Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRAPLEU.AEROSOL SUR.TALC(BRY

Facility

$668.00

Hospital Charge Code	270335411
Hospital Revenue Code	272
Min. Negotiated Rate	$86.84
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$200.40
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.84
Rate for Payer: Oxford Commercial	$334.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.20
Rate for Payer: UnitedHealthcare Commercial	$334.00

INTRAVASC US COR VESS/GFT ADD

Facility

$6,070.00

Service Code	HCPCS 92979
Hospital Charge Code	5100651
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

INTRAVASC US COR VESS/GFT ADD

Facility

$6,070.00

Service Code	HCPCS 92979
Hospital Charge Code	5100651
Hospital Revenue Code	480
Min. Negotiated Rate	$789.10
Max. Negotiated Rate	$3,035.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$3,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

INTRAVASC US COR VESS/GFT ADD

Facility

$6,070.00

Service Code	HCPCS 92979
Hospital Charge Code	74110061
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

INTRAVASC US COR VESS/GFT ADD

Facility

$6,070.00

Service Code	HCPCS 92979
Hospital Charge Code	74110061
Hospital Revenue Code	480
Min. Negotiated Rate	$789.10
Max. Negotiated Rate	$3,035.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$3,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

INTRAVASC US COR VESS/GFT INIT

Facility

$4,403.75

Service Code	HCPCS 92978
Hospital Charge Code	5100650
Hospital Revenue Code	481
Min. Negotiated Rate	$660.56
Max. Negotiated Rate	$660.56
Rate for Payer: Qualcare PPO/HMO/WC	$660.56

INTRAVASC US COR VESS/GFT INIT

Facility

$4,403.75

Service Code	HCPCS 92978
Hospital Charge Code	5100650
Hospital Revenue Code	481
Min. Negotiated Rate	$572.49
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,321.12
Rate for Payer: Aetna Medicare Advantage	$1,321.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.96
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	$1,122.96
Rate for Payer: Cigna Commercial	$2,201.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$572.49
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.56
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRAVASC US COR VESS/GFT INIT

Facility

$4,403.75

Service Code	HCPCS 92978
Hospital Charge Code	74110060
Hospital Revenue Code	481
Min. Negotiated Rate	$660.56
Max. Negotiated Rate	$660.56
Rate for Payer: Qualcare PPO/HMO/WC	$660.56

INTRAVASC US COR VESS/GFT INIT

Facility

$4,403.75

Service Code	HCPCS 92978
Hospital Charge Code	74110060
Hospital Revenue Code	481
Min. Negotiated Rate	$572.49
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,321.12
Rate for Payer: Aetna Medicare Advantage	$1,321.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.96
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	$1,122.96
Rate for Payer: Cigna Commercial	$2,201.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$572.49
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.56
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRAVENOUS

Facility

$21.15

Hospital Charge Code	7000011
Hospital Revenue Code	258
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

INTRAVENOUS

Facility

$21.15

Hospital Charge Code	7000011
Hospital Revenue Code	258
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

INTRAVU NEEDLE SCOPE SUPERIOR

Facility

$3,000.00

Hospital Charge Code	270691835
Hospital Revenue Code	272
Min. Negotiated Rate	$390.00
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) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00

INTRAVU NEEDLE SCOPE SUPERIOR

Facility

$3,000.00

Hospital Charge Code	270691835
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

INTRDCR CHCKFLO GUIDSHEATH16FR

Facility

$595.15

Service Code	HCPCS C1893
Hospital Charge Code	270622441C
Hospital Revenue Code	278
Min. Negotiated Rate	$89.27
Max. Negotiated Rate	$297.57
Rate for Payer: Aetna Commercial	$178.54
Rate for Payer: Aetna Medicare Advantage	$178.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.76
Rate for Payer: Cigna Commercial	$297.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.03
Rate for Payer: Qualcare PPO/HMO/WC	$89.27

INTRDCR CHCKFLO GUIDSHEATH16FR

Facility

$595.15

Service Code	HCPCS C1893
Hospital Charge Code	270622441N
Hospital Revenue Code	278
Min. Negotiated Rate	$89.27
Max. Negotiated Rate	$297.57
Rate for Payer: Aetna Commercial	$178.54
Rate for Payer: Aetna Medicare Advantage	$178.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.76
Rate for Payer: Cigna Commercial	$297.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.03
Rate for Payer: Qualcare PPO/HMO/WC	$89.27

INTRDCR CHCKFLO GUIDSHEATH16FR

Facility

$595.15

Service Code	HCPCS C1893
Hospital Charge Code	270622441C
Hospital Revenue Code	278
Min. Negotiated Rate	$89.27
Max. Negotiated Rate	$144.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.03
Rate for Payer: Qualcare PPO/HMO/WC	$89.27

INTRDCR CHCKFLO GUIDSHEATH16FR

Facility

$595.15

Service Code	HCPCS C1893
Hospital Charge Code	270622441N
Hospital Revenue Code	278
Min. Negotiated Rate	$89.27
Max. Negotiated Rate	$144.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.03
Rate for Payer: Qualcare PPO/HMO/WC	$89.27

INTRDCR TRACHAL TUBE ST TTIC10

Facility

$42.25

Hospital Charge Code	270634129
Hospital Revenue Code	272
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$21.12
Rate for Payer: Aetna Commercial	$12.68
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.77
Rate for Payer: Cigna Commercial	$21.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.49
Rate for Payer: Oxford Commercial	$21.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$21.12

INTRDCR TRACHAL TUBE ST TTIC10

Facility

$42.25

Hospital Charge Code	270634129
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

INTRDCR TRACHAL TUBE ST TTIS10

Facility

$42.25

Hospital Charge Code	270634130
Hospital Revenue Code	272
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$21.12
Rate for Payer: Aetna Commercial	$12.68
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.77
Rate for Payer: Cigna Commercial	$21.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.49
Rate for Payer: Oxford Commercial	$21.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$21.12

INTRDCR TRACHAL TUBE ST TTIS10

Facility

$42.25

Hospital Charge Code	270634130
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

INT REP FACE 2.5-5.0

Facility

$687.50

Service Code	HCPCS 12052
Hospital Charge Code	1600000730
Hospital Revenue Code	360
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$103.12
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

INT REP FACE 2.5-5.0

Facility

$687.50

Service Code	HCPCS 12052
Hospital Charge Code	1600000730
Hospital Revenue Code	360
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$206.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
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	$175.31
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.38
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTREPID I/A TIP 0.3MM BENT

Facility

$1,500.00

Hospital Charge Code	270662665
Hospital Revenue Code	270
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$750.00

INTREPID I/A TIP 0.3MM BENT

Facility

$1,500.00

Hospital Charge Code	270662665
Hospital Revenue Code	270
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges