Heights University Hospital

All Charges

Charge

Type

Setting

Price

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$919.50
Max. Negotiated Rate	$3,065.00
Rate for Payer: Aetna Commercial	$1,839.00
Rate for Payer: Aetna Medicare Advantage	$1,839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,563.15
Rate for Payer: Cigna Commercial	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: Qualcare PPO/HMO/WC	$919.50

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$919.50
Max. Negotiated Rate	$1,483.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: Qualcare PPO/HMO/WC	$919.50

VASCULAR KIT

Facility

$147.00

Hospital Charge Code	270338759
Hospital Revenue Code	272
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

VASCULAR KIT

Facility

$147.00

Hospital Charge Code	270338759
Hospital Revenue Code	272
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$44.10
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.11
Rate for Payer: Oxford Commercial	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$73.50

VASCULAR LINEAR STAPLER 30MM

Facility

$172.00

Hospital Charge Code	270338702
Hospital Revenue Code	272
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

VASCULAR LINEAR STAPLER 30MM

Facility

$172.00

Hospital Charge Code	270338702
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

VASCULAR STUDY ABDOMEN SMA

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692175
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

VASCULAR STUDY ABDOMEN SMA

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692175
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VASCULAR STUDY COM

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	94061203
Hospital Revenue Code	921
Min. Negotiated Rate	$372.60
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$372.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

VASCULAR STUDY COM

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	94061203
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	5600123
Hospital Revenue Code	361
Min. Negotiated Rate	$367.54
Max. Negotiated Rate	$367.54
Rate for Payer: Qualcare PPO/HMO/WC	$367.54

VASCULAR SURGERY PROCEDURE

Facility

$3,327.75

Service Code	HCPCS 37799
Hospital Charge Code	421037799
Hospital Revenue Code	761
Min. Negotiated Rate	$432.61
Max. Negotiated Rate	$1,663.88
Rate for Payer: Aetna Commercial	$998.33
Rate for Payer: Aetna Medicare Advantage	$998.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.58
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.61
Rate for Payer: Oxford Commercial	$1,663.88
Rate for Payer: Qualcare PPO/HMO/WC	$499.16
Rate for Payer: UnitedHealthcare Commercial	$1,663.88

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	5600123
Hospital Revenue Code	361
Min. Negotiated Rate	$318.54
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$735.08
Rate for Payer: Aetna Medicare Advantage	$735.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.82
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	$624.82
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.54
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.54
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	16000385
Hospital Revenue Code	360
Min. Negotiated Rate	$367.54
Max. Negotiated Rate	$367.54
Rate for Payer: Qualcare PPO/HMO/WC	$367.54

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	16000385
Hospital Revenue Code	360
Min. Negotiated Rate	$318.54
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$735.08
Rate for Payer: Aetna Medicare Advantage	$735.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.82
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	$624.82
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.54
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.54
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

VASCULAR SURGERY PROCEDURE

Facility

$3,327.75

Service Code	HCPCS 37799
Hospital Charge Code	421037799
Hospital Revenue Code	761
Min. Negotiated Rate	$499.16
Max. Negotiated Rate	$499.16
Rate for Payer: Qualcare PPO/HMO/WC	$499.16

VASECTOMY

Facility

$20,610.70

Service Code	HCPCS 55250
Hospital Charge Code	1600000320
Hospital Revenue Code	360
Min. Negotiated Rate	$3,091.61
Max. Negotiated Rate	$3,091.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61

VASECTOMY

Facility

$20,610.70

Service Code	HCPCS 55250
Hospital Charge Code	1600000320
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,183.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61
Rate for Payer: Aetna Commercial	$6,183.21
Rate for Payer: Aetna Medicare Advantage	$6,183.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,255.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,255.73
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	$5,255.73
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,679.39
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

VASELINE TUBEN*****

Facility

$25.00

Hospital Charge Code	8002149
Hospital Revenue Code	279
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

VASELINE TUBEN*****

Facility

$25.00

Hospital Charge Code	8002149
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

VASOACTIVE INTESTINAL POLYPEPT

Facility

$250.24

Service Code	HCPCS 84586
Hospital Charge Code	38472677
Hospital Revenue Code	301
Min. Negotiated Rate	$37.54
Max. Negotiated Rate	$37.54
Rate for Payer: Qualcare PPO/HMO/WC	$37.54

VASOACTIVE INTESTINAL POLYPEPT

Facility

$250.24

Service Code	HCPCS 84586
Hospital Charge Code	38472677
Hospital Revenue Code	301
Min. Negotiated Rate	$17.66
Max. Negotiated Rate	$129.45
Rate for Payer: Aetna Commercial	$114.47
Rate for Payer: Aetna Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.45
Rate for Payer: Cigna Commercial	$35.33
Rate for Payer: Cigna Medicare Advantage	$17.66
Rate for Payer: Clover Medicare Advantage	$33.56
Rate for Payer: EmblemHealth Commercial	$105.99
Rate for Payer: Humana Medicare Advantage	$36.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.45
Rate for Payer: Wellcare Medicare Advantage	$35.33

VASOACTIVE INTEST PEPTID VIP

Facility

$256.00

Service Code	HCPCS 84586
Hospital Charge Code	3007721
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

VASOACTIVE INTEST PEPTID VIP

Facility

$256.00

Service Code	HCPCS 84586
Hospital Charge Code	3007721
Hospital Revenue Code	301
Min. Negotiated Rate	$17.66
Max. Negotiated Rate	$129.45
Rate for Payer: Aetna Commercial	$114.47
Rate for Payer: Aetna Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.45
Rate for Payer: Cigna Commercial	$35.33
Rate for Payer: Cigna Medicare Advantage	$17.66
Rate for Payer: Clover Medicare Advantage	$33.56
Rate for Payer: EmblemHealth Commercial	$105.99
Rate for Payer: Humana Medicare Advantage	$36.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.45
Rate for Payer: Wellcare Medicare Advantage	$35.33

VASOCIDIN 0.25% OPHTH/5ML

Facility

$44.00

Hospital Charge Code	60634127
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

Know your out-of-pocket cost for care.

All Charges