Heights University Hospital

All Charges

Charge

Type

Setting

Price

GRANULEX/60ML

Facility

$71.00

Hospital Charge Code	60633055
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

GRANULEX/60ML

Facility

$71.00

Hospital Charge Code	60633055
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

GRANULEX SPRAY 2 OZ

Facility

$163.20

Hospital Charge Code	6007165
Hospital Revenue Code	250
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

GRANULEX SPRAY 2 OZ

Facility

$163.20

Hospital Charge Code	6007165
Hospital Revenue Code	250
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.22
Rate for Payer: Oxford Commercial	$81.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$81.60

GRANULOCYTE AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008349
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

GRANULOCYTE AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008349
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

GRANULOCYTE CONCENTRATE,APHERE

Facility

$4,978.60

Hospital Charge Code	3100567
Hospital Revenue Code	390
Min. Negotiated Rate	$647.22
Max. Negotiated Rate	$2,489.30
Rate for Payer: Aetna Commercial	$1,493.58
Rate for Payer: Aetna Medicare Advantage	$1,493.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,269.54
Rate for Payer: Cigna Commercial	$2,489.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.22
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.79
Rate for Payer: UnitedHealthcare Commercial	$756.00

GRANULOCYTE CONCENTRATE,APHERE

Facility

$4,978.60

Hospital Charge Code	3100567
Hospital Revenue Code	390
Min. Negotiated Rate	$746.79
Max. Negotiated Rate	$746.79
Rate for Payer: Qualcare PPO/HMO/WC	$746.79

GRANULOCYTES PHERESIS EACH

Facility

$8,954.00

Service Code	HCPCS P9060
Hospital Charge Code	38477230
Hospital Revenue Code	390
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$2,686.20
Rate for Payer: Aetna Commercial	$2,686.20
Rate for Payer: Aetna Medicare Advantage	$2,686.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,283.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,283.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,283.27
Rate for Payer: Cigna Commercial	$124.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,164.02
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,343.10
Rate for Payer: UnitedHealthcare Commercial	$756.00

GRANULOCYTES PHERESIS EACH

Facility

$8,954.00

Service Code	HCPCS P9060
Hospital Charge Code	38477230
Hospital Revenue Code	390
Min. Negotiated Rate	$1,343.10
Max. Negotiated Rate	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,343.10

GRASPER 5mm 35cm LAPAROS C4130

Facility

$303.50

Hospital Charge Code	270642079
Hospital Revenue Code	272
Min. Negotiated Rate	$45.52
Max. Negotiated Rate	$45.52
Rate for Payer: Qualcare PPO/HMO/WC	$45.52

GRASPER 5mm 35cm LAPAROS C4130

Facility

$303.50

Hospital Charge Code	270642079
Hospital Revenue Code	272
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$151.75
Rate for Payer: Aetna Commercial	$91.05
Rate for Payer: Aetna Medicare Advantage	$91.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.39
Rate for Payer: Cigna Commercial	$151.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.45
Rate for Payer: Oxford Commercial	$151.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.52
Rate for Payer: UnitedHealthcare Commercial	$151.75

GRASPER DOUBLE FENESTRATED

Facility

$10,000.00

Hospital Charge Code	270664215
Hospital Revenue Code	270
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$5,000.00

GRASPER DOUBLE FENESTRATED

Facility

$10,000.00

Hospital Charge Code	270664215
Hospital Revenue Code	270
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

GRASPER FLE 3 PRO 115CM

Facility

$1,689.65

Hospital Charge Code	270601117
Hospital Revenue Code	272
Min. Negotiated Rate	$253.45
Max. Negotiated Rate	$253.45
Rate for Payer: Qualcare PPO/HMO/WC	$253.45

GRASPER FLE 3 PRO 115CM

Facility

$1,689.65

Hospital Charge Code	270601117
Hospital Revenue Code	272
Min. Negotiated Rate	$219.65
Max. Negotiated Rate	$844.83
Rate for Payer: Aetna Commercial	$506.89
Rate for Payer: Aetna Medicare Advantage	$506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.86
Rate for Payer: Cigna Commercial	$844.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.65
Rate for Payer: Oxford Commercial	$844.83
Rate for Payer: Qualcare PPO/HMO/WC	$253.45
Rate for Payer: UnitedHealthcare Commercial	$844.83

GRASPER VM SLIDELOCK 5MM 22MM

Facility

$2,625.00

Hospital Charge Code	270666058
Hospital Revenue Code	270
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

GRASPER VM SLIDELOCK 5MM 22MM

Facility

$2,625.00

Hospital Charge Code	270666058
Hospital Revenue Code	270
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.25
Rate for Payer: Oxford Commercial	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$1,312.50

GRASPER W/RATCHET HANDLE 5MM

Facility

$296.20

Hospital Charge Code	270671541
Hospital Revenue Code	272
Min. Negotiated Rate	$38.51
Max. Negotiated Rate	$148.10
Rate for Payer: Aetna Commercial	$88.86
Rate for Payer: Aetna Medicare Advantage	$88.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.53
Rate for Payer: Cigna Commercial	$148.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.51
Rate for Payer: Oxford Commercial	$148.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.43
Rate for Payer: UnitedHealthcare Commercial	$148.10

GRASPER W/RATCHET HANDLE 5MM

Facility

$296.20

Hospital Charge Code	270671541
Hospital Revenue Code	272
Min. Negotiated Rate	$44.43
Max. Negotiated Rate	$44.43
Rate for Payer: Qualcare PPO/HMO/WC	$44.43

GRASP NDL OPEN LOOP DISP 10165

Facility

$270.00

Hospital Charge Code	270641145
Hospital Revenue Code	272
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$135.00

GRASP NDL OPEN LOOP DISP 10165

Facility

$270.00

Hospital Charge Code	270641145
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

GREAT RELEASE MTP RELEASE INST

Facility

$2,750.00

Hospital Charge Code	270704035
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

GREAT RELEASE MTP RELEASE INST

Facility

$2,750.00

Hospital Charge Code	270704035
Hospital Revenue Code	272
Min. Negotiated Rate	$357.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.50
Rate for Payer: Oxford Commercial	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$1,375.00

GREAT TOE LPT REG SZ 0

Facility

$9,970.00

Hospital Charge Code	270675918
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.50
Max. Negotiated Rate	$4,985.00
Rate for Payer: Aetna Commercial	$2,991.00
Rate for Payer: Aetna Medicare Advantage	$2,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,542.35
Rate for Payer: Cigna Commercial	$4,985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.50

Know your out-of-pocket cost for care.

All Charges