Heights University Hospital

All Charges

Charge

Type

Setting

Price

VIPIERWIRE, 012 X 200CM, BX O

Facility

$950.00

Hospital Charge Code	270666951
Hospital Revenue Code	270
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

VIPIERWIRE, 012 X 200CM, BX O

Facility

$950.00

Hospital Charge Code	270666951
Hospital Revenue Code	270
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Commercial	$475.00

VIRA A OPTIC OINT

Facility

$107.00

Hospital Charge Code	60635065
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

VIRA A OPTIC OINT

Facility

$107.00

Hospital Charge Code	60635065
Hospital Revenue Code	250
Min. Negotiated Rate	$13.91
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

VIRACEFT 250MG TABS

Facility

$21.00

Hospital Charge Code	60635141
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

VIRACEFT 250MG TABS

Facility

$21.00

Hospital Charge Code	60635141
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

VIRACEPT 625MG TAB

Facility

$65.26

Service Code	NDC 63010002770
Hospital Charge Code	60635517
Hospital Revenue Code	250
Min. Negotiated Rate	$8.48
Max. Negotiated Rate	$32.63
Rate for Payer: Aetna Commercial	$19.58
Rate for Payer: Aetna Medicare Advantage	$19.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.64
Rate for Payer: Cigna Commercial	$32.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Oxford Commercial	$32.63
Rate for Payer: Qualcare PPO/HMO/WC	$9.79
Rate for Payer: UnitedHealthcare Commercial	$32.63

VIRACEPT 625MG TAB

Facility

$65.26

Service Code	NDC 63010002770
Hospital Charge Code	60635517
Hospital Revenue Code	250
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$9.79

VIRAL CULTURE

Facility

$489.00

Service Code	HCPCS 87250
Hospital Charge Code	38475053
Hospital Revenue Code	309
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.37
Rate for Payer: Aetna Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.67
Rate for Payer: Cigna Commercial	$19.56
Rate for Payer: Cigna Medicare Advantage	$9.78
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.73
Rate for Payer: Wellcare Medicare Advantage	$19.56

VIRAL CULTURE

Facility

$489.00

Service Code	HCPCS 87250
Hospital Charge Code	38475053
Hospital Revenue Code	309
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$73.35
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

VIRAL CULTURE, RAPID FLU A/B I

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	3038084A
Hospital Revenue Code	309
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

VIRAL CULTURE, RAPID FLU A/B I

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	3038084A
Hospital Revenue Code	309
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.37
Rate for Payer: Aetna Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.67
Rate for Payer: Cigna Commercial	$19.56
Rate for Payer: Cigna Medicare Advantage	$9.78
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.73
Rate for Payer: Wellcare Medicare Advantage	$19.56

VIRAL CULTURE, RAPID FLU A/B I

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	3038084B
Hospital Revenue Code	309
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.37
Rate for Payer: Aetna Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.67
Rate for Payer: Cigna Commercial	$19.56
Rate for Payer: Cigna Medicare Advantage	$9.78
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.73
Rate for Payer: Wellcare Medicare Advantage	$19.56

VIRAL CULTURE, RAPID FLU A/B I

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	3038084B
Hospital Revenue Code	309
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

VIRAL ILLNESS

Facility

$7,033.11

Service Code	APR-DRG 7232
Min. Negotiated Rate	$5,020.81
Max. Negotiated Rate	$7,033.11
Rate for Payer: Aetna Better Health Medicaid	$6,895.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,033.11
Rate for Payer: Wellpoint Medicaid Managed Care	$5,020.81

VIRAL ILLNESS

Facility

$10,757.58

Service Code	APR-DRG 7233
Min. Negotiated Rate	$8,116.08
Max. Negotiated Rate	$10,757.58
Rate for Payer: Aetna Better Health Medicaid	$10,546.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,757.58
Rate for Payer: Wellpoint Medicaid Managed Care	$8,116.08

VIRAL ILLNESS

Facility

$5,052.99

Service Code	APR-DRG 7231
Min. Negotiated Rate	$3,707.03
Max. Negotiated Rate	$5,052.99
Rate for Payer: Aetna Better Health Medicaid	$4,953.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,052.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3,707.03

