Heights University Hospital

All Charges

Charge

Type

Setting

Price

I-KNIFE II 15 DEGREE 5MM

Facility

$35.50

Hospital Charge Code	270655016
Hospital Revenue Code	272
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

IL ABC BLOOD GAS CONTROLS

Facility

$25.00

Hospital Charge Code	270331754
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

IL ABC BLOOD GAS CONTROLS

Facility

$25.00

Hospital Charge Code	270331754
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

ILETIN II NPH(PORK)/100U

Facility

$122.00

Hospital Charge Code	60633152
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

ILETIN II NPH(PORK)/100U

Facility

$122.00

Hospital Charge Code	60633152
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

ILETIN II REGULAR(PORK)/1

Facility

$122.00

Hospital Charge Code	60633153
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

ILETIN II REGULAR(PORK)/1

Facility

$122.00

Hospital Charge Code	60633153
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

ILETIN I NPH/100U/1ML

Facility

$71.00

Hospital Charge Code	60633150
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ILETIN I NPH/100U/1ML

Facility

$71.00

Hospital Charge Code	60633150
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

ILETIN I ULTRALENTE/100U

Facility

$71.00

Hospital Charge Code	60633151
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ILETIN I ULTRALENTE/100U

Facility

$71.00

Hospital Charge Code	60633151
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

ILIAC ART ANGIO W CATH

Facility

$4,553.61

Service Code	HCPCS G0278
Hospital Charge Code	4046G0278
Hospital Revenue Code	323
Min. Negotiated Rate	$10.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$1,366.08
Rate for Payer: Aetna Medicare Advantage	$1,366.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,161.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,161.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,161.17
Rate for Payer: Cigna Commercial	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.97
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$683.04
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ILIAC ART ANGIO W CATH

Facility

$4,553.61

Service Code	HCPCS G0278
Hospital Charge Code	4046G0278
Hospital Revenue Code	323
Min. Negotiated Rate	$683.04
Max. Negotiated Rate	$683.04
Rate for Payer: Qualcare PPO/HMO/WC	$683.04

ILIAC CREST WEDGE 2.5

Facility

$5,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270663599
Hospital Revenue Code	278
Min. Negotiated Rate	$814.50
Max. Negotiated Rate	$2,715.00
Rate for Payer: Aetna Commercial	$1,629.00
Rate for Payer: Aetna Medicare Advantage	$1,629.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,384.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,384.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,086.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,384.65
Rate for Payer: Cigna Commercial	$2,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,314.06
Rate for Payer: Qualcare PPO/HMO/WC	$814.50

ILIAC CREST WEDGE 2.5

Facility

$5,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270663599
Hospital Revenue Code	278
Min. Negotiated Rate	$814.50
Max. Negotiated Rate	$1,314.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,086.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,314.06
Rate for Payer: Qualcare PPO/HMO/WC	$814.50

ILIAC EXTENSION 14X18X100mm 14

Facility

$23,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270680532
Hospital Revenue Code	278
Min. Negotiated Rate	$3,524.25
Max. Negotiated Rate	$5,685.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,685.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,524.25

ILIAC EXTENSION 14X18X100mm 14

Facility

$23,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270680532
Hospital Revenue Code	278
Min. Negotiated Rate	$3,524.25
Max. Negotiated Rate	$11,747.50
Rate for Payer: Aetna Commercial	$7,048.50
Rate for Payer: Aetna Medicare Advantage	$7,048.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,991.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,991.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,991.23
Rate for Payer: Cigna Commercial	$11,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,685.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,524.25

ILIAC EXT SYSTEM 12mm-12mm45cm

Facility

$21,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270679992
Hospital Revenue Code	278
Min. Negotiated Rate	$3,224.25
Max. Negotiated Rate	$10,747.50
Rate for Payer: Aetna Commercial	$6,448.50
Rate for Payer: Aetna Medicare Advantage	$6,448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,481.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,481.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,481.23
Rate for Payer: Cigna Commercial	$10,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,201.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,224.25

ILIAC EXT SYSTEM 12mm-12mm45cm

Facility

$21,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270679992
Hospital Revenue Code	278
Min. Negotiated Rate	$3,224.25
Max. Negotiated Rate	$5,201.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,201.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,224.25

ILIAC/FEMORAL ARTRY ANGIO

Facility

$221.00

Service Code	HCPCS G0278
Hospital Charge Code	7411269
Hospital Revenue Code	323
Min. Negotiated Rate	$10.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$66.30
Rate for Payer: Aetna Medicare Advantage	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.35
Rate for Payer: Cigna Commercial	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.15
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ILIAC/FEMORAL ARTRY ANGIO

Facility

$221.00

Service Code	HCPCS G0278
Hospital Charge Code	7411269
Hospital Revenue Code	323
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$33.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.15

ILIAC LEG GRAFT

Facility

$18,825.00

Service Code	HCPCS C1768
Hospital Charge Code	270686468
Hospital Revenue Code	278
Min. Negotiated Rate	$2,823.75
Max. Negotiated Rate	$4,555.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,555.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,823.75

ILIAC LEG GRAFT

Facility

$18,825.00

Service Code	HCPCS C1768
Hospital Charge Code	270686468
Hospital Revenue Code	278
Min. Negotiated Rate	$2,823.75
Max. Negotiated Rate	$9,412.50
Rate for Payer: Aetna Commercial	$5,647.50
Rate for Payer: Aetna Medicare Advantage	$5,647.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,800.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,800.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,800.38
Rate for Payer: Cigna Commercial	$9,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,555.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,823.75

ILIAC LIMB

Facility

$24,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270679762
Hospital Revenue Code	278
Min. Negotiated Rate	$3,749.25
Max. Negotiated Rate	$6,048.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,048.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,749.25

ILIAC LIMB

Facility

$24,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270679762
Hospital Revenue Code	278
Min. Negotiated Rate	$3,749.25
Max. Negotiated Rate	$12,497.50
Rate for Payer: Aetna Commercial	$7,498.50
Rate for Payer: Aetna Medicare Advantage	$7,498.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,373.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,373.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,373.73
Rate for Payer: Cigna Commercial	$12,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,048.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,749.25

Know your out-of-pocket cost for care.

All Charges