Heights University Hospital

All Charges

Charge

Type

Setting

Price

RIVASTIGMINE 9.5 MG PATCH

Facility

$100.70

Service Code	NDC 78050215
Hospital Charge Code	60630007
Hospital Revenue Code	250
Min. Negotiated Rate	$13.09
Max. Negotiated Rate	$50.35
Rate for Payer: Aetna Commercial	$30.21
Rate for Payer: Aetna Medicare Advantage	$30.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.68
Rate for Payer: Cigna Commercial	$50.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.09
Rate for Payer: Oxford Commercial	$50.35
Rate for Payer: Qualcare PPO/HMO/WC	$15.11
Rate for Payer: UnitedHealthcare Commercial	$50.35

RIVASTIGMINE 9.5 MG PATCH

Facility

$100.70

Service Code	NDC 78050215
Hospital Charge Code	60630007
Hospital Revenue Code	250
Min. Negotiated Rate	$15.11
Max. Negotiated Rate	$15.11
Rate for Payer: Qualcare PPO/HMO/WC	$15.11

RIVET ATK POP LACTOSORB 905800

Facility

$1,740.00

Hospital Charge Code	270617180
Hospital Revenue Code	272
Min. Negotiated Rate	$261.00
Max. Negotiated Rate	$261.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00

RIVET ATK POP LACTOSORB 905800

Facility

$1,740.00

Hospital Charge Code	270617180
Hospital Revenue Code	272
Min. Negotiated Rate	$226.20
Max. Negotiated Rate	$870.00
Rate for Payer: Aetna Commercial	$522.00
Rate for Payer: Aetna Medicare Advantage	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.70
Rate for Payer: Cigna Commercial	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.20
Rate for Payer: Oxford Commercial	$870.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00
Rate for Payer: UnitedHealthcare Commercial	$870.00

RL 3000ML***********

Facility

$23.00

Hospital Charge Code	1608249
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

RL 3000ML***********

Facility

$23.00

Hospital Charge Code	1608249
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

R&L HRT ART/GRAFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93461
Hospital Charge Code	74110070
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R&L HRT ART/GRAFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93461
Hospital Charge Code	5100669
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R&L HRT ART/GRAFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93461
Hospital Charge Code	74110070
Hospital Revenue Code	481
Min. Negotiated Rate	$2,104.70
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$4,857.00
Rate for Payer: Aetna Medicare Advantage	$4,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.45
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT ART/GRAFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93461
Hospital Charge Code	5100669
Hospital Revenue Code	481
Min. Negotiated Rate	$2,104.70
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$4,857.00
Rate for Payer: Aetna Medicare Advantage	$4,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.45
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT ART/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	74110069
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT ART/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	74110069
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

R&L HRT ART W OR W/O LV

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	5100668
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

R&L HRT ART W OR W/O LV

Facility

$25,737.16

Service Code	HCPCS 93460
Hospital Charge Code	5100668
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT CATH CHD ABNL NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93597
Hospital Charge Code	411093597
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

R&L HRT CATH CHD ABNL NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93597
Hospital Charge Code	411093597
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93596
Hospital Charge Code	411093596
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

R&L HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93596
Hospital Charge Code	411093596
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

RMVL DEVITALIZED TISSUE NON-SE

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	75190165
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$93.47
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

RMVL DEVITALIZED TISSUE NON-SE

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	75190165
Hospital Revenue Code	761
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$186.94
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$23.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.01
Rate for Payer: Oxford Commercial	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Commercial	$311.57

RMVL NINFCT MESH HERNIA RPR

Facility

$13,461.00

Service Code	HCPCS 49623
Hospital Charge Code	1600000389
Hospital Revenue Code	360
Min. Negotiated Rate	$2,019.15
Max. Negotiated Rate	$2,019.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,019.15

RMVL NINFCT MESH HERNIA RPR

Facility

$13,461.00

Service Code	HCPCS 49623
Hospital Charge Code	1600000389
Hospital Revenue Code	360
Min. Negotiated Rate	$198.71
Max. Negotiated Rate	$4,038.30
Rate for Payer: Aetna Commercial	$4,038.30
Rate for Payer: Aetna Medicare Advantage	$4,038.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,432.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,432.55
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	$3,432.55
Rate for Payer: Cigna Commercial	$198.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,749.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,019.15
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RMVL OF SPINAL LAMINA SGL CERV

Facility

$47,548.90

Service Code	HCPCS 63045
Hospital Charge Code	16000652
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

RMVL OF SPINAL LAMINA SGL CERV

Facility

$47,548.90

Service Code	HCPCS 63045
Hospital Charge Code	16000652
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RMVL OF SPINL LAMINA SGL THRCC

Facility

$47,548.90

Service Code	HCPCS 63046
Hospital Charge Code	16001021
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

Know your out-of-pocket cost for care.

All Charges