Heights University Hospital

All Charges

Charge

Type

Setting

Price

ATAZANAVIR 300 MG CAPSULE

Facility

$339.62

Service Code	NDC 3362212
Hospital Charge Code	60630009
Hospital Revenue Code	250
Min. Negotiated Rate	$50.94
Max. Negotiated Rate	$50.94
Rate for Payer: Qualcare PPO/HMO/WC	$50.94

ATEC SCREW INVICTUS MIS 2 FC C

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270703996
Hospital Revenue Code	278
Min. Negotiated Rate	$1,331.25
Max. Negotiated Rate	$2,147.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25

ATEC SCREW INVICTUS MIS 2 FC C

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270703996
Hospital Revenue Code	278
Min. Negotiated Rate	$1,331.25
Max. Negotiated Rate	$4,437.50
Rate for Payer: Aetna Commercial	$2,662.50
Rate for Payer: Aetna Medicare Advantage	$2,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,263.12
Rate for Payer: Cigna Commercial	$4,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25

ATEC SCREW INVICTUS MIS FC CC

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704129
Hospital Revenue Code	278
Min. Negotiated Rate	$1,331.25
Max. Negotiated Rate	$4,437.50
Rate for Payer: Aetna Commercial	$2,662.50
Rate for Payer: Aetna Medicare Advantage	$2,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,263.12
Rate for Payer: Cigna Commercial	$4,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25

ATEC SCREW INVICTUS MIS FC CC

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704129
Hospital Revenue Code	278
Min. Negotiated Rate	$1,331.25
Max. Negotiated Rate	$2,147.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25

ATEC SYSTEM SIGMA LTP-LIF ILLU

Facility

$6,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270704043
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ATEC SYSTEM SIGMA LTP-LIF ILLU

Facility

$6,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270704043
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ATENOLOL 100MG TAB

Facility

$9.98

Service Code	NDC 51079068501
Hospital Charge Code	6063943060
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

ATENOLOL 100MG TAB

Facility

$9.98

Service Code	NDC 51079068501
Hospital Charge Code	6063943060
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$4.99
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$4.99

ATENOLOL 12.5MG TAB

Facility

$3.00

Hospital Charge Code	60635655
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

ATENOLOL 12.5MG TAB

Facility

$3.00

Hospital Charge Code	60635655
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ATENOLOL 25 MG TAB

Facility

$5.36

Service Code	NDC 51079075920
Hospital Charge Code	6027080
Hospital Revenue Code	251
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

ATENOLOL 25 MG TAB

Facility

$5.36

Service Code	NDC 51079075920
Hospital Charge Code	6027080
Hospital Revenue Code	251
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.68
Rate for Payer: Aetna Commercial	$1.61
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$2.68

ATENOLOL 50 MG TAB

Facility

$5.96

Service Code	NDC 51079068420
Hospital Charge Code	60627547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

ATENOLOL 50 MG TAB

Facility

$5.96

Service Code	NDC 51079068420
Hospital Charge Code	60627547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$1.79
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.77
Rate for Payer: Oxford Commercial	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Commercial	$2.98

ATENOLOL TAB 12.5MG/0.5

Facility

$3.20

Hospital Charge Code	60628923
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

ATENOLOL TAB 12.5MG/0.5

Facility

$3.20

Hospital Charge Code	60628923
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

ATF CANNISTER W/O GEL

Facility

$796.60

Hospital Charge Code	270635002
Hospital Revenue Code	270
Min. Negotiated Rate	$103.56
Max. Negotiated Rate	$398.30
Rate for Payer: Aetna Commercial	$238.98
Rate for Payer: Aetna Medicare Advantage	$238.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.13
Rate for Payer: Cigna Commercial	$398.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.56
Rate for Payer: Oxford Commercial	$398.30
Rate for Payer: Qualcare PPO/HMO/WC	$119.49
Rate for Payer: UnitedHealthcare Commercial	$398.30

ATF CANNISTER W/O GEL

Facility

$796.60

Hospital Charge Code	270635002
Hospital Revenue Code	270
Min. Negotiated Rate	$119.49
Max. Negotiated Rate	$119.49
Rate for Payer: Qualcare PPO/HMO/WC	$119.49

ATGAM 50MG/ML 5ML

Facility

$1,491.00

Hospital Charge Code	60635104
Hospital Revenue Code	636
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$360.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.82
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

ATGAM 50MG/ML 5ML

Facility

$1,491.00

Hospital Charge Code	60635104
Hospital Revenue Code	636
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$745.50
Rate for Payer: Aetna Commercial	$447.30
Rate for Payer: Aetna Medicare Advantage	$447.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.20
Rate for Payer: Cigna Commercial	$745.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.82
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$14,313.52
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,202.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$14,313.52
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,202.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

Know your out-of-pocket cost for care.

All Charges