Heights University Hospital

All Charges

Charge

Type

Setting

Price

VIABHN VBX/RT EXT ILIAC STNT

Facility

$16,275.00

Service Code	HCPCS C1876
Hospital Charge Code	270680298N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,441.25
Max. Negotiated Rate	$8,137.50
Rate for Payer: Aetna Commercial	$4,882.50
Rate for Payer: Aetna Medicare Advantage	$4,882.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,150.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,150.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,150.12
Rate for Payer: Cigna Commercial	$8,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,938.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,441.25

VIABHN VBX/RT EXT ILIAC STNT

Facility

$16,275.00

Service Code	HCPCS C1876
Hospital Charge Code	270680298N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,441.25
Max. Negotiated Rate	$3,938.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,938.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,441.25

VIABLE BONE MATRIX 1 CC BIO4

Facility

$4,125.00

Service Code	HCPCS C1762
Hospital Charge Code	270692124
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,237.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

VIABLE BONE MATRIX 1 CC BIO4

Facility

$4,125.00

Service Code	HCPCS C1762
Hospital Charge Code	270692124
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

VIAFILL DEMINE BONE FIBER 3CC

Facility

$3,750.00

Hospital Charge Code	270702355
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

VIAFILL DEMINE BONE FIBER 3CC

Facility

$3,750.00

Hospital Charge Code	270702355
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

VIAFILL DEMINE BONE FIBER 6CC

Facility

$7,500.00

Hospital Charge Code	270702366
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

VIAFILL DEMINE BONE FIBER 6CC

Facility

$7,500.00

Hospital Charge Code	270702366
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

VIAFLOW 1.0CC AMBIENT TISSUE

Facility

$16,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270697593
Hospital Revenue Code	278
Min. Negotiated Rate	$2,504.25
Max. Negotiated Rate	$8,347.50
Rate for Payer: Aetna Commercial	$5,008.50
Rate for Payer: Aetna Medicare Advantage	$5,008.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,257.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,257.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,257.23
Rate for Payer: Cigna Commercial	$8,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,040.19
Rate for Payer: Qualcare PPO/HMO/WC	$2,504.25

VIAFLOW 1.0CC AMBIENT TISSUE

Facility

$16,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270697593
Hospital Revenue Code	278
Min. Negotiated Rate	$2,504.25
Max. Negotiated Rate	$4,040.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,040.19
Rate for Payer: Qualcare PPO/HMO/WC	$2,504.25

VIAL-O-JET

Facility

$26.45

Hospital Charge Code	270060060V
Hospital Revenue Code	761
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.97

VIAL-O-JET

Facility

$5.13

Hospital Charge Code	270060060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

VIAL-O-JET

Facility

$26.45

Hospital Charge Code	270060060V
Hospital Revenue Code	761
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$13.22
Rate for Payer: Aetna Commercial	$7.93
Rate for Payer: Aetna Medicare Advantage	$7.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.74
Rate for Payer: Cigna Commercial	$13.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.44
Rate for Payer: Oxford Commercial	$13.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.97
Rate for Payer: UnitedHealthcare Commercial	$13.22

VIAL-O-JET

Facility

$5.13

Hospital Charge Code	270060060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$2.56
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.31
Rate for Payer: Cigna Commercial	$2.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$2.56

VIAL STERILE EMPTY

Facility

$7.25

Hospital Charge Code	60628557
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

VIAL STERILE EMPTY

Facility

$7.25

Hospital Charge Code	60628557
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

VIAL STERILE EMPTY

Facility

$5.80

Hospital Charge Code	60628611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

VIAL STERILE EMPTY

Facility

$5.80

Hospital Charge Code	60628611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.90
Rate for Payer: Aetna Commercial	$1.74
Rate for Payer: Aetna Medicare Advantage	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.48
Rate for Payer: Cigna Commercial	$2.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$2.90

VIASHIELD AMNION DL PTCH 4X8CM

Facility

$25,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270696766
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

VIASHIELD AMNION DL PTCH 4X8CM

Facility

$25,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270696766
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

VIASHLD DUL LYR AMNI PTCH4X8CM

Facility

$15,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270696329
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

VIASHLD DUL LYR AMNI PTCH4X8CM

Facility

$15,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270696329
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

VIATORR ENDOPRT 10x8 PTB108275

Facility

$23,770.00

Service Code	HCPCS C1876
Hospital Charge Code	270635474
Hospital Revenue Code	278
Min. Negotiated Rate	$3,565.50
Max. Negotiated Rate	$5,752.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,752.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,565.50

VIATORR ENDOPRT 10x8 PTB108275

Facility

$23,770.00

Service Code	HCPCS C1876
Hospital Charge Code	270635474
Hospital Revenue Code	278
Min. Negotiated Rate	$3,565.50
Max. Negotiated Rate	$11,885.00
Rate for Payer: Aetna Commercial	$7,131.00
Rate for Payer: Aetna Medicare Advantage	$7,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,061.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,061.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,061.35
Rate for Payer: Cigna Commercial	$11,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,752.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,565.50

VIATORR ENDOPRT 10x8 PTB108275

Facility

$19,500.00

Hospital Charge Code	270635474V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

Know your out-of-pocket cost for care.

All Charges