Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTERBODY STANDALONE 12X17X7MM

Facility

$32,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270669220
Hospital Revenue Code	278
Min. Negotiated Rate	$4,893.75
Max. Negotiated Rate	$7,895.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,895.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,893.75

INTERCED 3X4 ABSORBABLE

Facility

$14,628.00

Hospital Charge Code	270656002
Hospital Revenue Code	278
Min. Negotiated Rate	$2,194.20
Max. Negotiated Rate	$7,314.00
Rate for Payer: Aetna Commercial	$4,388.40
Rate for Payer: Aetna Medicare Advantage	$4,388.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,730.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,730.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,925.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,730.14
Rate for Payer: Cigna Commercial	$7,314.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,539.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,194.20

INTERCED 3X4 ABSORBABLE

Facility

$14,628.00

Hospital Charge Code	270656002
Hospital Revenue Code	278
Min. Negotiated Rate	$2,194.20
Max. Negotiated Rate	$3,539.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,925.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,539.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,194.20

INTERCEED ADHESION BARRIER 3x4

Facility

$1,630.42

Hospital Charge Code	270601039
Hospital Revenue Code	272
Min. Negotiated Rate	$211.95
Max. Negotiated Rate	$815.21
Rate for Payer: Aetna Commercial	$489.13
Rate for Payer: Aetna Medicare Advantage	$489.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.76
Rate for Payer: Cigna Commercial	$815.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.95
Rate for Payer: Oxford Commercial	$815.21
Rate for Payer: Qualcare PPO/HMO/WC	$244.56
Rate for Payer: UnitedHealthcare Commercial	$815.21

INTERCEED ADHESION BARRIER 3x4

Facility

$1,630.42

Hospital Charge Code	270601039
Hospital Revenue Code	272
Min. Negotiated Rate	$244.56
Max. Negotiated Rate	$244.56
Rate for Payer: Qualcare PPO/HMO/WC	$244.56

INTERDISCAL PERQ ASPIR DX

Facility

$3,392.55

Service Code	HCPCS 62267
Hospital Charge Code	404362267
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

INTERDISCAL PERQ ASPIR DX

Facility

$3,392.55

Service Code	HCPCS 62267
Hospital Charge Code	404362267
Hospital Revenue Code	361
Min. Negotiated Rate	$441.03
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,017.76
Rate for Payer: Aetna Medicare Advantage	$1,017.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$865.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$865.10
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	$865.10
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.03
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

INTERFER ALPHA -1 INJ 15MCG/ML

Facility

$379.55

Hospital Charge Code	60628794
Hospital Revenue Code	636
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$91.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.93

INTERFER ALPHA -1 INJ 15MCG/ML

Facility

$379.55

Hospital Charge Code	60628794
Hospital Revenue Code	636
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$189.78
Rate for Payer: Aetna Commercial	$113.86
Rate for Payer: Aetna Medicare Advantage	$113.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.79
Rate for Payer: Cigna Commercial	$189.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.93

INTERFERANCE SCREW 10 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684924
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

INTERFERANCE SCREW 10 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684924
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

INTERFERANCE SCREW 9 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684925
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

INTERFERANCE SCREW 9 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684925
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

INTERFERON 3MU

Facility

$153.00

Hospital Charge Code	6000301
Hospital Revenue Code	636
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$45.90
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

INTERFERON 3MU

Facility

$153.00

Hospital Charge Code	6000301
Hospital Revenue Code	636
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$37.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

INTERFERON ALPHCN1 15MCG/MLINJ

Facility

$517.60

Hospital Charge Code	60628935
Hospital Revenue Code	636
Min. Negotiated Rate	$77.64
Max. Negotiated Rate	$125.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.26
Rate for Payer: Qualcare PPO/HMO/WC	$77.64

INTERFERON ALPHCN1 15MCG/MLINJ

Facility

$517.60

Hospital Charge Code	60628935
Hospital Revenue Code	636
Min. Negotiated Rate	$77.64
Max. Negotiated Rate	$258.80
Rate for Payer: Aetna Commercial	$155.28
Rate for Payer: Aetna Medicare Advantage	$155.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.99
Rate for Payer: Cigna Commercial	$258.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.26
Rate for Payer: Qualcare PPO/HMO/WC	$77.64

INTERFERON BETA 1A INJ 30MCG

Facility

$4,086.00

Hospital Charge Code	60628755
Hospital Revenue Code	636
Min. Negotiated Rate	$612.90
Max. Negotiated Rate	$2,043.00
Rate for Payer: Aetna Commercial	$1,225.80
Rate for Payer: Aetna Medicare Advantage	$1,225.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,041.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,041.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,041.93
Rate for Payer: Cigna Commercial	$2,043.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.81
Rate for Payer: Qualcare PPO/HMO/WC	$612.90

INTERFERON BETA 1A INJ 30MCG

Facility

$4,086.00

Hospital Charge Code	60628755
Hospital Revenue Code	636
Min. Negotiated Rate	$612.90
Max. Negotiated Rate	$988.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.81
Rate for Payer: Qualcare PPO/HMO/WC	$612.90

INTERFERON GAMMA (PROFILE)

Facility

$265.00

Service Code	HCPCS 83520
Hospital Charge Code	401383520A
Hospital Revenue Code	306
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

INTERFERON GAMMA (PROFILE)

Facility

$265.00

Service Code	HCPCS 83520
Hospital Charge Code	401383520A
Hospital Revenue Code	306
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	$34.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
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

INTERFERON INJ 15 MG/ML ALPHA

Facility

$379.55

Hospital Charge Code	60628786
Hospital Revenue Code	636
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$91.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.93

INTERFERON INJ 15 MG/ML ALPHA

Facility

$379.55

Hospital Charge Code	60628786
Hospital Revenue Code	636
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$189.78
Rate for Payer: Aetna Commercial	$113.86
Rate for Payer: Aetna Medicare Advantage	$113.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.79
Rate for Payer: Cigna Commercial	$189.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.93

INTERFERON INJ 30MCG/1ML

Facility

$994.60

Hospital Charge Code	60629149
Hospital Revenue Code	636
Min. Negotiated Rate	$149.19
Max. Negotiated Rate	$240.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.69
Rate for Payer: Qualcare PPO/HMO/WC	$149.19

INTERFERON INJ 30MCG/1ML

Facility

$994.60

Hospital Charge Code	60629149
Hospital Revenue Code	636
Min. Negotiated Rate	$149.19
Max. Negotiated Rate	$497.30
Rate for Payer: Aetna Commercial	$298.38
Rate for Payer: Aetna Medicare Advantage	$298.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.62
Rate for Payer: Cigna Commercial	$497.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.69
Rate for Payer: Qualcare PPO/HMO/WC	$149.19

Know your out-of-pocket cost for care.

All Charges