Heights University Hospital

All Charges

Charge

Type

Setting

Price

VIMAX BONE MATRIX CARTRIDGE 5

Facility

$12,875.00

Service Code	HCPCS C1763
Hospital Charge Code	270697338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$3,862.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

VIMAX BONE MATRIX CARTRIDGE 5

Facility

$12,875.00

Service Code	HCPCS C1763
Hospital Charge Code	270697338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

VIMAX BONE MATRIX VL 2CC

Facility

$6,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270697764
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

VIMAX BONE MATRIX VL 2CC

Facility

$6,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270697764
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$1,980.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

VINBLASTINE 10 MG INJ

Facility

$110.95

Service Code	HCPCS J9360
Hospital Charge Code	6005664
Hospital Revenue Code	636
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$26.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$16.64

VINBLASTINE 10 MG INJ

Facility

$110.95

Service Code	HCPCS J9360
Hospital Charge Code	6005664
Hospital Revenue Code	636
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$33.28
Rate for Payer: Aetna Commercial	$33.28
Rate for Payer: Aetna Medicare Advantage	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.29
Rate for Payer: Cigna Commercial	$5.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$16.64

VINBLASTINE SULFATE/1MG/1

Facility

$131.00

Hospital Charge Code	60634156
Hospital Revenue Code	636
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$31.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

VINBLASTINE SULFATE/1MG/1

Facility

$131.00

Hospital Charge Code	60634156
Hospital Revenue Code	636
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

VINCRISTINE/1MG

Facility

$227.00

Hospital Charge Code	60633572
Hospital Revenue Code	636
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$113.50
Rate for Payer: Aetna Commercial	$68.10
Rate for Payer: Aetna Medicare Advantage	$68.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.88
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.93
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

VINCRISTINE/1MG

Facility

$227.00

Hospital Charge Code	60633572
Hospital Revenue Code	636
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$54.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.93
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

VINCRISTINE 1 MG/ML INJ

Facility

$45.56

Service Code	HCPCS J9370
Hospital Charge Code	6005680
Hospital Revenue Code	636
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$11.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.83

VINCRISTINE 1 MG/ML INJ

Facility

$45.56

Service Code	HCPCS J9370
Hospital Charge Code	6005680
Hospital Revenue Code	636
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$13.67
Rate for Payer: Aetna Commercial	$13.67
Rate for Payer: Aetna Medicare Advantage	$13.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.62
Rate for Payer: Cigna Commercial	$8.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.83

VINCRISTINE 2 MG INJ

Facility

$414.00

Hospital Charge Code	60633575
Hospital Revenue Code	636
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$100.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.19
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

VINCRISTINE 2 MG INJ

Facility

$414.00

Hospital Charge Code	60633575
Hospital Revenue Code	636
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.57
Rate for Payer: Cigna Commercial	$207.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.19
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

VINCRISTINE IV/1MG/ML

Facility

$131.00

Hospital Charge Code	60634418
Hospital Revenue Code	636
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

VINCRISTINE IV/1MG/ML

Facility

$131.00

Hospital Charge Code	60634418
Hospital Revenue Code	636
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$31.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

VINCRISTINE SUL INJ 1MG/ML 1ML

Facility

$109.45

Hospital Charge Code	6005672
Hospital Revenue Code	250
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

VINCRISTINE SUL INJ 1MG/ML 1ML

Facility

$109.45

Hospital Charge Code	6005672
Hospital Revenue Code	250
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

VINDRELBINE INJ 10MG/1ML

Facility

$386.60

Hospital Charge Code	60627409
Hospital Revenue Code	636
Min. Negotiated Rate	$57.99
Max. Negotiated Rate	$193.30
Rate for Payer: Aetna Commercial	$115.98
Rate for Payer: Aetna Medicare Advantage	$115.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.58
Rate for Payer: Cigna Commercial	$193.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.99

VINDRELBINE INJ 10MG/1ML

Facility

$386.60

Hospital Charge Code	60627409
Hospital Revenue Code	636
Min. Negotiated Rate	$57.99
Max. Negotiated Rate	$93.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.99

VINDRELBINE INJ 50MG

Facility

$1,768.35

Hospital Charge Code	6010565
Hospital Revenue Code	636
Min. Negotiated Rate	$265.25
Max. Negotiated Rate	$884.17
Rate for Payer: Aetna Commercial	$530.50
Rate for Payer: Aetna Medicare Advantage	$530.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.93
Rate for Payer: Cigna Commercial	$884.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.94
Rate for Payer: Qualcare PPO/HMO/WC	$265.25

VINDRELBINE INJ 50MG

Facility

$1,768.35

Hospital Charge Code	6010565
Hospital Revenue Code	636
Min. Negotiated Rate	$265.25
Max. Negotiated Rate	$427.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.94
Rate for Payer: Qualcare PPO/HMO/WC	$265.25

VINORELBINE 10 MG/ML INJ

Facility

$285.42

Service Code	HCPCS J9390
Hospital Charge Code	60627410
Hospital Revenue Code	636
Min. Negotiated Rate	$42.81
Max. Negotiated Rate	$69.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.07
Rate for Payer: Qualcare PPO/HMO/WC	$42.81

VINORELBINE 10 MG/ML INJ

Facility

$285.42

Service Code	HCPCS J9390
Hospital Charge Code	60627410
Hospital Revenue Code	636
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$85.63
Rate for Payer: Aetna Commercial	$85.63
Rate for Payer: Aetna Medicare Advantage	$85.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.78
Rate for Payer: Cigna Commercial	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.07
Rate for Payer: Qualcare PPO/HMO/WC	$42.81

VINYL CONNECTIING TUBE 30CM

Facility

$62.60

Hospital Charge Code	2709003575
Hospital Revenue Code	272
Min. Negotiated Rate	$8.14
Max. Negotiated Rate	$31.30
Rate for Payer: Aetna Commercial	$18.78
Rate for Payer: Aetna Medicare Advantage	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.96
Rate for Payer: Cigna Commercial	$31.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: Oxford Commercial	$31.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.39
Rate for Payer: UnitedHealthcare Commercial	$31.30

Know your out-of-pocket cost for care.

All Charges