Heights University Hospital

All Charges

Charge

Type

Setting

Price

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$11,392.88
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$11,392.88
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$11,392.88
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$11,392.88
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$11,107.88
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$11,392.88
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREXAN/50MG/TAB

Facility

$3.00

Hospital Charge Code	60634404
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges