Heights University Hospital

All Charges

Charge

Type

Setting

Price

VENOUS MAPPING UPPER EXT RT

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2692235
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	$501.40
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

VENOUS MAPPING UPPER EXT RT

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74117065
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

VENOUS MAPPING UPPER EXT RT

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	74115065
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

VENOUS MAPPING UPPER EXT RT

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	74115065
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	$501.40
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

VENOUS MECH THROMBECTOMY

Facility

$20,340.00

Service Code	HCPCS 37187
Hospital Charge Code	16000953
Hospital Revenue Code	360
Min. Negotiated Rate	$3,051.00
Max. Negotiated Rate	$3,051.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00

VENOUS MECH THROMBECTOMY

Facility

$20,340.00

Service Code	HCPCS 37187
Hospital Charge Code	16000953
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$6,102.00
Rate for Payer: Aetna Medicare Advantage	$6,102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,186.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,186.70
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	$5,186.70
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,644.20
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

VENOUS OUTFLOW COMPONENT

Facility

$9,775.00

Hospital Charge Code	270645659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$4,887.50
Rate for Payer: Aetna Commercial	$2,932.50
Rate for Payer: Aetna Medicare Advantage	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,492.62
Rate for Payer: Cigna Commercial	$4,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

VENOUS OUTFLOW COMPONENT

Facility

$9,775.00

Hospital Charge Code	270645659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$2,365.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

VENOUS PVR

Facility

$551.00

Hospital Charge Code	2692065
Hospital Revenue Code	921
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.63
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

VENOUS PVR

Facility

$551.00

Hospital Charge Code	2692065
Hospital Revenue Code	921
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

VENOUS VAS FAMILY OTHER 1&2ORD

Facility

$331.55

Service Code	HCPCS 36012
Hospital Charge Code	5100573
Hospital Revenue Code	361
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

VENOUS VAS FAMILY OTHER 1&2ORD

Facility

$331.55

Service Code	HCPCS 36012
Hospital Charge Code	5100573
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

VENTANA C INTERBODY 14X11X6MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704423
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

VENTANA C INTERBODY 14X11X6MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704423
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

VENT CIRCUIT W/MR290 DUAL HEAT

Facility

$128.12

Hospital Charge Code	270648118
Hospital Revenue Code	272
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$19.22
Rate for Payer: Qualcare PPO/HMO/WC	$19.22

VENT CIRCUIT W/MR290 DUAL HEAT

Facility

$128.12

Hospital Charge Code	270648118
Hospital Revenue Code	272
Min. Negotiated Rate	$16.66
Max. Negotiated Rate	$64.06
Rate for Payer: Aetna Commercial	$38.44
Rate for Payer: Aetna Medicare Advantage	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.67
Rate for Payer: Cigna Commercial	$64.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.66
Rate for Payer: Oxford Commercial	$64.06
Rate for Payer: Qualcare PPO/HMO/WC	$19.22
Rate for Payer: UnitedHealthcare Commercial	$64.06

VENTILATOR ASSIST AND MANAGEM

Facility

$2,375.50

Service Code	HCPCS 94002
Hospital Charge Code	1600000668
Hospital Revenue Code	360
Min. Negotiated Rate	$356.32
Max. Negotiated Rate	$356.32
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

VENTILATOR ASSIST AND MANAGEM

Facility

$2,375.50

Service Code	HCPCS 94002
Hospital Charge Code	1600000668
Hospital Revenue Code	360
Min. Negotiated Rate	$308.81
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$712.65
Rate for Payer: Aetna Medicare Advantage	$712.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.75
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	$605.75
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.81
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

VENTILATOR MGMT ADULT - SUBSEQ

Facility

$2,375.50

Service Code	HCPCS 94003
Hospital Charge Code	1600000669
Hospital Revenue Code	360
Min. Negotiated Rate	$308.81
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$712.65
Rate for Payer: Aetna Medicare Advantage	$712.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.75
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	$605.75
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.81
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

VENTILATOR MGMT ADULT - SUBSEQ

Facility

$2,375.50

Service Code	HCPCS 94003
Hospital Charge Code	1600000669
Hospital Revenue Code	360
Min. Negotiated Rate	$356.32
Max. Negotiated Rate	$356.32
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

Ventiscan Kit

Facility

$2,421.17

Hospital Charge Code	4509092
Hospital Revenue Code	270
Min. Negotiated Rate	$363.18
Max. Negotiated Rate	$363.18
Rate for Payer: Qualcare PPO/HMO/WC	$363.18

Ventiscan Kit

Facility

$2,421.17

Hospital Charge Code	4509092
Hospital Revenue Code	270
Min. Negotiated Rate	$314.75
Max. Negotiated Rate	$1,210.59
Rate for Payer: Aetna Commercial	$726.35
Rate for Payer: Aetna Medicare Advantage	$726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.40
Rate for Payer: Cigna Commercial	$1,210.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.75
Rate for Payer: Oxford Commercial	$1,210.59
Rate for Payer: Qualcare PPO/HMO/WC	$363.18
Rate for Payer: UnitedHealthcare Commercial	$1,210.59

VENTOLIN 0.5%/5MG/1ML

Facility

$65.00

Hospital Charge Code	60634147
Hospital Revenue Code	250
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$32.50

VENTOLIN 0.5%/5MG/1ML

Facility

$65.00

Hospital Charge Code	60634147
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

VENTOLIN/17GM

Facility

$118.00

Hospital Charge Code	60634142
Hospital Revenue Code	250
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

Know your out-of-pocket cost for care.

All Charges