VIRAL ILLNESS

Facility

$27,135.08

Service Code	APR-DRG 7234
Min. Negotiated Rate	$21,975.84
Max. Negotiated Rate	$27,135.08
Rate for Payer: Aetna Better Health Medicaid	$21,975.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,415.36
Rate for Payer: Wellpoint Medicaid Managed Care	$27,135.08

VIRAL ILLNESS WITH MCC

Facility

$55,311.48

Service Code	MSDRG 865
Min. Negotiated Rate	$16,350.32
Max. Negotiated Rate	$55,311.48
Rate for Payer: Aetna Commercial	$50,522.49
Rate for Payer: Aetna Medicare Advantage	$16,350.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,209.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,209.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,437.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,209.88
Rate for Payer: Cigna Commercial	$32,244.91
Rate for Payer: Cigna Medicare Advantage	$18,437.16
Rate for Payer: Clover Medicare Advantage	$17,515.30
Rate for Payer: EmblemHealth Commercial	$55,311.48
Rate for Payer: Humana Medicare Advantage	$18,990.27
Rate for Payer: Oxford Commercial	$20,152.13
Rate for Payer: UnitedHealthcare Commercial	$22,874.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,437.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19,543.39
Rate for Payer: Wellcare Medicare Advantage	$18,437.16

VIRAL ILLNESS WITHOUT MCC

Facility

$37,062.99

Service Code	MSDRG 866
Min. Negotiated Rate	$9,489.58
Max. Negotiated Rate	$37,062.99
Rate for Payer: Aetna Commercial	$29,322.80
Rate for Payer: Aetna Medicare Advantage	$9,489.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,361.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,361.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,354.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,361.64
Rate for Payer: Cigna Commercial	$18,714.66
Rate for Payer: Cigna Medicare Advantage	$12,354.33
Rate for Payer: Clover Medicare Advantage	$11,736.61
Rate for Payer: EmblemHealth Commercial	$37,062.99
Rate for Payer: Humana Medicare Advantage	$12,724.96
Rate for Payer: Oxford Commercial	$11,696.12
Rate for Payer: UnitedHealthcare Commercial	$13,276.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,354.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,095.59
Rate for Payer: Wellcare Medicare Advantage	$12,354.33

VIRAL MENINGITIS

Facility

$9,888.25

Service Code	APR-DRG 0512
Min. Negotiated Rate	$7,450.17
Max. Negotiated Rate	$9,888.25
Rate for Payer: Aetna Better Health Medicaid	$9,694.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,888.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7,450.17

VIRAL MENINGITIS

Facility

$30,566.33

Service Code	APR-DRG 0514
Min. Negotiated Rate	$26,628.04
Max. Negotiated Rate	$30,566.33
Rate for Payer: Aetna Better Health Medicaid	$29,966.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,566.33
Rate for Payer: Wellpoint Medicaid Managed Care	$26,628.04

VIRAL MENINGITIS

Facility

$16,717.76

Service Code	APR-DRG 0513
Min. Negotiated Rate	$13,057.99
Max. Negotiated Rate	$16,717.76
Rate for Payer: Aetna Better Health Medicaid	$16,389.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,717.76
Rate for Payer: Wellpoint Medicaid Managed Care	$13,057.99

VIRAL MENINGITIS

Facility

$6,658.14

Service Code	APR-DRG 0511
Min. Negotiated Rate	$5,398.92
Max. Negotiated Rate	$6,658.14
Rate for Payer: Aetna Better Health Medicaid	$6,527.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,658.14
Rate for Payer: Wellpoint Medicaid Managed Care	$5,398.92

VIRAL MENINGITIS WITH CC/MCC

Facility

$67,479.09

Service Code	MSDRG 075
Min. Negotiated Rate	$20,924.88
Max. Negotiated Rate	$67,479.09
Rate for Payer: Aetna Commercial	$64,657.88
Rate for Payer: Aetna Medicare Advantage	$20,924.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52,652.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52,652.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,493.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52,652.97
Rate for Payer: Cigna Medicare Advantage	$22,493.03
Rate for Payer: Clover Medicare Advantage	$21,368.38
Rate for Payer: EmblemHealth Commercial	$67,479.09
Rate for Payer: Humana Medicare Advantage	$23,167.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,493.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23,842.61
Rate for Payer: Wellcare Medicare Advantage	$22,493.03

Know your out-of-pocket cost for care.

All Charges