Heights University Hospital

All Charges

Charge

Type

Setting

Price

IV SET PUSH BUTTON W/LUER 25GX

Facility

$321.90

Hospital Charge Code	270664447
Hospital Revenue Code	270
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$160.95
Rate for Payer: Aetna Commercial	$96.57
Rate for Payer: Aetna Medicare Advantage	$96.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.08
Rate for Payer: Cigna Commercial	$160.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.85
Rate for Payer: Oxford Commercial	$160.95
Rate for Payer: Qualcare PPO/HMO/WC	$48.28
Rate for Payer: UnitedHealthcare Commercial	$160.95

IV SOLUTION

Facility

$8.75

Hospital Charge Code	270000001
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$4.38
Rate for Payer: Aetna Commercial	$2.62
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.14
Rate for Payer: Oxford Commercial	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$4.38

IV SOLUTION

Facility

$8.75

Hospital Charge Code	270000001
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

IV START KIT ******

Facility

$5.00

Hospital Charge Code	7000813
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

IV START KIT ******

Facility

$5.00

Hospital Charge Code	7000813
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

IV START KIT *******

Facility

$4.00

Hospital Charge Code	8004418
Hospital Revenue Code	279
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

IV START KIT *******

Facility

$4.00

Hospital Charge Code	8004418
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	2600243
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

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	7411535
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

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	321037252
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

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	321037252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	7411535
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	2600243
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	2600244
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	321037253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	2600244
Hospital Revenue Code	361
Min. Negotiated Rate	$67.06
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	$67.06
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

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	321037253
Hospital Revenue Code	361
Min. Negotiated Rate	$67.06
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	$67.06
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

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	7411536
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

IVUS NON-CORONARY EA ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	7411536
Hospital Revenue Code	361
Min. Negotiated Rate	$67.06
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	$67.06
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

IXABEPILONE 1MG INJ 45MG KIT

Facility

$17,286.80

Hospital Charge Code	60630300
Hospital Revenue Code	636
Min. Negotiated Rate	$2,593.02
Max. Negotiated Rate	$4,183.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,183.41
Rate for Payer: Qualcare PPO/HMO/WC	$2,593.02

IXABEPILONE 1MG INJ 45MG KIT

Facility

$17,286.80

Hospital Charge Code	60630300
Hospital Revenue Code	636
Min. Negotiated Rate	$2,593.02
Max. Negotiated Rate	$8,643.40
Rate for Payer: Aetna Commercial	$5,186.04
Rate for Payer: Aetna Medicare Advantage	$5,186.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,408.13
Rate for Payer: Cigna Commercial	$8,643.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,183.41
Rate for Payer: Qualcare PPO/HMO/WC	$2,593.02

IXABEPILONE PER IMG INJ(15 MG)

Facility

$5,762.27

Hospital Charge Code	60630299
Hospital Revenue Code	636
Min. Negotiated Rate	$864.34
Max. Negotiated Rate	$1,394.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.47
Rate for Payer: Qualcare PPO/HMO/WC	$864.34

IXABEPILONE PER IMG INJ(15 MG)

Facility

$5,762.27

Hospital Charge Code	60630299
Hospital Revenue Code	636
Min. Negotiated Rate	$864.34
Max. Negotiated Rate	$2,881.14
Rate for Payer: Aetna Commercial	$1,728.68
Rate for Payer: Aetna Medicare Advantage	$1,728.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,469.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,469.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,469.38
Rate for Payer: Cigna Commercial	$2,881.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.47
Rate for Payer: Qualcare PPO/HMO/WC	$864.34

IXEMPRA 1MG KIT

Facility

$249.18

Hospital Charge Code	60630002
Hospital Revenue Code	636
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$60.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.30
Rate for Payer: Qualcare PPO/HMO/WC	$37.38

IXEMPRA 1MG KIT

Facility

$249.18

Hospital Charge Code	60630002
Hospital Revenue Code	636
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$124.59
Rate for Payer: Aetna Commercial	$74.75
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.54
Rate for Payer: Cigna Commercial	$124.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.30
Rate for Payer: Qualcare PPO/HMO/WC	$37.38

Know your out-of-pocket cost for care.

All Charges