Heights University Hospital

All Charges

Charge

Type

Setting

Price

INVEGA HSP 6MG TAB

Facility

$58.00

Hospital Charge Code	60635671
Hospital Revenue Code	250
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

INVEGA SUSTENA 117 MG

Facility

$7,774.95

Service Code	NDC 50458056201
Hospital Charge Code	60634951
Hospital Revenue Code	250
Min. Negotiated Rate	$1,010.74
Max. Negotiated Rate	$3,887.47
Rate for Payer: Aetna Commercial	$2,332.49
Rate for Payer: Aetna Medicare Advantage	$2,332.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,982.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,982.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,982.61
Rate for Payer: Cigna Commercial	$3,887.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,010.74
Rate for Payer: Oxford Commercial	$3,887.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.24
Rate for Payer: UnitedHealthcare Commercial	$3,887.47

INVEGA SUSTENA 117 MG

Facility

$7,774.95

Service Code	NDC 50458056201
Hospital Charge Code	60634951
Hospital Revenue Code	250
Min. Negotiated Rate	$1,166.24
Max. Negotiated Rate	$1,166.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.24

INVEGA SUSTENNA 156 MG INJ

Facility

$10,366.91

Service Code	HCPCS J2426
Hospital Charge Code	606350946
Hospital Revenue Code	636
Min. Negotiated Rate	$1,555.04
Max. Negotiated Rate	$3,110.07
Rate for Payer: Aetna Commercial	$3,110.07
Rate for Payer: Aetna Medicare Advantage	$3,110.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,643.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,643.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,643.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,508.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,555.04

INVEGA SUSTENNA 156 MG INJ

Facility

$10,366.91

Service Code	HCPCS J2426
Hospital Charge Code	606350946
Hospital Revenue Code	636
Min. Negotiated Rate	$1,555.04
Max. Negotiated Rate	$2,508.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,508.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,555.04

INVEGA SUSTENNA 234MG

Facility

$15,550.10

Service Code	HCPCS J2426
Hospital Charge Code	6063943348
Hospital Revenue Code	636
Min. Negotiated Rate	$2,332.51
Max. Negotiated Rate	$4,665.03
Rate for Payer: Aetna Commercial	$4,665.03
Rate for Payer: Aetna Medicare Advantage	$4,665.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.51

INVEGA SUSTENNA 234MG

Facility

$15,550.10

Service Code	HCPCS J2426
Hospital Charge Code	6063943348
Hospital Revenue Code	636
Min. Negotiated Rate	$2,332.51
Max. Negotiated Rate	$3,763.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.51

INVIA CONNECTOR DBL LUM

Facility

$67.90

Hospital Charge Code	270687289
Hospital Revenue Code	271
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$33.95
Rate for Payer: Aetna Commercial	$20.37
Rate for Payer: Aetna Medicare Advantage	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.31
Rate for Payer: Cigna Commercial	$33.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.83
Rate for Payer: Oxford Commercial	$33.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$33.95

INVIA CONNECTOR DBL LUM

Facility

$67.90

Hospital Charge Code	270687289
Hospital Revenue Code	271
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

INVIA FITPAD WHITE

Facility

$52.50

Hospital Charge Code	270687295
Hospital Revenue Code	271
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

INVIA FITPAD WHITE

Facility

$52.50

Hospital Charge Code	270687295
Hospital Revenue Code	271
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.83
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$26.25

INVIA FOAM DRESSING KIT FITPAD

Facility

$175.00

Hospital Charge Code	270687290
Hospital Revenue Code	271
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

INVIA FOAM DRESSING KIT FITPAD

Facility

$175.00

Hospital Charge Code	270687290
Hospital Revenue Code	271
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

INVIA WHITE FOAM SMALL NPWT

Facility

$49.00

Hospital Charge Code	270687292
Hospital Revenue Code	271
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

INVIA WHITE FOAM SMALL NPWT

Facility

$49.00

Hospital Charge Code	270687292
Hospital Revenue Code	271
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$24.50

INVICTUS GUIDEWIRE

Facility

$400.00

Hospital Charge Code	270703549
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

INVICTUS GUIDEWIRE

Facility

$400.00

Hospital Charge Code	270703549
Hospital Revenue Code	272
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$200.00

INVICTUS MIS TI ROD 5.5X60MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703544
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$352.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

INVICTUS MIS TI ROD 5.5X60MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703544
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

INVICTUS MIS TI ROD 5.5X65MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703543
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

INVICTUS MIS TI ROD 5.5X65MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703543
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$352.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

INVICTUS REDUCTION SCREW 7.5X5

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704967
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

INVICTUS REDUCTION SCREW 7.5X5

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704967
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

INVIRASE 200MG CAPSULE

Facility

$15.00

Hospital Charge Code	60635113
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

INVIRASE 200MG CAPSULE

Facility

$15.00

Hospital Charge Code	60635113
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

Know your out-of-pocket cost for care.

All Charges