Heights University Hospital

All Charges

Charge

Type

Setting

Price

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784
Hospital Revenue Code	272
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$23.52

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784
Hospital Revenue Code	272
Min. Negotiated Rate	$20.38
Max. Negotiated Rate	$78.40
Rate for Payer: Aetna Commercial	$47.04
Rate for Payer: Aetna Medicare Advantage	$47.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.98
Rate for Payer: Cigna Commercial	$78.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.38
Rate for Payer: Oxford Commercial	$78.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.52
Rate for Payer: UnitedHealthcare Commercial	$78.40

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Hospital Charge Code	270634520V
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,560.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Hospital Charge Code	270634520V
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,560.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

INFLATOR LEVEEN & PRESS GA****

Facility

$225.00

Hospital Charge Code	1604719
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

INFLATOR LEVEEN & PRESS GA****

Facility

$225.00

Hospital Charge Code	1604719
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$96.00
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$153.18
Rate for Payer: Aetna Commercial	$153.18
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.20
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.38
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$1,119.46
Max. Negotiated Rate	$2,238.92
Rate for Payer: Aetna Commercial	$2,238.92
Rate for Payer: Aetna Medicare Advantage	$2,238.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,903.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,903.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,903.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$1,119.46
Max. Negotiated Rate	$1,806.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$555.82
Max. Negotiated Rate	$1,111.63
Rate for Payer: Aetna Commercial	$1,111.63
Rate for Payer: Aetna Medicare Advantage	$1,111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$944.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$944.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$944.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$555.82
Max. Negotiated Rate	$896.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82

INFLIXIMAB ANTI-DRUG AB(SERUM)

Facility

$250.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520J
Hospital Revenue Code	301
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

INFLIXIMAB ANTI-DRUG AB(SERUM)

Facility

$250.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520J
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

INFLIXIMAB-DYYB 100MG VIAL

Facility

$3,567.01

Service Code	HCPCS Q5103
Hospital Charge Code	606390259
Hospital Revenue Code	636
Min. Negotiated Rate	$535.05
Max. Negotiated Rate	$863.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$863.22
Rate for Payer: Qualcare PPO/HMO/WC	$535.05

INFLIXIMAB-DYYB 100MG VIAL

Facility

$3,567.01

Service Code	HCPCS Q5103
Hospital Charge Code	606390259
Hospital Revenue Code	636
Min. Negotiated Rate	$535.05
Max. Negotiated Rate	$1,070.10
Rate for Payer: Aetna Commercial	$1,070.10
Rate for Payer: Aetna Medicare Advantage	$1,070.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$909.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$909.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$909.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$863.22
Rate for Payer: Qualcare PPO/HMO/WC	$535.05

INFLIXIMAB LEVEL FOR IBD

Facility

$250.00

Service Code	HCPCS 80230
Hospital Charge Code	401180230
Hospital Revenue Code	301
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

INFLIXIMAB LEVEL FOR IBD

Facility

$250.00

Service Code	HCPCS 80230
Hospital Charge Code	401180230
Hospital Revenue Code	301
Min. Negotiated Rate	$19.29
Max. Negotiated Rate	$141.32
Rate for Payer: Aetna Commercial	$124.97
Rate for Payer: Aetna Medicare Advantage	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.32
Rate for Payer: Cigna Commercial	$38.57
Rate for Payer: Cigna Medicare Advantage	$19.29
Rate for Payer: Clover Medicare Advantage	$36.64
Rate for Payer: EmblemHealth Commercial	$115.71
Rate for Payer: Humana Medicare Advantage	$39.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$40.88
Rate for Payer: Wellcare Medicare Advantage	$38.57

INFLOW & OUTFLOW TUBING

Facility

$6,250.00

Hospital Charge Code	270662954
Hospital Revenue Code	270
Min. Negotiated Rate	$812.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Oxford Commercial	$3,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$3,125.00

Know your out-of-pocket cost for care.

All Charges