Heights University Hospital

All Charges

Charge

Type

Setting

Price

PIN ZIM STEINMAN 6 187-02-69

Facility

$39.25

Hospital Charge Code	270608044
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

PIN ZIM STEINMAN 6 187-02-69

Facility

$39.25

Hospital Charge Code	270608044
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$19.62
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

PIN ZIM STEINMAN SM 1/8

Facility

$50.45

Hospital Charge Code	270601760
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN SM 1/8

Facility

$50.45

Hospital Charge Code	270601760
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN SM 187-06-69

Facility

$65.65

Service Code	HCPCS C1713
Hospital Charge Code	270601759
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

PIN ZIM STEINMAN SM 187-06-69

Facility

$65.65

Service Code	HCPCS C1713
Hospital Charge Code	270601759
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

PIN ZIM STEINMAN SM 3/16

Facility

$44.00

Hospital Charge Code	270601761
Hospital Revenue Code	278
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

PIN ZIM STEINMAN SM 3/16

Facility

$44.00

Hospital Charge Code	270601761
Hospital Revenue Code	278
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

PIN ZIM STEINMAN SM 5/64

Facility

$37.65

Hospital Charge Code	270606038
Hospital Revenue Code	278
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.11
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

PIN ZIM STEINMAN SM 5/64

Facility

$37.65

Hospital Charge Code	270606038
Hospital Revenue Code	278
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.11
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

PIN ZIM STEINMAN SM 9/64

Facility

$50.45

Hospital Charge Code	270601758
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN SM 9/64

Facility

$50.45

Hospital Charge Code	270601758
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN THRD 3/16

Facility

$85.65

Hospital Charge Code	270601757
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$25.70
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PIN ZIM STEINMAN THRD 3/16

Facility

$85.65

Hospital Charge Code	270601757
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PIN ZIM STEINMAN THRD 5/32

Facility

$61.59

Hospital Charge Code	270601756
Hospital Revenue Code	278
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$14.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.24

PIN ZIM STEINMAN THRD 5/32

Facility

$61.59

Hospital Charge Code	270601756
Hospital Revenue Code	278
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$30.80
Rate for Payer: Aetna Commercial	$18.48
Rate for Payer: Aetna Medicare Advantage	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.71
Rate for Payer: Cigna Commercial	$30.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.24

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.55

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$41.84
Rate for Payer: Aetna Commercial	$25.10
Rate for Payer: Aetna Medicare Advantage	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.34
Rate for Payer: Cigna Commercial	$41.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.88
Rate for Payer: Oxford Commercial	$41.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.55
Rate for Payer: UnitedHealthcare Commercial	$41.84

PIOGLITAZONE 30 MG TAB

Facility

$127.90

Service Code	NDC 64764030114
Hospital Charge Code	60629055
Hospital Revenue Code	250
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

PIOGLITAZONE 30 MG TAB

Facility

$127.90

Service Code	NDC 64764030114
Hospital Charge Code	60629055
Hospital Revenue Code	250
Min. Negotiated Rate	$16.63
Max. Negotiated Rate	$63.95
Rate for Payer: Aetna Commercial	$38.37
Rate for Payer: Aetna Medicare Advantage	$38.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.61
Rate for Payer: Cigna Commercial	$63.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.63
Rate for Payer: Oxford Commercial	$63.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$63.95

PIOGLITAZONE 45 MG TAB

Facility

$138.76

Service Code	NDC 64764045124
Hospital Charge Code	60629060
Hospital Revenue Code	250
Min. Negotiated Rate	$18.04
Max. Negotiated Rate	$69.38
Rate for Payer: Aetna Commercial	$41.63
Rate for Payer: Aetna Medicare Advantage	$41.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.38
Rate for Payer: Cigna Commercial	$69.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.04
Rate for Payer: Oxford Commercial	$69.38
Rate for Payer: Qualcare PPO/HMO/WC	$20.81
Rate for Payer: UnitedHealthcare Commercial	$69.38

PIOGLITAZONE 45 MG TAB

Facility

$138.76

Service Code	NDC 64764045124
Hospital Charge Code	60629060
Hospital Revenue Code	250
Min. Negotiated Rate	$20.81
Max. Negotiated Rate	$20.81
Rate for Payer: Qualcare PPO/HMO/WC	$20.81

PIPELINE EMBOLIZATION 4.5X20MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270697151S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

PIPELINE EMBOLIZATION 4.5X20MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270697151S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

PIPELLE 3.1 MM O.D

Facility

$29.72

Hospital Charge Code	270662678
Hospital Revenue Code	270
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$4.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

Know your out-of-pocket cost for care.

All Charges