Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRFRN ALFA-2B 10MILL IU/VIAL

Facility

$1,620.06

Service Code	HCPCS J9214
Hospital Charge Code	60627390
Hospital Revenue Code	636
Min. Negotiated Rate	$243.01
Max. Negotiated Rate	$810.03
Rate for Payer: Aetna Commercial	$486.02
Rate for Payer: Aetna Medicare Advantage	$486.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.12
Rate for Payer: Cigna Commercial	$810.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.05
Rate for Payer: Qualcare PPO/HMO/WC	$243.01

INTRFRN ALFA-2B 10MILL IU/VIAL

Facility

$1,620.06

Service Code	HCPCS J9214
Hospital Charge Code	60627390
Hospital Revenue Code	636
Min. Negotiated Rate	$243.01
Max. Negotiated Rate	$392.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.05
Rate for Payer: Qualcare PPO/HMO/WC	$243.01

INTRINSIC FACTOR ANTIBODY

Facility

$133.65

Service Code	HCPCS 86340
Hospital Charge Code	3007556
Hospital Revenue Code	302
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

INTRINSIC FACTOR ANTIBODY

Facility

$145.00

Service Code	HCPCS 86340
Hospital Charge Code	38476229
Hospital Revenue Code	302
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

INTRINSIC FACTOR ANTIBODY

Facility

$133.65

Service Code	HCPCS 86340
Hospital Charge Code	3007556
Hospital Revenue Code	302
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

INTRINSIC FACTOR ANTIBODY

Facility

$145.00

Service Code	HCPCS 86340
Hospital Charge Code	38476229
Hospital Revenue Code	302
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

INTRINSIC FACTOR BLOCKING

Facility

$390.00

Service Code	HCPCS 86340
Hospital Charge Code	39900218
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INTRINSIC FACTOR BLOCKING

Facility

$390.00

Service Code	HCPCS 86340
Hospital Charge Code	39900218
Hospital Revenue Code	302
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.86
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.25
Rate for Payer: Cigna Commercial	$15.08
Rate for Payer: Cigna Medicare Advantage	$7.54
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.98
Rate for Payer: Wellcare Medicare Advantage	$15.08

INTRO CATH DIALYSIS CIRC BALLO

Facility

$20,340.00

Service Code	HCPCS 36902
Hospital Charge Code	16000949
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$6,102.00
Rate for Payer: Aetna Medicare Advantage	$6,102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,186.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,186.70
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	$5,186.70
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,644.20
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

INTRO CATH DIALYSIS CIRC BALLO

Facility

$20,340.00

Service Code	HCPCS 36902
Hospital Charge Code	16000949
Hospital Revenue Code	360
Min. Negotiated Rate	$3,051.00
Max. Negotiated Rate	$3,051.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	2692127
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	321036901
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	2692127
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	5100835
Hospital Revenue Code	361
Min. Negotiated Rate	$444.50
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,025.76
Rate for Payer: Aetna Medicare Advantage	$1,025.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.90
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	$871.90
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	2709022
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	366836901
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	321036901
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	7412056
Hospital Revenue Code	361
Min. Negotiated Rate	$444.50
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,025.76
Rate for Payer: Aetna Medicare Advantage	$1,025.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.90
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	$871.90
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	5100835
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	2709022
Hospital Revenue Code	361
Min. Negotiated Rate	$444.50
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,025.76
Rate for Payer: Aetna Medicare Advantage	$1,025.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.90
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	$871.90
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	7412056
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	366836901
Hospital Revenue Code	361
Min. Negotiated Rate	$444.50
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,025.76
Rate for Payer: Aetna Medicare Advantage	$1,025.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.90
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	$871.90
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	74110053
Hospital Revenue Code	761
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	5100500
Hospital Revenue Code	761
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$165.78
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.55
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Oxford Commercial	$165.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$165.78

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	404636140
Hospital Revenue Code	481
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges