Heights University Hospital

All Charges

Charge

Type

Setting

Price

HELIXX SI LAG IMPLANT 12X50MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704261
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

HELIXX SI LAG IMPLANT 12X55MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704263
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

HELIXX SI LAG IMPLANT 12X55MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704263
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

HEMABATE INJECTION

Facility

$122.00

Hospital Charge Code	60634873
Hospital Revenue Code	250
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

HEMABATE INJECTION

Facility

$122.00

Hospital Charge Code	60634873
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

HEMAGGLUTINATION INHBTN- (HAI)

Facility

$58.00

Service Code	HCPCS 86280
Hospital Charge Code	38477053
Hospital Revenue Code	302
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.54
Rate for Payer: Aetna Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.01
Rate for Payer: Cigna Commercial	$8.19
Rate for Payer: Cigna Medicare Advantage	$4.09
Rate for Payer: Clover Medicare Advantage	$7.78
Rate for Payer: EmblemHealth Commercial	$24.57
Rate for Payer: Humana Medicare Advantage	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.68
Rate for Payer: Wellcare Medicare Advantage	$8.19

HEMAGGLUTINATION INHBTN- (HAI)

Facility

$58.00

Service Code	HCPCS 86280
Hospital Charge Code	38477053
Hospital Revenue Code	302
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

HEMAGLOBIN OR RBCS,FETAL

Facility

$47.00

Service Code	HCPCS 85461
Hospital Charge Code	38477048
Hospital Revenue Code	305
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.33
Rate for Payer: Aetna Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.30
Rate for Payer: Cigna Commercial	$9.36
Rate for Payer: Cigna Medicare Advantage	$4.68
Rate for Payer: Clover Medicare Advantage	$8.89
Rate for Payer: EmblemHealth Commercial	$28.08
Rate for Payer: Humana Medicare Advantage	$9.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.92
Rate for Payer: Wellcare Medicare Advantage	$9.36

HEMAGLOBIN OR RBCS,FETAL

Facility

$47.00

Service Code	HCPCS 85461
Hospital Charge Code	38477048
Hospital Revenue Code	305
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

HEMAQUET INTRODUCER SET 7 FR

Facility

$176.00

Hospital Charge Code	270331203
Hospital Revenue Code	278
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.59
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

HEMAQUET INTRODUCER SET 7 FR

Facility

$176.00

Hospital Charge Code	270331203
Hospital Revenue Code	278
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$88.00
Rate for Payer: Aetna Commercial	$52.80
Rate for Payer: Aetna Medicare Advantage	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.59
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

HEMASHEILD GOLD VASCULAR GRAFT

Facility

$3,386.25

Hospital Charge Code	270656589
Hospital Revenue Code	278
Min. Negotiated Rate	$507.94
Max. Negotiated Rate	$1,693.12
Rate for Payer: Aetna Commercial	$1,015.88
Rate for Payer: Aetna Medicare Advantage	$1,015.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$863.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$863.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$863.49
Rate for Payer: Cigna Commercial	$1,693.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.47
Rate for Payer: Qualcare PPO/HMO/WC	$507.94

HEMASHEILD GOLD VASCULAR GRAFT

Facility

$3,386.25

Hospital Charge Code	270656589
Hospital Revenue Code	278
Min. Negotiated Rate	$507.94
Max. Negotiated Rate	$819.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.47
Rate for Payer: Qualcare PPO/HMO/WC	$507.94

HEMASHIELD CORATID PTCH-BOSTON

Facility

$509.00

Hospital Charge Code	270335452
Hospital Revenue Code	278
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$123.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.18
Rate for Payer: Qualcare PPO/HMO/WC	$76.35

HEMASHIELD CORATID PTCH-BOSTON

Facility

$509.00

Hospital Charge Code	270335452
Hospital Revenue Code	278
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$254.50
Rate for Payer: Aetna Commercial	$152.70
Rate for Payer: Aetna Medicare Advantage	$152.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.79
Rate for Payer: Cigna Commercial	$254.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.18
Rate for Payer: Qualcare PPO/HMO/WC	$76.35

HEMASHIELD PLATINUM WOVEN VASC

Facility

$3,491.25

Service Code	HCPCS C1768
Hospital Charge Code	270656587
Hospital Revenue Code	278
Min. Negotiated Rate	$523.69
Max. Negotiated Rate	$844.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.88
Rate for Payer: Qualcare PPO/HMO/WC	$523.69

HEMASHIELD PLATINUM WOVEN VASC

Facility

$3,491.25

Service Code	HCPCS C1768
Hospital Charge Code	270656587
Hospital Revenue Code	278
Min. Negotiated Rate	$523.69
Max. Negotiated Rate	$1,745.62
Rate for Payer: Aetna Commercial	$1,047.38
Rate for Payer: Aetna Medicare Advantage	$1,047.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.27
Rate for Payer: Cigna Commercial	$1,745.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.88
Rate for Payer: Qualcare PPO/HMO/WC	$523.69

HEMASTIX REAGENT STRIPS

Facility

$5.65

Hospital Charge Code	270602049
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

HEMASTIX REAGENT STRIPS

Facility

$5.65

Hospital Charge Code	270602049
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

HEMATINIC PLUS TAB

Facility

$2.00

Hospital Charge Code	60635650
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

HEMATINIC PLUS TAB

Facility

$2.00

Hospital Charge Code	60635650
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

HEMATOCRIT

Facility

$44.00

Service Code	HCPCS 85014
Hospital Charge Code	38474117
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

HEMATOCRIT

Facility

$44.00

Service Code	HCPCS 85014
Hospital Charge Code	38474117
Hospital Revenue Code	305
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

HEMATOXYLIN AND EOSIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005322
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

HEMATOXYLIN AND EOSIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005322
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges