Heights University Hospital

All Charges

Charge

Type

Setting

Price

VALPROIC ACID,FREE

Facility

$67.20

Service Code	HCPCS 80164
Hospital Charge Code	39900005
Hospital Revenue Code	301
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$10.08
Rate for Payer: Qualcare PPO/HMO/WC	$10.08

VALSARTAN 160 MG TAB

Facility

$9.60

Hospital Charge Code	60629836
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

VALSARTAN 160 MG TAB

Facility

$9.60

Hospital Charge Code	60629836
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.80
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: Aetna Medicare Advantage	$2.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$4.80

VALSARTAN 40 MG TAB

Facility

$7.50

Hospital Charge Code	60629835
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

VALSARTAN 40 MG TAB

Facility

$7.50

Hospital Charge Code	60629835
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$2.25
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.91
Rate for Payer: Cigna Commercial	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$3.75

VALSARTAN 80 MG TAB

Facility

$8.00

Hospital Charge Code	60629228
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

VALSARTAN 80 MG TAB

Facility

$8.00

Hospital Charge Code	60629228
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

VALSARTAN CAP 80MG

Facility

$12.00

Service Code	HCPCS J8499
Hospital Charge Code	60628734
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

VALSARTAN CAP 80MG

Facility

$12.00

Service Code	HCPCS J8499
Hospital Charge Code	60628734
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

VALSARTAN (DIOVAN) 320MG TAB

Facility

$33.03

Service Code	NDC 78036034
Hospital Charge Code	60630147
Hospital Revenue Code	250
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$16.52
Rate for Payer: Aetna Commercial	$9.91
Rate for Payer: Aetna Medicare Advantage	$9.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.42
Rate for Payer: Cigna Commercial	$16.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$16.52

VALSARTAN (DIOVAN) 320MG TAB

Facility

$33.03

Service Code	NDC 78036034
Hospital Charge Code	60630147
Hospital Revenue Code	250
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

VAL SCREW TI 2.4 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690417
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

VAL SCREW TI 2.4 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690417
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

VALTREX 500MG/TAB

Facility

$6.00

Hospital Charge Code	60635412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

VALTREX 500MG/TAB

Facility

$6.00

Hospital Charge Code	60635412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

VALUEAIR WATER SUCTION BIOPSY

Facility

$28.00

Hospital Charge Code	270700336
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

VALUEAIR WATER SUCTION BIOPSY

Facility

$28.00

Hospital Charge Code	270700336
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

VALUE PASSY-MUIR AQUA

Facility

$348.54

Hospital Charge Code	270633316
Hospital Revenue Code	270
Min. Negotiated Rate	$52.28
Max. Negotiated Rate	$52.28
Rate for Payer: Qualcare PPO/HMO/WC	$52.28

VALUE PASSY-MUIR AQUA

Facility

$348.54

Hospital Charge Code	270633316
Hospital Revenue Code	270
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$174.27
Rate for Payer: Aetna Commercial	$104.56
Rate for Payer: Aetna Medicare Advantage	$104.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.88
Rate for Payer: Cigna Commercial	$174.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.31
Rate for Payer: Oxford Commercial	$174.27
Rate for Payer: Qualcare PPO/HMO/WC	$52.28
Rate for Payer: UnitedHealthcare Commercial	$174.27

VALVE ACCESSPLUS ANGIO KIT LG

Facility

$33.28

Hospital Charge Code	270637998S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

VALVE ACCESSPLUS ANGIO KIT LG

Facility

$33.28

Hospital Charge Code	270637998S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$16.64
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$9.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.49
Rate for Payer: Cigna Commercial	$16.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.33
Rate for Payer: Oxford Commercial	$16.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$16.64

VALVE BIOPSY SINGLE USE

Facility

$22.00

Hospital Charge Code	270654385
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

VALVE BIOPSY SINGLE USE

Facility

$22.00

Hospital Charge Code	270654385
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$6.60
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$11.00

VALVE BIOPSY SINGLE USE

Facility

$372.50

Hospital Charge Code	270651525
Hospital Revenue Code	272
Min. Negotiated Rate	$48.42
Max. Negotiated Rate	$186.25
Rate for Payer: Aetna Commercial	$111.75
Rate for Payer: Aetna Medicare Advantage	$111.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.99
Rate for Payer: Cigna Commercial	$186.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.42
Rate for Payer: Oxford Commercial	$186.25
Rate for Payer: Qualcare PPO/HMO/WC	$55.88
Rate for Payer: UnitedHealthcare Commercial	$186.25

VALVE BIOPSY SINGLE USE

Facility

$372.50

Hospital Charge Code	270651525
Hospital Revenue Code	272
Min. Negotiated Rate	$55.88
Max. Negotiated Rate	$55.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.88

Know your out-of-pocket cost for care.

All Charges