Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMAGER II SELECT CATH 4F C1/65

Facility

$279.10

Hospital Charge Code	270679676
Hospital Revenue Code	272
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Qualcare PPO/HMO/WC	$41.87

IMAGER II SELECT CATH 4F C2/65

Facility

$279.10

Hospital Charge Code	270679681
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

IMAGER II SELECT CATH 4F C2/65

Facility

$279.10

Hospital Charge Code	270679681
Hospital Revenue Code	272
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Qualcare PPO/HMO/WC	$41.87

IMAGER II SELECT CATH 5F C1/65

Facility

$268.25

Hospital Charge Code	270679675
Hospital Revenue Code	272
Min. Negotiated Rate	$40.24
Max. Negotiated Rate	$40.24
Rate for Payer: Qualcare PPO/HMO/WC	$40.24

IMAGER II SELECT CATH 5F C1/65

Facility

$268.25

Hospital Charge Code	270679675
Hospital Revenue Code	272
Min. Negotiated Rate	$34.87
Max. Negotiated Rate	$134.12
Rate for Payer: Aetna Commercial	$80.47
Rate for Payer: Aetna Medicare Advantage	$80.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.40
Rate for Payer: Cigna Commercial	$134.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.87
Rate for Payer: Oxford Commercial	$134.12
Rate for Payer: Qualcare PPO/HMO/WC	$40.24
Rate for Payer: UnitedHealthcare Commercial	$134.12

IMAGER II SELECT CATH 5F C2/65

Facility

$55.82

Hospital Charge Code	270627307
Hospital Revenue Code	272
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$27.91
Rate for Payer: Aetna Commercial	$16.75
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.23
Rate for Payer: Cigna Commercial	$27.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.26
Rate for Payer: Oxford Commercial	$27.91
Rate for Payer: Qualcare PPO/HMO/WC	$8.37
Rate for Payer: UnitedHealthcare Commercial	$27.91

IMAGER II SELECT CATH 5F C2/65

Facility

$55.82

Hospital Charge Code	270627307
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$8.37

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	321010030
Hospital Revenue Code	361
Min. Negotiated Rate	$663.28
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,530.64
Rate for Payer: Aetna Medicare Advantage	$1,530.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.05
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	$1,301.05
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.28
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	7411332
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	321010030
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	2692120
Hospital Revenue Code	361
Min. Negotiated Rate	$663.28
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,530.64
Rate for Payer: Aetna Medicare Advantage	$1,530.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.05
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	$1,301.05
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.28
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	2692120
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	323010030
Hospital Revenue Code	450
Min. Negotiated Rate	$663.28
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$1,530.64
Rate for Payer: Aetna Medicare Advantage	$1,530.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,301.05
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.28
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	7411332
Hospital Revenue Code	361
Min. Negotiated Rate	$663.28
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,530.64
Rate for Payer: Aetna Medicare Advantage	$1,530.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.05
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	$1,301.05
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.28
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	323010030
Hospital Revenue Code	450
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMA INJ

Facility

$440.85

Service Code	HCPCS 93564
Hospital Charge Code	74110016
Hospital Revenue Code	481
Min. Negotiated Rate	$51.07
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$132.25
Rate for Payer: Aetna Medicare Advantage	$132.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.42
Rate for Payer: Cigna Commercial	$51.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.31
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.13
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IMA INJ

Facility

$440.85

Service Code	HCPCS 93564
Hospital Charge Code	5100136
Hospital Revenue Code	481
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$66.13
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

IMA INJ

Facility

$440.85

Service Code	HCPCS 93564
Hospital Charge Code	74110016
Hospital Revenue Code	481
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$66.13
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

IMA INJ

Facility

$440.85

Service Code	HCPCS 93564
Hospital Charge Code	5100136
Hospital Revenue Code	481
Min. Negotiated Rate	$51.07
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$132.25
Rate for Payer: Aetna Medicare Advantage	$132.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.42
Rate for Payer: Cigna Commercial	$51.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.31
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.13
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IMATINB MESYLATE 100MG CAPSULE

Facility

$123.00

Service Code	HCPCS J8999
Hospital Charge Code	6062947
Hospital Revenue Code	636
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$61.50
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

IMATINB MESYLATE 100MG CAPSULE

Facility

$123.00

Service Code	HCPCS J8999
Hospital Charge Code	6062947
Hospital Revenue Code	636
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$29.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

IMATINIB MESYLATE 100 MG CAP

Facility

$98.45

Hospital Charge Code	60629247
Hospital Revenue Code	259
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$49.23
Rate for Payer: Aetna Commercial	$29.54
Rate for Payer: Aetna Medicare Advantage	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.10
Rate for Payer: Cigna Commercial	$49.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.80
Rate for Payer: Oxford Commercial	$49.23
Rate for Payer: Qualcare PPO/HMO/WC	$14.77
Rate for Payer: UnitedHealthcare Commercial	$49.23

IMATINIB MESYLATE 100 MG CAP

Facility

$98.45

Hospital Charge Code	60629247
Hospital Revenue Code	259
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$14.77
Rate for Payer: Qualcare PPO/HMO/WC	$14.77

IMDUR 120

Facility

$3.00

Hospital Charge Code	60635097
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

IMDUR 120

Facility

$3.00

Hospital Charge Code	60635097
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges