Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTERGRA WND DRSG 2X2CM

Facility

$4,990.00

Hospital Charge Code	270332621
Hospital Revenue Code	636
Min. Negotiated Rate	$748.50
Max. Negotiated Rate	$1,207.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.58
Rate for Payer: Qualcare PPO/HMO/WC	$748.50

INTERGRA WND DRSG 2X2CM

Facility

$4,990.00

Hospital Charge Code	270332621
Hospital Revenue Code	636
Min. Negotiated Rate	$748.50
Max. Negotiated Rate	$2,495.00
Rate for Payer: Aetna Commercial	$1,497.00
Rate for Payer: Aetna Medicare Advantage	$1,497.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,272.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,272.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,272.45
Rate for Payer: Cigna Commercial	$2,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.58
Rate for Payer: Qualcare PPO/HMO/WC	$748.50

INTERGRA WND DRSG 2X2CM/SQCMJW

Facility

$1,247.50

Hospital Charge Code	270332621W
Hospital Revenue Code	636
Min. Negotiated Rate	$187.12
Max. Negotiated Rate	$301.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.89
Rate for Payer: Qualcare PPO/HMO/WC	$187.12

INTERGRA WND DRSG 2X2CM/SQCMJW

Facility

$1,247.50

Hospital Charge Code	270332621W
Hospital Revenue Code	636
Min. Negotiated Rate	$187.12
Max. Negotiated Rate	$623.75
Rate for Payer: Aetna Commercial	$374.25
Rate for Payer: Aetna Medicare Advantage	$374.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.11
Rate for Payer: Cigna Commercial	$623.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.89
Rate for Payer: Qualcare PPO/HMO/WC	$187.12

INTERGRA WND DRSG 4X5CM

Facility

$4,332.00

Hospital Charge Code	270332611
Hospital Revenue Code	636
Min. Negotiated Rate	$649.80
Max. Negotiated Rate	$1,048.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,048.34
Rate for Payer: Qualcare PPO/HMO/WC	$649.80

INTERGRA WND DRSG 4X5CM

Facility

$4,332.00

Hospital Charge Code	270332611
Hospital Revenue Code	636
Min. Negotiated Rate	$649.80
Max. Negotiated Rate	$2,166.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,299.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.66
Rate for Payer: Cigna Commercial	$2,166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,048.34
Rate for Payer: Qualcare PPO/HMO/WC	$649.80

INTERGRA WND DRSG 4X5CM/SQCMJW

Facility

$216.60

Hospital Charge Code	270332611W
Hospital Revenue Code	636
Min. Negotiated Rate	$32.49
Max. Negotiated Rate	$108.30
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$64.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.23
Rate for Payer: Cigna Commercial	$108.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.42
Rate for Payer: Qualcare PPO/HMO/WC	$32.49

INTERGRA WND DRSG 4X5CM/SQCMJW

Facility

$216.60

Hospital Charge Code	270332611W
Hospital Revenue Code	636
Min. Negotiated Rate	$32.49
Max. Negotiated Rate	$52.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.42
Rate for Payer: Qualcare PPO/HMO/WC	$32.49

INTERGRO DBM 10cc DBM010

Facility

$5,456.00

Hospital Charge Code	270636951
Hospital Revenue Code	272
Min. Negotiated Rate	$709.28
Max. Negotiated Rate	$2,728.00
Rate for Payer: Aetna Commercial	$1,636.80
Rate for Payer: Aetna Medicare Advantage	$1,636.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.28
Rate for Payer: Cigna Commercial	$2,728.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.28
Rate for Payer: Oxford Commercial	$2,728.00
Rate for Payer: Qualcare PPO/HMO/WC	$818.40
Rate for Payer: UnitedHealthcare Commercial	$2,728.00

INTERGRO DBM 10cc DBM010

Facility

$5,456.00

Hospital Charge Code	270636951
Hospital Revenue Code	272
Min. Negotiated Rate	$818.40
Max. Negotiated Rate	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$818.40

INTERGRO DBM 5cc DBM005

Facility

$3,125.00

Hospital Charge Code	270636731
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

INTERGRO DBM 5cc DBM005

Facility

$3,125.00

Hospital Charge Code	270636731
Hospital Revenue Code	272
Min. Negotiated Rate	$406.25
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.25
Rate for Payer: Oxford Commercial	$1,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$1,562.50

INTERGRO DBM PLUS 10cc DBMW10

Facility

$6,375.00

Hospital Charge Code	270637165
Hospital Revenue Code	272
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$956.25
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

INTERGRO DBM PLUS 10cc DBMW10

Facility

$6,375.00

Hospital Charge Code	270637165
Hospital Revenue Code	272
Min. Negotiated Rate	$828.75
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$1,912.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.75
Rate for Payer: Oxford Commercial	$3,187.50
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Commercial	$3,187.50

INTERGRO DBM PLUS 2cc DBMW002

Facility

$2,405.65

Hospital Charge Code	270636733
Hospital Revenue Code	272
Min. Negotiated Rate	$312.73
Max. Negotiated Rate	$1,202.83
Rate for Payer: Aetna Commercial	$721.70
Rate for Payer: Aetna Medicare Advantage	$721.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.44
Rate for Payer: Cigna Commercial	$1,202.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.73
Rate for Payer: Oxford Commercial	$1,202.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.85
Rate for Payer: UnitedHealthcare Commercial	$1,202.83

INTERGRO DBM PLUS 2cc DBMW002

Facility

$2,405.65

Hospital Charge Code	270636733
Hospital Revenue Code	272
Min. Negotiated Rate	$360.85
Max. Negotiated Rate	$360.85
Rate for Payer: Qualcare PPO/HMO/WC	$360.85

INTERGRO DBM PLUS 5cc DBMW005

Facility

$4,092.00

Hospital Charge Code	270636732
Hospital Revenue Code	272
Min. Negotiated Rate	$531.96
Max. Negotiated Rate	$2,046.00
Rate for Payer: Aetna Commercial	$1,227.60
Rate for Payer: Aetna Medicare Advantage	$1,227.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.46
Rate for Payer: Cigna Commercial	$2,046.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.96
Rate for Payer: Oxford Commercial	$2,046.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.80
Rate for Payer: UnitedHealthcare Commercial	$2,046.00

INTERGRO DBM PLUS 5cc DBMW005

Facility

$4,092.00

Hospital Charge Code	270636732
Hospital Revenue Code	272
Min. Negotiated Rate	$613.80
Max. Negotiated Rate	$613.80
Rate for Payer: Qualcare PPO/HMO/WC	$613.80

INTERLAM FUSION DEVICE-14

Facility

$35,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705823
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$10,500.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLAM FUSION DEVICE-14

Facility

$35,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705823
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLAMINATE FUSION DEVICE 10

Facility

$35,000.00

Hospital Charge Code	270702354
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$10,500.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLAMINATE FUSION DEVICE 10

Facility

$35,000.00

Hospital Charge Code	270702354
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLEUKIN-10 (IL-10) Serum

Facility

$86.35

Service Code	HCPCS 83520
Hospital Charge Code	401383520
Hospital Revenue Code	306
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$12.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.95

INTERLEUKIN-10 (IL-10) Serum

Facility

$86.35

Service Code	HCPCS 83520
Hospital Charge Code	401383520
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	$11.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.95
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

INTERLEUKIN-1 BETA

Facility

$582.68

Service Code	HCPCS 83520
Hospital Charge Code	401183520H
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	$75.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.40
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

Know your out-of-pocket cost for care.

All Charges