max. Negotiated Rate	$2,497.25
Rate for Payer: Aetna Commercial	$1,498.35
Rate for Payer: Aetna Medicare Advantage	$1,498.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.60
Rate for Payer: Cigna Commercial	$2,497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: Qualcare PPO/HMO/WC	$749.17

FILTER VENA CAVA JUGULAR 12FR

Facility

$4,994.50

Hospital Charge Code	270601105
Hospital Revenue Code	278
Min. Negotiated Rate	$749.17
Max. Negotiated Rate	$1,208.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: Qualcare PPO/HMO/WC	$749.17

FILTER VENA CAVA PLATINUM

Facility

$5,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FILTER VENA CAVA PLATINUM

Facility

$5,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529S
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FILTER VENA CAVA PLATINUM

Facility

$5,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529S
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FILTER VENA CAVA PLATINUM

Facility

$7,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.75
Max. Negotiated Rate	$3,812.50
Rate for Payer: Aetna Commercial	$2,287.50
Rate for Payer: Aetna Medicare Advantage	$2,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,944.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,944.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,944.38
Rate for Payer: Cigna Commercial	$3,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,845.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.75

FILTER VENA CAVA PLATINUM

Facility

$7,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.75
Max. Negotiated Rate	$1,845.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,845.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.75

FILTER VENA CAVA PLATINUM

Facility

$5,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270668529
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FILTER W/WATER TRAP AVEA DISPO

Facility

$109.33

Hospital Charge Code	270654996
Hospital Revenue Code	270
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.40

FILTER W/WATER TRAP AVEA DISPO

Facility

$109.33

Hospital Charge Code	270654996
Hospital Revenue Code	270
Min. Negotiated Rate	$14.21
Max. Negotiated Rate	$54.66
Rate for Payer: Aetna Commercial	$32.80
Rate for Payer: Aetna Medicare Advantage	$32.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.88
Rate for Payer: Cigna Commercial	$54.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.21
Rate for Payer: Oxford Commercial	$54.66
Rate for Payer: Qualcare PPO/HMO/WC	$16.40
Rate for Payer: UnitedHealthcare Commercial	$54.66

FIMBOPLASTY

Facility

$9,165.70

Service Code	HCPCS 58760
Hospital Charge Code	1600000814
Hospital Revenue Code	360
Min. Negotiated Rate	$1,374.86
Max. Negotiated Rate	$1,374.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,374.86

FIMBOPLASTY

Facility

$9,165.70

Service Code	HCPCS 58760
Hospital Charge Code	1600000814
Hospital Revenue Code	360
Min. Negotiated Rate	$789.07
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,749.71
Rate for Payer: Aetna Medicare Advantage	$2,749.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,337.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,337.25
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	$2,337.25
Rate for Payer: Cigna Commercial	$789.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,374.86
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

FINASTERIDE 5 MG TAB

Facility

$20.97

Service Code	NDC 16729009001
Hospital Charge Code	60628191
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

FINASTERIDE 5 MG TAB

Facility

$20.97

Service Code	NDC 16729009001
Hospital Charge Code	60628191
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.48
Rate for Payer: Aetna Commercial	$6.29
Rate for Payer: Aetna Medicare Advantage	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.35
Rate for Payer: Cigna Commercial	$10.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.48
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.48

FINASTERIDE TAB 5MG

Facility

$19.85

Hospital Charge Code	6008759
Hospital Revenue Code	252
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$5.96
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$9.93

FINASTERIDE TAB 5MG

Facility

$19.85

Hospital Charge Code	6008759
Hospital Revenue Code	252
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

FINE NEEDLE ASPIRATION IMMED

Facility

$538.00

Service Code	HCPCS 88172
Hospital Charge Code	38474074
Hospital Revenue Code	311
Min. Negotiated Rate	$30.27
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$161.40
Rate for Payer: Aetna Medicare Advantage	$161.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.19
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$30.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

FINE NEEDLE ASPIRATION IMMED

Facility

$538.00

Service Code	HCPCS 88172
Hospital Charge Code	38474074
Hospital Revenue Code	311
Min. Negotiated Rate	$80.70
Max. Negotiated Rate	$80.70
Rate for Payer: Qualcare PPO/HMO/WC	$80.70

Know your out-of-pocket cost for care.

All Charges