Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR NEPHROSTOMY DILATION LEFT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	7411683
Hospital Revenue Code	320
Min. Negotiated Rate	$231.51
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$534.25
Rate for Payer: Aetna Medicare Advantage	$534.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$454.12
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$267.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR NEPHROSTOMY DILATION LEFT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	2600105
Hospital Revenue Code	320
Min. Negotiated Rate	$231.51
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$534.25
Rate for Payer: Aetna Medicare Advantage	$534.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$454.12
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$267.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR NEPHROSTOMY DILATION LEFT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	7411683
Hospital Revenue Code	320
Min. Negotiated Rate	$267.13
Max. Negotiated Rate	$267.13
Rate for Payer: Qualcare PPO/HMO/WC	$267.13

IR NEPHROSTOMY DILATION RIGHT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	2600106
Hospital Revenue Code	320
Min. Negotiated Rate	$231.51
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$534.25
Rate for Payer: Aetna Medicare Advantage	$534.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$454.12
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$267.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR NEPHROSTOMY DILATION RIGHT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	7411684
Hospital Revenue Code	320
Min. Negotiated Rate	$267.13
Max. Negotiated Rate	$267.13
Rate for Payer: Qualcare PPO/HMO/WC	$267.13

IR NEPHROSTOMY DILATION RIGHT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	2600106
Hospital Revenue Code	320
Min. Negotiated Rate	$267.13
Max. Negotiated Rate	$267.13
Rate for Payer: Qualcare PPO/HMO/WC	$267.13

IR NEPHROSTOMY DILATION RIGHT

Facility

$1,780.85

Service Code	HCPCS 74485
Hospital Charge Code	7411684
Hospital Revenue Code	320
Min. Negotiated Rate	$231.51
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$534.25
Rate for Payer: Aetna Medicare Advantage	$534.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$454.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$454.12
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$267.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR OFFICE CONSULTATION

Facility

$225.20

Service Code	HCPCS 99241
Hospital Charge Code	2101160
Hospital Revenue Code	510
Min. Negotiated Rate	$29.28
Max. Negotiated Rate	$112.60
Rate for Payer: Aetna Commercial	$67.56
Rate for Payer: Aetna Medicare Advantage	$67.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$112.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.28
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

IR OFFICE CONSULTATION

Facility

$225.20

Service Code	HCPCS 99241
Hospital Charge Code	2101160
Hospital Revenue Code	510
Min. Negotiated Rate	$33.78
Max. Negotiated Rate	$33.78
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

IRON

Facility

$239.00

Service Code	HCPCS 83540
Hospital Charge Code	38472425
Hospital Revenue Code	301
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

IRON

Facility

$239.00

Service Code	HCPCS 83540
Hospital Charge Code	38472425
Hospital Revenue Code	301
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.96
Rate for Payer: Aetna Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$6.47
Rate for Payer: Cigna Medicare Advantage	$3.23
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.86
Rate for Payer: Wellcare Medicare Advantage	$6.47

IRON B12 VIT C,E, FOLATE TAB

Facility

$8.35

Hospital Charge Code	60628498
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$4.17
Rate for Payer: Aetna Commercial	$2.50
Rate for Payer: Aetna Medicare Advantage	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.13
Rate for Payer: Cigna Commercial	$4.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.09
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$4.17

IRON B12 VIT C,E, FOLATE TAB

Facility

$8.35

Hospital Charge Code	60628498
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

IRON BINDING CAP

Facility

$267.00

Service Code	HCPCS 83550
Hospital Charge Code	38479471
Hospital Revenue Code	301
Min. Negotiated Rate	$40.05
Max. Negotiated Rate	$40.05
Rate for Payer: Qualcare PPO/HMO/WC	$40.05

IRON BINDING CAP

Facility

$267.00

Service Code	HCPCS 83550
Hospital Charge Code	38479471
Hospital Revenue Code	301
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.32
Rate for Payer: Aetna Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.02
Rate for Payer: Cigna Commercial	$8.74
Rate for Payer: Cigna Medicare Advantage	$4.37
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.26
Rate for Payer: Wellcare Medicare Advantage	$8.74

IRON BINDING CAPACITY

Facility

$91.25

Service Code	HCPCS 83550
Hospital Charge Code	8200316RS
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

IRON BINDING CAPACITY

Facility

$267.00

Service Code	HCPCS 83550
Hospital Charge Code	38472428
Hospital Revenue Code	301
Min. Negotiated Rate	$40.05
Max. Negotiated Rate	$40.05
Rate for Payer: Qualcare PPO/HMO/WC	$40.05

IRON BINDING CAPACITY

Facility

$91.25

Service Code	HCPCS 83550
Hospital Charge Code	8200316RS
Hospital Revenue Code	301
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.32
Rate for Payer: Aetna Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.02
Rate for Payer: Cigna Commercial	$8.74
Rate for Payer: Cigna Medicare Advantage	$4.37
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.26
Rate for Payer: Wellcare Medicare Advantage	$8.74

IRON BINDING CAPACITY

Facility

$267.00

Service Code	HCPCS 83550
Hospital Charge Code	38472428
Hospital Revenue Code	301
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.32
Rate for Payer: Aetna Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.02
Rate for Payer: Cigna Commercial	$8.74
Rate for Payer: Cigna Medicare Advantage	$4.37
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.26
Rate for Payer: Wellcare Medicare Advantage	$8.74

IRON CARBONYL CAPLET 50MG

Facility

$3.20

Hospital Charge Code	60628818
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

IRON CARBONYL CAPLET 50MG

Facility

$3.20

Hospital Charge Code	60628818
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

IRON DEXTRAN 50 MG/ML SOL

Facility

$75.40

Hospital Charge Code	6003172
Hospital Revenue Code	636
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$37.70
Rate for Payer: Aetna Commercial	$22.62
Rate for Payer: Aetna Medicare Advantage	$22.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.23
Rate for Payer: Cigna Commercial	$37.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.31

IRON DEXTRAN 50 MG/ML SOL

Facility

$75.40

Hospital Charge Code	6003172
Hospital Revenue Code	636
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$18.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.31

IRON DEXTRAN INJ 50MG/ML***

Facility

$113.20

Service Code	HCPCS J1760
Hospital Charge Code	6003172P
Hospital Revenue Code	259
Min. Negotiated Rate	$14.72
Max. Negotiated Rate	$56.60
Rate for Payer: Aetna Commercial	$33.96
Rate for Payer: Aetna Medicare Advantage	$33.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.87
Rate for Payer: Cigna Commercial	$56.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.72
Rate for Payer: Oxford Commercial	$56.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.98
Rate for Payer: UnitedHealthcare Commercial	$56.60

IRON DEXTRAN INJ 50MG/ML***

Facility

$113.20

Service Code	HCPCS J1760
Hospital Charge Code	6003172P
Hospital Revenue Code	259
Min. Negotiated Rate	$16.98
Max. Negotiated Rate	$16.98
Rate for Payer: Qualcare PPO/HMO/WC	$16.98

Know your out-of-pocket cost for care.

All Charges