Heights University Hospital

All Charges

Charge

Type

Setting

Price

ILLUMINATION SYSTEM

Facility

$1,418.45

Hospital Charge Code	270706018
Hospital Revenue Code	272
Min. Negotiated Rate	$212.77
Max. Negotiated Rate	$212.77
Rate for Payer: Qualcare PPO/HMO/WC	$212.77

ILLUMINATION SYSTEM

Facility

$1,418.45

Hospital Charge Code	270706018
Hospital Revenue Code	272
Min. Negotiated Rate	$184.40
Max. Negotiated Rate	$709.23
Rate for Payer: Aetna Commercial	$425.54
Rate for Payer: Aetna Medicare Advantage	$425.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.70
Rate for Payer: Cigna Commercial	$709.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.40
Rate for Payer: Oxford Commercial	$709.23
Rate for Payer: Qualcare PPO/HMO/WC	$212.77
Rate for Payer: UnitedHealthcare Commercial	$709.23

ILLUMINATION SYSTEM 2 BLADE

Facility

$1,418.45

Hospital Charge Code	270706019
Hospital Revenue Code	279
Min. Negotiated Rate	$184.40
Max. Negotiated Rate	$709.23
Rate for Payer: Aetna Commercial	$425.54
Rate for Payer: Aetna Medicare Advantage	$425.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.70
Rate for Payer: Cigna Commercial	$709.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.40
Rate for Payer: Oxford Commercial	$709.23
Rate for Payer: Qualcare PPO/HMO/WC	$212.77
Rate for Payer: UnitedHealthcare Commercial	$709.23

ILLUMINATION SYSTEM 2 BLADE

Facility

$1,418.45

Hospital Charge Code	270706019
Hospital Revenue Code	279
Min. Negotiated Rate	$212.77
Max. Negotiated Rate	$212.77
Rate for Payer: Qualcare PPO/HMO/WC	$212.77

ILLUMINATOR LITMAT SURG 004804

Facility

$395.90

Hospital Charge Code	270634203
Hospital Revenue Code	272
Min. Negotiated Rate	$59.38
Max. Negotiated Rate	$59.38
Rate for Payer: Qualcare PPO/HMO/WC	$59.38

ILLUMINATOR LITMAT SURG 004804

Facility

$395.90

Hospital Charge Code	270634203
Hospital Revenue Code	272
Min. Negotiated Rate	$51.47
Max. Negotiated Rate	$197.95
Rate for Payer: Aetna Commercial	$118.77
Rate for Payer: Aetna Medicare Advantage	$118.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.95
Rate for Payer: Cigna Commercial	$197.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.47
Rate for Payer: Oxford Commercial	$197.95
Rate for Payer: Qualcare PPO/HMO/WC	$59.38
Rate for Payer: UnitedHealthcare Commercial	$197.95

ILLUMINATOR POST 26MM

Facility

$3,005.00

Hospital Charge Code	270703130
Hospital Revenue Code	278
Min. Negotiated Rate	$450.75
Max. Negotiated Rate	$727.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: Qualcare PPO/HMO/WC	$450.75

ILLUMINATOR POST 26MM

Facility

$3,005.00

Hospital Charge Code	270703130
Hospital Revenue Code	278
Min. Negotiated Rate	$450.75
Max. Negotiated Rate	$1,502.50
Rate for Payer: Aetna Commercial	$901.50
Rate for Payer: Aetna Medicare Advantage	$901.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$766.27
Rate for Payer: Cigna Commercial	$1,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.21
Rate for Payer: Qualcare PPO/HMO/WC	$450.75

ILOPAN INJECTION/250MG/1M

Facility

$51.00

Hospital Charge Code	60633154
Hospital Revenue Code	250
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

ILOPAN INJECTION/250MG/1M

Facility

$51.00

Hospital Charge Code	60633154
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

ILOSONE/100MG/1ML

Facility

$122.00

Hospital Charge Code	60633155
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

ILOSONE/100MG/1ML

Facility

$122.00

Hospital Charge Code	60633155
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

ILOTYCIN OPHTH/3.5GM

Facility

$32.00

Hospital Charge Code	60633156
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

ILOTYCIN OPHTH/3.5GM

Facility

$32.00

Hospital Charge Code	60633156
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

ILUMYA (TILDRAKIZUMAB) 1MG/ML

Facility

$111,876.60

Service Code	HCPCS J3245
Hospital Charge Code	606390483
Hospital Revenue Code	636
Min. Negotiated Rate	$16,781.49
Max. Negotiated Rate	$27,074.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27,074.14
Rate for Payer: Qualcare PPO/HMO/WC	$16,781.49

ILUMYA (TILDRAKIZUMAB) 1MG/ML

Facility

$111,876.60

Service Code	HCPCS J3245
Hospital Charge Code	606390483
Hospital Revenue Code	636
Min. Negotiated Rate	$16,781.49
Max. Negotiated Rate	$33,562.98
Rate for Payer: Aetna Commercial	$33,562.98
Rate for Payer: Aetna Medicare Advantage	$33,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,528.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,528.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,528.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27,074.14
Rate for Payer: Qualcare PPO/HMO/WC	$16,781.49

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2003093
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IMAGE CATH FLUID COLXN VISC

Facility

$5,392.12

Service Code	HCPCS 49405
Hospital Charge Code	16000386
Hospital Revenue Code	360
Min. Negotiated Rate	$808.82
Max. Negotiated Rate	$808.82
Rate for Payer: Qualcare PPO/HMO/WC	$808.82

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2003093
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IMAGE CATH FLUID COLXN VISC

Facility

$5,392.12

Service Code	HCPCS 49405
Hospital Charge Code	16000386
Hospital Revenue Code	360
Min. Negotiated Rate	$700.98
Max. Negotiated Rate	$3,933.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$808.82
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Aetna Commercial	$1,617.64
Rate for Payer: Aetna Medicare Advantage	$1,617.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,374.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,374.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,374.99
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$700.98

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	321049406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	321049406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IMAGE CATH FLUID PE/RETRO

Facility

$14,529.00

Service Code	HCPCS 49406
Hospital Charge Code	16000258
Hospital Revenue Code	360
Min. Negotiated Rate	$2,179.35
Max. Negotiated Rate	$2,179.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,179.35

IMAGE CATH FLUID PE/RETRO

Facility

$14,529.00

Service Code	HCPCS 49406
Hospital Charge Code	16000258
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,358.70
Rate for Payer: Aetna Commercial	$4,358.70
Rate for Payer: Aetna Medicare Advantage	$4,358.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,704.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,704.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,704.89
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,888.77
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,179.35
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IMAGER II SELECT CATH 4F C1/65

Facility

$279.10

Hospital Charge Code	270679676
Hospital Revenue Code	272
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$139.55
Rate for Payer: Aetna Commercial	$83.73
Rate for Payer: Aetna Medicare Advantage	$83.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.17
Rate for Payer: Cigna Commercial	$139.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.28
Rate for Payer: Oxford Commercial	$139.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.87
Rate for Payer: UnitedHealthcare Commercial	$139.55

Know your out-of-pocket cost for care.

All Charges