Heights University Hospital

All Charges

Charge

Type

Setting

Price

NM VENA CAVA

Facility

$12,000.00

Service Code	HCPCS 78445
Hospital Charge Code	4500369
Hospital Revenue Code	341
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$3,600.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VENA CAVA

Facility

$12,000.00

Service Code	HCPCS 78445
Hospital Charge Code	4500369
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM VENOGRAM FLOW

Facility

$1,132.85

Service Code	HCPCS 78445
Hospital Charge Code	4500294
Hospital Revenue Code	341
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$3,540.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Aetna Commercial	$339.86
Rate for Payer: Aetna Medicare Advantage	$339.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.88
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.27
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.93

NM VENOGRAM FLOW

Facility

$1,132.85

Service Code	HCPCS 78445
Hospital Charge Code	4500294
Hospital Revenue Code	341
Min. Negotiated Rate	$169.93
Max. Negotiated Rate	$169.93
Rate for Payer: Qualcare PPO/HMO/WC	$169.93

NM VENOUS THROMBO VENOGRAM BI

Facility

$1,941.65

Service Code	HCPCS 78458
Hospital Charge Code	4500916
Hospital Revenue Code	341
Min. Negotiated Rate	$252.41
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$582.50
Rate for Payer: Aetna Medicare Advantage	$582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.12
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.41
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.25
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VENOUS THROMBO VENOGRAM BI

Facility

$1,941.65

Service Code	HCPCS 78458
Hospital Charge Code	4500916
Hospital Revenue Code	341
Min. Negotiated Rate	$291.25
Max. Negotiated Rate	$291.25
Rate for Payer: Qualcare PPO/HMO/WC	$291.25

NM VENOUS THROMBO VENOGRAM UNI

Facility

$1,288.00

Service Code	HCPCS 78457
Hospital Charge Code	4500914
Hospital Revenue Code	341
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$193.20
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

NM VENOUS THROMBO VENOGRAM UNI

Facility

$1,288.00

Service Code	HCPCS 78457
Hospital Charge Code	4500914
Hospital Revenue Code	341
Min. Negotiated Rate	$167.44
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.44
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.44
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.20
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VENOUS THROMBSIS IMAGE RGHT

Facility

$1,288.00

Service Code	HCPCS 78457
Hospital Charge Code	4501017
Hospital Revenue Code	341
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$193.20
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

NM VENOUS THROMBSIS IMAGE RGHT

Facility

$1,288.00

Service Code	HCPCS 78457
Hospital Charge Code	4501017
Hospital Revenue Code	341
Min. Negotiated Rate	$167.44
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.44
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.44
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.20
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VENTRICULOGRAM

Facility

$1,242.20

Service Code	HCPCS 78635
Hospital Charge Code	4501018
Hospital Revenue Code	341
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$186.33
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

NM VENTRICULOGRAM

Facility

$1,242.20

Service Code	HCPCS 78635
Hospital Charge Code	4501018
Hospital Revenue Code	341
Min. Negotiated Rate	$161.49
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$372.66
Rate for Payer: Aetna Medicare Advantage	$372.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.76
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.49
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.33
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VIT B 12 ABSORP W & WO INTR

Facility

$1,124.85

Service Code	HCPCS 78272
Hospital Charge Code	4500912
Hospital Revenue Code	341
Min. Negotiated Rate	$146.23
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$337.45
Rate for Payer: Aetna Medicare Advantage	$337.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.84
Rate for Payer: Cigna Commercial	$562.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.23
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.73
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM VIT B 12 ABSORP W & WO INTR

Facility

$1,124.85

Service Code	HCPCS 78272
Hospital Charge Code	4500912
Hospital Revenue Code	341
Min. Negotiated Rate	$168.73
Max. Negotiated Rate	$168.73
Rate for Payer: Qualcare PPO/HMO/WC	$168.73

NM WHOLE BLOOD VOLUME

Facility

$1,222.15

Service Code	HCPCS 78122
Hospital Charge Code	4501019
Hospital Revenue Code	341
Min. Negotiated Rate	$158.88
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$366.64
Rate for Payer: Aetna Medicare Advantage	$366.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.65
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.88
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM WHOLE BLOOD VOLUME

Facility

$1,222.15

Service Code	HCPCS 78122
Hospital Charge Code	4501019
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM XE133 PER 10 MCI

Facility

$9.00

Service Code	HCPCS A9558
Hospital Charge Code	4509030
Hospital Revenue Code	343
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NM XE133 PER 10 MCI

Facility

$9.00

Service Code	HCPCS A9558
Hospital Charge Code	4509030
Hospital Revenue Code	343
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$217.54
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

Facility

$0.65

Hospital Charge Code	71010
Hospital Revenue Code	320
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.10

Facility

$0.65

Hospital Charge Code	71010
Hospital Revenue Code	320
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$0.20
Rate for Payer: Aetna Medicare Advantage	$0.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.17
Rate for Payer: Cigna Commercial	$0.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.08
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.10
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

No.3 Knife Handle

Facility

$19.20

Hospital Charge Code	270607725
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.60
Rate for Payer: Aetna Commercial	$5.76
Rate for Payer: Aetna Medicare Advantage	$5.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.90
Rate for Payer: Cigna Commercial	$9.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.88
Rate for Payer: UnitedHealthcare Commercial	$9.60

No.3 Knife Handle

Facility

$19.20

Hospital Charge Code	270607725
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.88

NOLVADEX/10MG/TAB

Facility

$7.00

Hospital Charge Code	60633540
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

NOLVADEX/10MG/TAB

Facility

$7.00

Hospital Charge Code	60633540
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC

Facility

$78,433.38

Service Code	MSDRG 098
Min. Negotiated Rate	$24,837.24
Max. Negotiated Rate	$78,433.38
Rate for Payer: Aetna Commercial	$77,383.77
Rate for Payer: Aetna Medicare Advantage	$25,043.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59,269.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59,269.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59,269.05
Rate for Payer: Cigna Medicare Advantage	$26,144.46
Rate for Payer: Clover Medicare Advantage	$24,837.24
Rate for Payer: EmblemHealth Commercial	$78,433.38
Rate for Payer: Humana Medicare Advantage	$26,928.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,144.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27,713.13
Rate for Payer: Wellcare Medicare Advantage	$26,144.46

Know your out-of-pocket cost for care.

All Charges