Heights University Hospital

All Charges

Charge

Type

Setting

Price

FOGARTY ART EMBO CATH 3FR 80CM

Facility

$308.00

Hospital Charge Code	270330913
Hospital Revenue Code	278
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$154.00
Rate for Payer: Aetna Commercial	$92.40
Rate for Payer: Aetna Medicare Advantage	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.54
Rate for Payer: Cigna Commercial	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.54
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

FOGARTY ART EMBO CATH 4FR/80CM

Facility

$305.00

Hospital Charge Code	270330919
Hospital Revenue Code	278
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$73.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.81
Rate for Payer: Qualcare PPO/HMO/WC	$45.75

FOGARTY ART EMBO CATH 4FR/80CM

Facility

$305.00

Hospital Charge Code	270330919
Hospital Revenue Code	278
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$152.50
Rate for Payer: Aetna Commercial	$91.50
Rate for Payer: Aetna Medicare Advantage	$91.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.78
Rate for Payer: Cigna Commercial	$152.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.81
Rate for Payer: Qualcare PPO/HMO/WC	$45.75

FOGARTYART IRRI CATH 4FR 80CM

Facility

$138.00

Hospital Charge Code	270330914
Hospital Revenue Code	278
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$41.40
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

FOGARTYART IRRI CATH 4FR 80CM

Facility

$138.00

Hospital Charge Code	270330914
Hospital Revenue Code	278
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$33.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

FOGARTY BILIARY BALLOON CATH.

Facility

$296.00

Hospital Charge Code	270330809
Hospital Revenue Code	278
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.63
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

FOGARTY BILIARY BALLOON CATH.

Facility

$296.00

Hospital Charge Code	270330809
Hospital Revenue Code	278
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$148.00
Rate for Payer: Aetna Commercial	$88.80
Rate for Payer: Aetna Medicare Advantage	$88.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.48
Rate for Payer: Cigna Commercial	$148.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.63
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

FOG-OUT SOLUTION/KENDALL

Facility

$12.08

Hospital Charge Code	270655926
Hospital Revenue Code	270
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$1.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.81

FOG-OUT SOLUTION/KENDALL

Facility

$12.08

Hospital Charge Code	270655926
Hospital Revenue Code	270
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$6.04
Rate for Payer: Aetna Commercial	$3.62
Rate for Payer: Aetna Medicare Advantage	$3.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.08
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
Rate for Payer: Oxford Commercial	$6.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.81
Rate for Payer: UnitedHealthcare Commercial	$6.04

FOLATE

Facility

$667.59

Service Code	HCPCS 82746
Hospital Charge Code	39888003
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FOLATE

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38479400
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38479400
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

FOLATE

Facility

$667.59

Service Code	HCPCS 82746
Hospital Charge Code	39888003
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE/B6/B12 TAB 2.5/25/1MG

Facility

$2.45

Hospital Charge Code	60629179
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

FOLATE/B6/B12 TAB 2.5/25/1MG

Facility

$2.45

Hospital Charge Code	60629179
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

FOLATE (FOLIC ACID)

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38472281
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

FOLATE (FOLIC ACID)

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38472281
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE (FOLIC ACID)

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	3001294
Hospital Revenue Code	301
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$40.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.66

FOLATE (FOLIC ACID)

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	3001294
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.63
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$14.70
Rate for Payer: Cigna Medicare Advantage	$7.35
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.66
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.58
Rate for Payer: Wellcare Medicare Advantage	$14.70

FOLATE RBC

Facility

$78.00

Service Code	HCPCS 82747
Hospital Charge Code	3007390A
Hospital Revenue Code	301
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FOLATE RBC

Facility

$78.00

Service Code	HCPCS 82747
Hospital Charge Code	3007390A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

FOLATE RBC

Facility

$390.00

Service Code	HCPCS 82747
Hospital Charge Code	39900330
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FOLATE RBC

Facility

$390.00

Service Code	HCPCS 82747
Hospital Charge Code	39900330
Hospital Revenue Code	301
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
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	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FOLATE, RBC

Facility

$169.00

Service Code	HCPCS 82747
Hospital Charge Code	38472006
Hospital Revenue Code	301
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FOLATE, RBC

Facility

$169.00

Service Code	HCPCS 82747
Hospital Charge Code	38472006
Hospital Revenue Code	301
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

Know your out-of-pocket cost for care.

All Charges