Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMODIUM/2MG/CAP

Facility

$5.00

Hospital Charge Code	60633160
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

IMODIUM/2MG/CAP

Facility

$7.00

Hospital Charge Code	60633161
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

IMODIUM/2MG/CAP

Facility

$5.00

Hospital Charge Code	60633160
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

IMPACT

Facility

$32.00

Hospital Charge Code	60634850
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

IMPACT

Facility

$32.00

Hospital Charge Code	60634850
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

IMPLA BRST SMOOTH MOD 350-2475

Facility

$3,000.00

Hospital Charge Code	270638757
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

IMPLA BRST SMOOTH MOD 350-2475

Facility

$3,000.00

Hospital Charge Code	270638757
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

IMPLANTABLE HEART ASSIST SYSTEMS

Facility

$193,843.92

Service Code	APR-DRG 1611
Min. Negotiated Rate	$39,193.64
Max. Negotiated Rate	$193,843.92
Rate for Payer: Aetna Better Health Medicaid	$190,043.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$193,843.92
Rate for Payer: Wellpoint Medicaid Managed Care	$39,193.64

IMPLANTABLE HEART ASSIST SYSTEMS

Facility

$203,800.96

Service Code	APR-DRG 1612
Min. Negotiated Rate	$50,598.88
Max. Negotiated Rate	$203,800.96
Rate for Payer: Aetna Better Health Medicaid	$199,804.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$203,800.96
Rate for Payer: Wellpoint Medicaid Managed Care	$50,598.88

IMPLANTABLE HEART ASSIST SYSTEMS

Facility

$335,371.87

Service Code	APR-DRG 1614
Min. Negotiated Rate	$195,262.78
Max. Negotiated Rate	$335,371.87
Rate for Payer: Aetna Better Health Medicaid	$328,795.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$335,371.87
Rate for Payer: Wellpoint Medicaid Managed Care	$195,262.78

IMPLANTABLE HEART ASSIST SYSTEMS

Facility

$254,134.04

Service Code	APR-DRG 1613
Min. Negotiated Rate	$81,376.25
Max. Negotiated Rate	$254,134.04
Rate for Payer: Aetna Better Health Medicaid	$249,151.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$254,134.04
Rate for Payer: Wellpoint Medicaid Managed Care	$81,376.25

IMPLANT ACUTE SYSTEM

Facility

$5,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270668535
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$1,687.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

IMPLANT ACUTE SYSTEM

Facility

$5,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270668535
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

IMPLANT ATHX TRNSFX 40 AR1351

Facility

$1,380.00

Hospital Charge Code	270614433
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$414.00
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

IMPLANT ATHX TRNSFX 40 AR1351

Facility

$1,380.00

Hospital Charge Code	270614433
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

IMPLANT ATHX TRNSFX 50 AR1351L

Facility

$1,149.65

Hospital Charge Code	270614980
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

IMPLANT ATHX TRNSFX 50 AR1351L

Facility

$1,149.65

Hospital Charge Code	270614980
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$344.89
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

IMPLANT BIOINDUCTIVE ARTH DEL

Facility

$14,000.00

Service Code	HCPCS C1781
Hospital Charge Code	270690425
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

IMPLANT BIOINDUCTIVE ARTH DEL

Facility

$14,000.00

Service Code	HCPCS C1781
Hospital Charge Code	270690425
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$4,200.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

IMPLANTBLE PULSE GENERATOR KIT

Facility

$102,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270703486
Hospital Revenue Code	278
Min. Negotiated Rate	$15,375.00
Max. Negotiated Rate	$51,250.00
Rate for Payer: Aetna Commercial	$30,750.00
Rate for Payer: Aetna Medicare Advantage	$30,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,137.50
Rate for Payer: Cigna Commercial	$51,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,805.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,375.00

IMPLANTBLE PULSE GENERATOR KIT

Facility

$102,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270703486
Hospital Revenue Code	278
Min. Negotiated Rate	$15,375.00
Max. Negotiated Rate	$24,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,805.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,375.00

IMPLANT BREAST 750CC

Facility

$4,775.00

Hospital Charge Code	270665514
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$1,155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

IMPLANT BREAST 750CC

Facility

$4,775.00

Hospital Charge Code	270665514
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$2,387.50
Rate for Payer: Aetna Commercial	$1,432.50
Rate for Payer: Aetna Medicare Advantage	$1,432.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.62
Rate for Payer: Cigna Commercial	$2,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

IMPLANT BREAST 800CC

Facility

$4,775.00

Hospital Charge Code	270665517
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$2,387.50
Rate for Payer: Aetna Commercial	$1,432.50
Rate for Payer: Aetna Medicare Advantage	$1,432.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.62
Rate for Payer: Cigna Commercial	$2,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

IMPLANT BREAST 800CC

Facility

$4,775.00

Hospital Charge Code	270665517
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$1,155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

Know your out-of-pocket cost for care.

All Charges