Heights University Hospital

All Charges

Charge

Type

Setting

Price

AV IMPULSE REGULAR

Facility

$350.00

Hospital Charge Code	270654501
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

AV IMPULSE REGULAR

Facility

$350.00

Hospital Charge Code	270654501
Hospital Revenue Code	272
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$175.00

AVISTA MRI 74CM 8 CON LEAD KIT

Facility

$12,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270702948
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

AVISTA MRI 74CM 8 CON LEAD KIT

Facility

$12,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270702948
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

AVITENE/1GM

Facility

$43.00

Hospital Charge Code	60632516
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

AVITENE/1GM

Facility

$43.00

Hospital Charge Code	60632516
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

AVITENE ENDOSCOPIC 1010150

Facility

$693.00

Hospital Charge Code	270608018
Hospital Revenue Code	272
Min. Negotiated Rate	$90.09
Max. Negotiated Rate	$346.50
Rate for Payer: Aetna Commercial	$207.90
Rate for Payer: Aetna Medicare Advantage	$207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.72
Rate for Payer: Cigna Commercial	$346.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.09
Rate for Payer: Oxford Commercial	$346.50
Rate for Payer: Qualcare PPO/HMO/WC	$103.95
Rate for Payer: UnitedHealthcare Commercial	$346.50

AVITENE ENDOSCOPIC 1010150

Facility

$693.00

Hospital Charge Code	270608018
Hospital Revenue Code	272
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$103.95
Rate for Payer: Qualcare PPO/HMO/WC	$103.95

AVITENE PADS

Facility

$776.00

Hospital Charge Code	270335092
Hospital Revenue Code	272
Min. Negotiated Rate	$100.88
Max. Negotiated Rate	$388.00
Rate for Payer: Aetna Commercial	$232.80
Rate for Payer: Aetna Medicare Advantage	$232.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.88
Rate for Payer: Cigna Commercial	$388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.88
Rate for Payer: Oxford Commercial	$388.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.40
Rate for Payer: UnitedHealthcare Commercial	$388.00

AVITENE PADS

Facility

$776.00

Hospital Charge Code	270335092
Hospital Revenue Code	272
Min. Negotiated Rate	$116.40
Max. Negotiated Rate	$116.40
Rate for Payer: Qualcare PPO/HMO/WC	$116.40

AV LINE (REDY)

Facility

$32.00

Hospital Charge Code	8200339
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

AV LINE (REDY)

Facility

$32.00

Hospital Charge Code	8200339
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

AVN DELIVERY NEEDLE

Facility

$1,475.00

Hospital Charge Code	270671805
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

AVN DELIVERY NEEDLE

Facility

$1,475.00

Hospital Charge Code	270671805
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

AVULS NAIL PL PART/COMP/SIMP

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	84208070
Hospital Revenue Code	361
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
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	$94.86
Rate for Payer: Cigna Commercial	$16.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

AVULS NAIL PL PART/COMP/SIMP

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	84208070
Hospital Revenue Code	361
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

AWL 5.5

Facility

$1,860.00

Hospital Charge Code	270687187
Hospital Revenue Code	272
Min. Negotiated Rate	$279.00
Max. Negotiated Rate	$279.00
Rate for Payer: Qualcare PPO/HMO/WC	$279.00

AWL 5.5

Facility

$1,860.00

Hospital Charge Code	270687187
Hospital Revenue Code	272
Min. Negotiated Rate	$241.80
Max. Negotiated Rate	$930.00
Rate for Payer: Aetna Commercial	$558.00
Rate for Payer: Aetna Medicare Advantage	$558.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$474.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$474.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$474.30
Rate for Payer: Cigna Commercial	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.80
Rate for Payer: Oxford Commercial	$930.00
Rate for Payer: Qualcare PPO/HMO/WC	$279.00
Rate for Payer: UnitedHealthcare Commercial	$930.00

AXID/150MG

Facility

$12.00

Hospital Charge Code	60634998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

AXID/150MG

Facility

$12.00

Hospital Charge Code	60634998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

AXILLARY BLOCK NEEDLE 22GX1

Facility

$26.00

Hospital Charge Code	270332389
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

AXILLARY BLOCK NEEDLE 22GX1

Facility

$26.00

Hospital Charge Code	270332389
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$7.80
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$13.00

AXIONICS NEUROSTIMULATOR F15

Facility

$60,750.00

Hospital Charge Code	270702118
Hospital Revenue Code	278
Min. Negotiated Rate	$9,112.50
Max. Negotiated Rate	$30,375.00
Rate for Payer: Aetna Commercial	$18,225.00
Rate for Payer: Aetna Medicare Advantage	$18,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,491.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,491.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,491.25
Rate for Payer: Cigna Commercial	$30,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,701.50
Rate for Payer: Qualcare PPO/HMO/WC	$9,112.50

AXIONICS NEUROSTIMULATOR F15

Facility

$60,750.00

Hospital Charge Code	270702118
Hospital Revenue Code	278
Min. Negotiated Rate	$9,112.50
Max. Negotiated Rate	$14,701.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,701.50
Rate for Payer: Qualcare PPO/HMO/WC	$9,112.50

AXIONICS PNE LEAD I 1901

Facility

$200.00

Service Code	HCPCS C1778
Hospital Charge Code	270702028
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

Know your out-of-pocket cost for care.

All Charges