Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRIVEX INFLOW TUBE SET

Facility

$178.00

Hospital Charge Code	270339010
Hospital Revenue Code	272
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$26.70
Rate for Payer: Qualcare PPO/HMO/WC	$26.70

TRIVEX INFLOW TUBE SET

Facility

$178.00

Hospital Charge Code	270339010
Hospital Revenue Code	272
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$89.00
Rate for Payer: Aetna Commercial	$53.40
Rate for Payer: Aetna Medicare Advantage	$53.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.39
Rate for Payer: Cigna Commercial	$89.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.14
Rate for Payer: Oxford Commercial	$89.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.70
Rate for Payer: UnitedHealthcare Commercial	$89.00

TRI-VI-FLOR/0.25MG/1ML

Facility

$49.00

Hospital Charge Code	60634058
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

TRI-VI-FLOR/0.25MG/1ML

Facility

$49.00

Hospital Charge Code	60634058
Hospital Revenue Code	250
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$24.50

TRI-VI-SOL/50ML

Facility

$43.00

Hospital Charge Code	60634059
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

TRI-VI-SOL/50ML

Facility

$43.00

Hospital Charge Code	60634059
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

TRIX3 TIB BER INRT PS SZ5 13MM

Facility

$4,985.30

Service Code	HCPCS C1776
Hospital Charge Code	270697569
Hospital Revenue Code	278
Min. Negotiated Rate	$747.79
Max. Negotiated Rate	$1,206.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.44
Rate for Payer: Qualcare PPO/HMO/WC	$747.79

TRIX3 TIB BER INRT PS SZ5 13MM

Facility

$4,985.30

Service Code	HCPCS C1776
Hospital Charge Code	270697569
Hospital Revenue Code	278
Min. Negotiated Rate	$747.79
Max. Negotiated Rate	$2,492.65
Rate for Payer: Aetna Commercial	$1,495.59
Rate for Payer: Aetna Medicare Advantage	$1,495.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,271.25
Rate for Payer: Cigna Commercial	$2,492.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.44
Rate for Payer: Qualcare PPO/HMO/WC	$747.79

TRIX3 TIB BER INST SZ 1 CS 9MM

Facility

$5,082.20

Service Code	HCPCS C1776
Hospital Charge Code	270697571
Hospital Revenue Code	278
Min. Negotiated Rate	$762.33
Max. Negotiated Rate	$2,541.10
Rate for Payer: Aetna Commercial	$1,524.66
Rate for Payer: Aetna Medicare Advantage	$1,524.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,295.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,295.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,295.96
Rate for Payer: Cigna Commercial	$2,541.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,229.89
Rate for Payer: Qualcare PPO/HMO/WC	$762.33

TRIX3 TIB BER INST SZ 1 CS 9MM

Facility

$5,082.20

Service Code	HCPCS C1776
Hospital Charge Code	270697571
Hospital Revenue Code	278
Min. Negotiated Rate	$762.33
Max. Negotiated Rate	$1,229.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,229.89
Rate for Payer: Qualcare PPO/HMO/WC	$762.33

TRIZIVIR 150/300MG

Facility

$215.67

Service Code	NDC 49702021718
Hospital Charge Code	60635560
Hospital Revenue Code	250
Min. Negotiated Rate	$28.04
Max. Negotiated Rate	$107.83
Rate for Payer: Aetna Commercial	$64.70
Rate for Payer: Aetna Medicare Advantage	$64.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.00
Rate for Payer: Cigna Commercial	$107.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.04
Rate for Payer: Oxford Commercial	$107.83
Rate for Payer: Qualcare PPO/HMO/WC	$32.35
Rate for Payer: UnitedHealthcare Commercial	$107.83

TRIZIVIR 150/300MG

Facility

$215.67

Service Code	NDC 49702021718
Hospital Charge Code	60635560
Hospital Revenue Code	250
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$32.35
Rate for Payer: Qualcare PPO/HMO/WC	$32.35

TRMT STERNOCLAV DISL W/MANIP

Facility

$2,251.00

Service Code	HCPCS 23525
Hospital Charge Code	5780030
Hospital Revenue Code	450
Min. Negotiated Rate	$127.33
Max. Negotiated Rate	$675.30
Rate for Payer: Aetna Commercial	$675.30
Rate for Payer: Aetna Medicare Advantage	$675.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$574.00
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.63
Rate for Payer: Qualcare PPO/HMO/WC	$337.65

