Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRO KIT PERCUTANEOUS SHEATH

Facility

$157.49

Hospital Charge Code	270649534
Hospital Revenue Code	272
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

INTRON A/3MU

Facility

$166.00

Hospital Charge Code	60633187
Hospital Revenue Code	636
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$40.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

INTRON A/3MU

Facility

$166.00

Hospital Charge Code	60633187
Hospital Revenue Code	636
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$49.80
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

INTRO NEEDLE INTO AV SHUN

Facility

$2,092.00

Hospital Charge Code	2009001
Hospital Revenue Code	761
Min. Negotiated Rate	$313.80
Max. Negotiated Rate	$313.80
Rate for Payer: Qualcare PPO/HMO/WC	$313.80

INTRO NEEDLE INTO AV SHUN

Facility

$2,092.00

Hospital Charge Code	2009001
Hospital Revenue Code	761
Min. Negotiated Rate	$271.96
Max. Negotiated Rate	$1,046.00
Rate for Payer: Aetna Commercial	$627.60
Rate for Payer: Aetna Medicare Advantage	$627.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.46
Rate for Payer: Cigna Commercial	$1,046.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.96
Rate for Payer: Oxford Commercial	$1,046.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.80
Rate for Payer: UnitedHealthcare Commercial	$1,046.00

INTRO OF CATHETER-AORT

Facility

$233.00

Service Code	HCPCS 36200
Hospital Charge Code	7411079
Hospital Revenue Code	361
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$34.95

INTRO OF CATHETER-AORT

Facility

$233.00

Service Code	HCPCS 36200
Hospital Charge Code	7411079
Hospital Revenue Code	361
Min. Negotiated Rate	$30.29
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$69.90
Rate for Payer: Aetna Medicare Advantage	$69.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.41
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	$59.41
Rate for Payer: Cigna Commercial	$131.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.29
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRO OF URET STNT-LT

Facility

$2,717.00

Hospital Charge Code	2009325
Hospital Revenue Code	320
Min. Negotiated Rate	$407.55
Max. Negotiated Rate	$407.55
Rate for Payer: Qualcare PPO/HMO/WC	$407.55

INTRO OF URET STNT-LT

Facility

$2,717.00

Hospital Charge Code	2009325
Hospital Revenue Code	320
Min. Negotiated Rate	$353.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$815.10
Rate for Payer: Aetna Medicare Advantage	$815.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.84
Rate for Payer: Cigna Commercial	$1,358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$407.55
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INTROPIN/80MG/1ML

Facility

$27.40

Service Code	NDC 517190525
Hospital Charge Code	60633188
Hospital Revenue Code	250
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$4.11
Rate for Payer: Qualcare PPO/HMO/WC	$4.11

INTROPIN/80MG/1ML

Facility

$27.40

Service Code	NDC 517190525
Hospital Charge Code	60633188
Hospital Revenue Code	250
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$13.70
Rate for Payer: Aetna Commercial	$8.22
Rate for Payer: Aetna Medicare Advantage	$8.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.99
Rate for Payer: Cigna Commercial	$13.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$13.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.11
Rate for Payer: UnitedHealthcare Commercial	$13.70

INTRO TRANSRAD PREL SHEATH

Facility

$32.00

Hospital Charge Code	270658207
Hospital Revenue Code	278
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.74
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

INTRO TRANSRAD PREL SHEATH

Facility

$32.00

Hospital Charge Code	270658207
Hospital Revenue Code	278
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.74
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008C
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$186.00
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008C
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$150.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTRO VISTABRITE 8FR 403-8553A

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374N
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$84.56
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRO VISTABRITE 8FR 403-8553A

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374N
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$84.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,551.09
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$84.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$84.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,551.09
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$84.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges