Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANZEMET100MG VIAL INJ 5ML

Facility

$779.00

Hospital Charge Code	60635300
Hospital Revenue Code	636
Min. Negotiated Rate	$116.85
Max. Negotiated Rate	$389.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$233.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.65
Rate for Payer: Cigna Commercial	$389.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.52
Rate for Payer: Qualcare PPO/HMO/WC	$116.85

ANZEMET 50MG TAB U/D

Facility

$261.00

Hospital Charge Code	60635301
Hospital Revenue Code	250
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$39.15
Rate for Payer: Qualcare PPO/HMO/WC	$39.15

ANZEMET 50MG TAB U/D

Facility

$261.00

Hospital Charge Code	60635301
Hospital Revenue Code	250
Min. Negotiated Rate	$33.93
Max. Negotiated Rate	$130.50
Rate for Payer: Aetna Commercial	$78.30
Rate for Payer: Aetna Medicare Advantage	$78.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.56
Rate for Payer: Cigna Commercial	$130.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$130.50
Rate for Payer: Qualcare PPO/HMO/WC	$39.15
Rate for Payer: UnitedHealthcare Commercial	$130.50

ANZEMET TAB 100MG U/D

Facility

$318.00

Hospital Charge Code	60635299
Hospital Revenue Code	250
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

ANZEMET TAB 100MG U/D

Facility

$318.00

Hospital Charge Code	60635299
Hospital Revenue Code	250
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$95.40
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$159.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Commercial	$159.00

AO CANNULATED HANDLE

Facility

$705.55

Service Code	HCPCS C1713
Hospital Charge Code	270704190
Hospital Revenue Code	278
Min. Negotiated Rate	$105.83
Max. Negotiated Rate	$352.77
Rate for Payer: Aetna Commercial	$211.66
Rate for Payer: Aetna Medicare Advantage	$211.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.92
Rate for Payer: Cigna Commercial	$352.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.74
Rate for Payer: Qualcare PPO/HMO/WC	$105.83

AO CANNULATED HANDLE

Facility

$705.55

Service Code	HCPCS C1713
Hospital Charge Code	270704190
Hospital Revenue Code	278
Min. Negotiated Rate	$105.83
Max. Negotiated Rate	$170.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.74
Rate for Payer: Qualcare PPO/HMO/WC	$105.83

A-OK SLIT KNIVES 3.2MM

Facility

$365.00

Hospital Charge Code	270330823
Hospital Revenue Code	272
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

A-OK SLIT KNIVES 3.2MM

Facility

$365.00

Hospital Charge Code	270330823
Hospital Revenue Code	272
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$109.50
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.45
Rate for Payer: Oxford Commercial	$182.50
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$182.50

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692095
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

AORTA&ILIAC ARTER DUP LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74116054
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692095
Hospital Revenue Code	921
Min. Negotiated Rate	$220.80
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

AORTA&ILIAC ARTER DUP LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74117054
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

AORTA&ILIAC ARTER DUP LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74117054
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

AORTA&ILIAC ARTER DUP LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74116054
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

AORTA&ILIAC ARTER DUP LTD

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	94053220
Hospital Revenue Code	921
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115054
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

AORTA&ILIAC ARTER DUP LTD

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	94053220
Hospital Revenue Code	921
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$168.94
Rate for Payer: Aetna Medicare Advantage	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.60
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.21
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115054
Hospital Revenue Code	921
Min. Negotiated Rate	$220.80
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

AORT BDY SYS OVATN iX PMA 34MM

Facility

$56,395.00

Service Code	HCPCS C1768
Hospital Charge Code	270679784
Hospital Revenue Code	278
Min. Negotiated Rate	$8,459.25
Max. Negotiated Rate	$13,647.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,647.59
Rate for Payer: Qualcare PPO/HMO/WC	$8,459.25

AORT BDY SYS OVATN iX PMA 34MM

Facility

$56,395.00

Service Code	HCPCS C1768
Hospital Charge Code	270679784
Hospital Revenue Code	278
Min. Negotiated Rate	$8,459.25
Max. Negotiated Rate	$28,197.50
Rate for Payer: Aetna Commercial	$16,918.50
Rate for Payer: Aetna Medicare Advantage	$16,918.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,380.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,380.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,380.73
Rate for Payer: Cigna Commercial	$28,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,647.59
Rate for Payer: Qualcare PPO/HMO/WC	$8,459.25

AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC

Facility

$231,921.96

Service Code	MSDRG 268
Min. Negotiated Rate	$66,961.81
Max. Negotiated Rate	$231,921.96
Rate for Payer: Aetna Commercial	$231,921.96
Rate for Payer: Aetna Medicare Advantage	$75,055.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70,486.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188,833.95
Rate for Payer: Cigna Commercial	$148,019.29
Rate for Payer: Cigna Medicare Advantage	$70,486.12
Rate for Payer: Clover Medicare Advantage	$66,961.81
Rate for Payer: EmblemHealth Commercial	$211,458.36
Rate for Payer: Humana Medicare Advantage	$72,600.70
Rate for Payer: Oxford Commercial	$92,507.76
Rate for Payer: UnitedHealthcare Commercial	$105,004.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$70,486.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$74,715.29
Rate for Payer: Wellcare Medicare Advantage	$70,486.12

AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC

Facility

$142,405.80

Service Code	MSDRG 269
Min. Negotiated Rate	$42,561.18
Max. Negotiated Rate	$142,405.80
Rate for Payer: Aetna Commercial	$142,405.80
Rate for Payer: Aetna Medicare Advantage	$46,086.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114,678.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114,678.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44,801.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114,678.72
Rate for Payer: Cigna Commercial	$90,887.49
Rate for Payer: Cigna Medicare Advantage	$44,801.24
Rate for Payer: Clover Medicare Advantage	$42,561.18
Rate for Payer: EmblemHealth Commercial	$134,403.72
Rate for Payer: Humana Medicare Advantage	$46,145.28
Rate for Payer: Oxford Commercial	$56,802.04
Rate for Payer: UnitedHealthcare Commercial	$64,475.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$44,801.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$47,489.31
Rate for Payer: Wellcare Medicare Advantage	$44,801.24

AORTIC ARCH FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411163
Hospital Revenue Code	320
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$909.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$773.26
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTIC ARCH FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411163
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

Know your out-of-pocket cost for care.

All Charges