TRMT STERNOCLAV DISL W/MANIP

Facility

$2,251.00

Service Code	HCPCS 23525
Hospital Charge Code	5780030
Hospital Revenue Code	450
Min. Negotiated Rate	$337.65
Max. Negotiated Rate	$337.65
Rate for Payer: Qualcare PPO/HMO/WC	$337.65

TROCAR ******

Facility

$209.00

Hospital Charge Code	8002420
Hospital Revenue Code	279
Min. Negotiated Rate	$27.17
Max. Negotiated Rate	$104.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.30
Rate for Payer: Cigna Commercial	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.17
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$104.50

TROCAR ******

Facility

$209.00

Hospital Charge Code	8002420
Hospital Revenue Code	279
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

TROCAR 10/11MM GRN 511SD

Facility

$1,107.25

Hospital Charge Code	270608754
Hospital Revenue Code	272
Min. Negotiated Rate	$166.09
Max. Negotiated Rate	$166.09
Rate for Payer: Qualcare PPO/HMO/WC	$166.09

TROCAR 10/11MM GRN 511SD

Facility

$1,107.25

Hospital Charge Code	270608754
Hospital Revenue Code	272
Min. Negotiated Rate	$143.94
Max. Negotiated Rate	$553.62
Rate for Payer: Aetna Commercial	$332.18
Rate for Payer: Aetna Medicare Advantage	$332.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$282.35
Rate for Payer: Cigna Commercial	$553.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.94
Rate for Payer: Oxford Commercial	$553.62
Rate for Payer: Qualcare PPO/HMO/WC	$166.09
Rate for Payer: UnitedHealthcare Commercial	$553.62

TROCAR 10/12MM LNG ML1012LD

Facility

$466.67

Hospital Charge Code	270600264
Hospital Revenue Code	272
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.00

TROCAR 10/12MM LNG ML1012LD

Facility

$466.67

Hospital Charge Code	270600264
Hospital Revenue Code	272
Min. Negotiated Rate	$60.67
Max. Negotiated Rate	$233.34
Rate for Payer: Aetna Commercial	$140.00
Rate for Payer: Aetna Medicare Advantage	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.00
Rate for Payer: Cigna Commercial	$233.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Oxford Commercial	$233.34
Rate for Payer: Qualcare PPO/HMO/WC	$70.00
Rate for Payer: UnitedHealthcare Commercial	$233.34

TROCAR 10/12MM LNG PURP 512XD

Facility

$250.15

Hospital Charge Code	270608756
Hospital Revenue Code	272
Min. Negotiated Rate	$32.52
Max. Negotiated Rate	$125.08
Rate for Payer: Aetna Commercial	$75.05
Rate for Payer: Aetna Medicare Advantage	$75.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.79
Rate for Payer: Cigna Commercial	$125.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.52
Rate for Payer: Oxford Commercial	$125.08
Rate for Payer: Qualcare PPO/HMO/WC	$37.52
Rate for Payer: UnitedHealthcare Commercial	$125.08

TROCAR 10/12MM LNG PURP 512XD

Facility

$250.15

Hospital Charge Code	270608756
Hospital Revenue Code	272
Min. Negotiated Rate	$37.52
Max. Negotiated Rate	$37.52
Rate for Payer: Qualcare PPO/HMO/WC	$37.52

TROCAR 10/12MM LNG PURP 512XD

Facility

$1,225.65

Hospital Charge Code	272608756
Hospital Revenue Code	272
Min. Negotiated Rate	$159.33
Max. Negotiated Rate	$612.83
Rate for Payer: Aetna Commercial	$367.69
Rate for Payer: Aetna Medicare Advantage	$367.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.54
Rate for Payer: Cigna Commercial	$612.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.33
Rate for Payer: Oxford Commercial	$612.83
Rate for Payer: Qualcare PPO/HMO/WC	$183.85
Rate for Payer: UnitedHealthcare Commercial	$612.83

TROCAR 10/12MM LNG PURP 512XD

Facility

$1,225.65

Hospital Charge Code	272608756
Hospital Revenue Code	272
Min. Negotiated Rate	$183.85
Max. Negotiated Rate	$183.85
Rate for Payer: Qualcare PPO/HMO/WC	$183.85

TROCAR 10/12MM ML1012D

Facility

$820.00

Hospital Charge Code	270600263
Hospital Revenue Code	272
Min. Negotiated Rate	$106.60
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$246.00
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.60
Rate for Payer: Oxford Commercial	$410.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$410.00

Know your out-of-pocket cost for care.

All Charges