Heights University Hospital

All Charges

Charge

Type

Setting

Price

VARISYNC ALIF CAGE 24X30MM 8DE

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705848
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

VARISYNC ALIF F3D-Z. CAGE 24X3

Facility

$35,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704099
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$10,500.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

VARISYNC ALIF F3D-Z. CAGE 24X3

Facility

$35,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704099
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

VARITHENA 180MG/18ML INJ FOAM

Facility

$23,416.50

Service Code	NDC 60635011801
Hospital Charge Code	6063943398
Hospital Revenue Code	250
Min. Negotiated Rate	$3,044.14
Max. Negotiated Rate	$11,708.25
Rate for Payer: Aetna Commercial	$7,024.95
Rate for Payer: Aetna Medicare Advantage	$7,024.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,971.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,971.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,971.21
Rate for Payer: Cigna Commercial	$11,708.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,044.14
Rate for Payer: Oxford Commercial	$11,708.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,512.47
Rate for Payer: UnitedHealthcare Commercial	$11,708.25

VARITHENA 180MG/18ML INJ FOAM

Facility

$23,416.50

Service Code	NDC 60635011801
Hospital Charge Code	6063943398
Hospital Revenue Code	250
Min. Negotiated Rate	$3,512.47
Max. Negotiated Rate	$3,512.47
Rate for Payer: Qualcare PPO/HMO/WC	$3,512.47

VAS ACCUCHECK

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	34046801
Hospital Revenue Code	301
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.33
Rate for Payer: Aetna Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.47
Rate for Payer: Cigna Commercial	$5.04
Rate for Payer: Cigna Medicare Advantage	$2.52
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.34
Rate for Payer: Wellcare Medicare Advantage	$5.04

VAS ACCUCHECK

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	7411762
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

VAS ACCUCHECK

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	7411762
Hospital Revenue Code	301
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.33
Rate for Payer: Aetna Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.47
Rate for Payer: Cigna Commercial	$5.04
Rate for Payer: Cigna Medicare Advantage	$2.52
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.34
Rate for Payer: Wellcare Medicare Advantage	$5.04

VAS ACCUCHECK

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	34046801
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

VASC BAND HEMOSTAT LARGE

Facility

$147.50

Hospital Charge Code	270677068
Hospital Revenue Code	272
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$22.12
Rate for Payer: Qualcare PPO/HMO/WC	$22.12

VASC BAND HEMOSTAT LARGE

Facility

$147.50

Hospital Charge Code	270677068
Hospital Revenue Code	272
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$73.75
Rate for Payer: Aetna Commercial	$44.25
Rate for Payer: Aetna Medicare Advantage	$44.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.61
Rate for Payer: Cigna Commercial	$73.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.18
Rate for Payer: Oxford Commercial	$73.75
Rate for Payer: Qualcare PPO/HMO/WC	$22.12
Rate for Payer: UnitedHealthcare Commercial	$73.75

VASC BAND HEMOSTAT REGULAR

Facility

$147.50

Hospital Charge Code	270677067
Hospital Revenue Code	272
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$22.12
Rate for Payer: Qualcare PPO/HMO/WC	$22.12

VASC BAND HEMOSTAT REGULAR

Facility

$147.50

Hospital Charge Code	270677067S
Hospital Revenue Code	272
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$22.12
Rate for Payer: Qualcare PPO/HMO/WC	$22.12

VASC BAND HEMOSTAT REGULAR

Facility

$14.75

Hospital Charge Code	270677067N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$7.38
Rate for Payer: Aetna Commercial	$4.42
Rate for Payer: Aetna Medicare Advantage	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.76
Rate for Payer: Cigna Commercial	$7.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$7.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.21
Rate for Payer: UnitedHealthcare Commercial	$7.38

VASC BAND HEMOSTAT REGULAR

Facility

$14.75

Hospital Charge Code	270677067N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.21

VASC BAND HEMOSTAT REGULAR

Facility

$147.50

Hospital Charge Code	270677067
Hospital Revenue Code	272
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$73.75
Rate for Payer: Aetna Commercial	$44.25
Rate for Payer: Aetna Medicare Advantage	$44.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.61
Rate for Payer: Cigna Commercial	$73.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.18
Rate for Payer: Oxford Commercial	$73.75
Rate for Payer: Qualcare PPO/HMO/WC	$22.12
Rate for Payer: UnitedHealthcare Commercial	$73.75

VASC BAND HEMOSTAT REGULAR

Facility

$147.50

Hospital Charge Code	270677067S
Hospital Revenue Code	272
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$73.75
Rate for Payer: Aetna Commercial	$44.25
Rate for Payer: Aetna Medicare Advantage	$44.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.61
Rate for Payer: Cigna Commercial	$73.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.18
Rate for Payer: Oxford Commercial	$73.75
Rate for Payer: Qualcare PPO/HMO/WC	$22.12
Rate for Payer: UnitedHealthcare Commercial	$73.75

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5700321
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5700321
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	411037244
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$15,754.17
Rate for Payer: Aetna Medicare Advantage	$15,754.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,391.04
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	$13,391.04
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,826.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	366837244
Hospital Revenue Code	361
Min. Negotiated Rate	$7,877.09
Max. Negotiated Rate	$7,877.09
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	7411533
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$15,754.17
Rate for Payer: Aetna Medicare Advantage	$15,754.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,391.04
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	$13,391.04
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,826.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	321037244
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	321037244
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	366837244
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$15,754.17
Rate for Payer: Aetna Medicare Advantage	$15,754.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,391.04
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	$13,391.04
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,826.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

Know your out-of-pocket cost for care.

All Charges