Heights University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT ZENITH AAA MAINB TFB3088

Facility

$36,704.00

Hospital Charge Code	270634659
Hospital Revenue Code	278
Min. Negotiated Rate	$5,505.60
Max. Negotiated Rate	$18,352.00
Rate for Payer: Aetna Commercial	$11,011.20
Rate for Payer: Aetna Medicare Advantage	$11,011.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,359.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,359.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,340.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,359.52
Rate for Payer: Cigna Commercial	$18,352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,882.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,505.60

GRAFT ZENITH AAA MAINB TFB3088

Facility

$37,000.00

Hospital Charge Code	270634659V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$11,100.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZENITH ALPHA 30MM

Facility

$77,500.00

Hospital Charge Code	270677133
Hospital Revenue Code	278
Min. Negotiated Rate	$11,625.00
Max. Negotiated Rate	$38,750.00
Rate for Payer: Aetna Commercial	$23,250.00
Rate for Payer: Aetna Medicare Advantage	$23,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,762.50
Rate for Payer: Cigna Commercial	$38,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,625.00

GRAFT ZENITH ALPHA 30MM

Facility

$77,500.00

Hospital Charge Code	270677133
Hospital Revenue Code	278
Min. Negotiated Rate	$11,625.00
Max. Negotiated Rate	$18,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,625.00

GRAFT ZENITH LEG EXTENSION

Facility

$13,905.00

Hospital Charge Code	270639241
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.75
Max. Negotiated Rate	$3,365.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75

GRAFT ZENITH LEG EXTENSION

Facility

$13,905.00

Hospital Charge Code	270639241
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.75
Max. Negotiated Rate	$6,952.50
Rate for Payer: Aetna Commercial	$4,171.50
Rate for Payer: Aetna Medicare Advantage	$4,171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,545.78
Rate for Payer: Cigna Commercial	$6,952.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75

GRAFT ZENITH REN MN BD RX12662

Facility

$26,075.00

Hospital Charge Code	270643453V
Hospital Revenue Code	278
Min. Negotiated Rate	$3,911.25
Max. Negotiated Rate	$6,310.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,310.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,911.25

GRAFT ZENITH REN MN BD RX12662

Facility

$26,075.00

Hospital Charge Code	270643453V
Hospital Revenue Code	278
Min. Negotiated Rate	$3,911.25
Max. Negotiated Rate	$13,037.50
Rate for Payer: Aetna Commercial	$7,822.50
Rate for Payer: Aetna Medicare Advantage	$7,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,649.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,649.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,649.12
Rate for Payer: Cigna Commercial	$13,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,310.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,911.25

GRAFT ZENITH RENU 36MM

Facility

$31,625.00

Hospital Charge Code	270644764
Hospital Revenue Code	278
Min. Negotiated Rate	$4,743.75
Max. Negotiated Rate	$15,812.50
Rate for Payer: Aetna Commercial	$9,487.50
Rate for Payer: Aetna Medicare Advantage	$9,487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,064.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,064.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,064.38
Rate for Payer: Cigna Commercial	$15,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,653.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,743.75

GRAFT ZENITH RENU 36MM

Facility

$31,625.00

Hospital Charge Code	270644764
Hospital Revenue Code	278
Min. Negotiated Rate	$4,743.75
Max. Negotiated Rate	$7,653.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,653.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,743.75

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,392.00

Hospital Charge Code	270634949
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,905.00

Hospital Charge Code	270634949V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.75
Max. Negotiated Rate	$3,365.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,905.00

Hospital Charge Code	270634949V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.75
Max. Negotiated Rate	$6,952.50
Rate for Payer: Aetna Commercial	$4,171.50
Rate for Payer: Aetna Medicare Advantage	$4,171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,545.78
Rate for Payer: Cigna Commercial	$6,952.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,392.00

Hospital Charge Code	270634949
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$4,017.60
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAMS STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005277
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRAMS STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005277
Hospital Revenue Code	310
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$62.63
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

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3003530
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	38475059
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
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	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3003530
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
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	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	38475059
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRANISEHCLVL 1MG/ML2941490

Facility

$500.00

Hospital Charge Code	6010334
Hospital Revenue Code	636
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GRANISEHCLVL 1MG/ML2941490

Facility

$500.00

Hospital Charge Code	6010334
Hospital Revenue Code	636
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GRANISETRON 1/MG 1/ML

Facility

$805.00

Hospital Charge Code	60634937
Hospital Revenue Code	250
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$120.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.75

GRANISETRON 1/MG 1/ML

Facility

$805.00

Hospital Charge Code	60634937
Hospital Revenue Code	250
Min. Negotiated Rate	$104.65
Max. Negotiated Rate	$402.50
Rate for Payer: Aetna Commercial	$241.50
Rate for Payer: Aetna Medicare Advantage	$241.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.28
Rate for Payer: Cigna Commercial	$402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.65
Rate for Payer: Oxford Commercial	$402.50
Rate for Payer: Qualcare PPO/HMO/WC	$120.75
Rate for Payer: UnitedHealthcare Commercial	$402.50

GRANISETRON 1MG/1ML VIAL

Facility

$190.00

Hospital Charge Code	60635644
Hospital Revenue Code	250
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

Know your out-of-pocket cost for care.

All Charges