Heights University Hospital

All Charges

Charge

Type

Setting

Price

AVELOX 400 MG TAB

Facility

$43.00

Hospital Charge Code	60635277
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

AVENIR CMPL HA HO COL SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270699206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA HO COL SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270699206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA HO COL SZ 7

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA HO COL SZ 7

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA STD COL SZ 0

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270694919
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA STD COL SZ 0

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270694919
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA VAR COL SZ 5

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270694800
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENIR CMPL HA VAR COL SZ 5

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270694800
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVENTYL LIQUID/16OZ

Facility

$24.00

Hospital Charge Code	60634586
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

AVENTYL LIQUID/16OZ

Facility

$24.00

Hospital Charge Code	60634586
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

AVERNIR CMPL HA VAR COL SZ 2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270699679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVERNIR CMPL HA VAR COL SZ 2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270699679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVERNIR CMPL HIP STD COL SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695047
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$4,436.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AVERNIR CMPL HIP STD COL SZ 6

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695047
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

AV FISTULA 14-17G CASE

Facility

$256.00

Hospital Charge Code	27059776
Hospital Revenue Code	271
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$128.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$128.00

AV FISTULA 14-17G CASE

Facility

$256.00

Hospital Charge Code	27059776
Hospital Revenue Code	271
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

AV FISTULA SET CASE

Facility

$91.25

Hospital Charge Code	27059774
Hospital Revenue Code	271
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

AV FISTULA SET CASE

Facility

$91.25

Hospital Charge Code	27059774
Hospital Revenue Code	271
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$45.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$45.62

AV FUSE UPPR ARM BASILIC

Facility

$38,857.60

Service Code	HCPCS 36819
Hospital Charge Code	1800000822
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$11,657.28
Rate for Payer: Aetna Medicare Advantage	$11,657.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,908.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,908.69
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	$9,908.69
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,051.49
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

AV FUSE UPPR ARM BASILIC

Facility

$38,857.60

Service Code	HCPCS 36819
Hospital Charge Code	1800000822
Hospital Revenue Code	360
Min. Negotiated Rate	$5,828.64
Max. Negotiated Rate	$5,828.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64

AV FUSION FOREARM VEIN

Facility

$31,830.40

Service Code	HCPCS 36280
Hospital Charge Code	1600000645
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,915.20
Rate for Payer: Aetna Commercial	$9,549.12
Rate for Payer: Aetna Medicare Advantage	$9,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,116.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,116.75
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	$8,116.75
Rate for Payer: Cigna Commercial	$15,915.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,137.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,774.56

AV FUSION FOREARM VEIN

Facility

$31,830.40

Service Code	HCPCS 36280
Hospital Charge Code	1600000645
Hospital Revenue Code	360
Min. Negotiated Rate	$4,774.56
Max. Negotiated Rate	$4,774.56
Rate for Payer: Qualcare PPO/HMO/WC	$4,774.56

AVIATOR BALLOON 6X20

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631S
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

AVIATOR BALLOON 6X20

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631S
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

Know your out-of-pocket cost for care.

All Charges