Heights University Hospital

All Charges

Charge

Type

Setting

Price

VITAGEL SURG.HEMOSTAT 4.5 ML

Facility

$858.00

Hospital Charge Code	270335970
Hospital Revenue Code	272
Min. Negotiated Rate	$111.54
Max. Negotiated Rate	$429.00
Rate for Payer: Aetna Commercial	$257.40
Rate for Payer: Aetna Medicare Advantage	$257.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.79
Rate for Payer: Cigna Commercial	$429.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.54
Rate for Payer: Oxford Commercial	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.70
Rate for Payer: UnitedHealthcare Commercial	$429.00

VITAL UTERINE SCISSON

Facility

$1,845.00

Hospital Charge Code	270665620
Hospital Revenue Code	272
Min. Negotiated Rate	$276.75
Max. Negotiated Rate	$276.75
Rate for Payer: Qualcare PPO/HMO/WC	$276.75

VITAL UTERINE SCISSON

Facility

$1,845.00

Hospital Charge Code	270665620
Hospital Revenue Code	272
Min. Negotiated Rate	$239.85
Max. Negotiated Rate	$922.50
Rate for Payer: Aetna Commercial	$553.50
Rate for Payer: Aetna Medicare Advantage	$553.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$470.48
Rate for Payer: Cigna Commercial	$922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.85
Rate for Payer: Oxford Commercial	$922.50
Rate for Payer: Qualcare PPO/HMO/WC	$276.75
Rate for Payer: UnitedHealthcare Commercial	$922.50

VITAL VU DISP TIP ******

Facility

$160.00

Hospital Charge Code	1801158
Hospital Revenue Code	279
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

VITAL VU DISP TIP ******

Facility

$160.00

Hospital Charge Code	1801158
Hospital Revenue Code	279
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

VITAL VUE TIP *******

Facility

$362.00

Hospital Charge Code	1608439
Hospital Revenue Code	272
Min. Negotiated Rate	$54.30
Max. Negotiated Rate	$54.30
Rate for Payer: Qualcare PPO/HMO/WC	$54.30

VITAL VUE TIP *******

Facility

$362.00

Hospital Charge Code	1608439
Hospital Revenue Code	272
Min. Negotiated Rate	$47.06
Max. Negotiated Rate	$181.00
Rate for Payer: Aetna Commercial	$108.60
Rate for Payer: Aetna Medicare Advantage	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.31
Rate for Payer: Cigna Commercial	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.06
Rate for Payer: Oxford Commercial	$181.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.30
Rate for Payer: UnitedHealthcare Commercial	$181.00

VITAMIN A

Facility

$390.00

Service Code	HCPCS 84590
Hospital Charge Code	39900149
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VITAMIN A

Facility

$390.00

Service Code	HCPCS 84590
Hospital Charge Code	39900149
Hospital Revenue Code	301
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.54
Rate for Payer: Cigna Commercial	$11.61
Rate for Payer: Cigna Medicare Advantage	$5.80
Rate for Payer: Clover Medicare Advantage	$11.03
Rate for Payer: EmblemHealth Commercial	$34.83
Rate for Payer: Humana Medicare Advantage	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.31
Rate for Payer: Wellcare Medicare Advantage	$11.61

VITAMIN A 10000 UNITS CAP

Facility

$0.85

Hospital Charge Code	60629212
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.43
Rate for Payer: Aetna Commercial	$0.26
Rate for Payer: Aetna Medicare Advantage	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.22
Rate for Payer: Cigna Commercial	$0.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.11
Rate for Payer: Oxford Commercial	$0.43
Rate for Payer: Qualcare PPO/HMO/WC	$0.13
Rate for Payer: UnitedHealthcare Commercial	$0.43

VITAMIN A 10000 UNITS CAP

Facility

$0.85

Hospital Charge Code	60629212
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.13

VITAMIN A & D/454GM

Facility

$3.00

Hospital Charge Code	60634159
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

VITAMIN A & D/454GM

Facility

$3.00

Hospital Charge Code	60634159
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

VITAMIN A,D,C&FLUOR 0.5MG/ML

Facility

$37.80

Hospital Charge Code	60628505
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

VITAMIN A,D,C&FLUOR 0.5MG/ML

Facility

$37.80

Hospital Charge Code	60628505
Hospital Revenue Code	250
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

VITAMIN A, D, C LIQUID 50 ML

Facility

$46.00

Service Code	HCPCS J8499
Hospital Charge Code	6062946
Hospital Revenue Code	250
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

VITAMIN A, D, C LIQUID 50 ML

Facility

$46.00

Service Code	HCPCS J8499
Hospital Charge Code	6062946
Hospital Revenue Code	250
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$13.80
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$23.00

VITAMIN A & D OINT

Facility

$13.80

Service Code	NDC 54162000002
Hospital Charge Code	6063943308
Hospital Revenue Code	250
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$6.90
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.52
Rate for Payer: Cigna Commercial	$6.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$6.90

VITAMIN A & D OINT

Facility

$13.80

Service Code	NDC 54162000002
Hospital Charge Code	6063943308
Hospital Revenue Code	250
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

VITAMIN A & D OINTMENT 4 OZ

Facility

$38.79

Service Code	NDC 168003504
Hospital Charge Code	606390235
Hospital Revenue Code	250
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$19.39
Rate for Payer: Aetna Commercial	$11.64
Rate for Payer: Aetna Medicare Advantage	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.89
Rate for Payer: Cigna Commercial	$19.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.04
Rate for Payer: Oxford Commercial	$19.39
Rate for Payer: Qualcare PPO/HMO/WC	$5.82
Rate for Payer: UnitedHealthcare Commercial	$19.39

VITAMIN A & D OINTMENT 4 OZ

Facility

$38.79

Service Code	NDC 168003504
Hospital Charge Code	606390235
Hospital Revenue Code	250
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$5.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

VITAMIN A (RETINOL)

Facility

$236.00

Service Code	HCPCS 84590
Hospital Charge Code	38472680
Hospital Revenue Code	301
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.54
Rate for Payer: Cigna Commercial	$11.61
Rate for Payer: Cigna Medicare Advantage	$5.80
Rate for Payer: Clover Medicare Advantage	$11.03
Rate for Payer: EmblemHealth Commercial	$34.83
Rate for Payer: Humana Medicare Advantage	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.31
Rate for Payer: Wellcare Medicare Advantage	$11.61

VITAMIN A (RETINOL)

Facility

$128.00

Service Code	HCPCS 84590
Hospital Charge Code	3007747
Hospital Revenue Code	301
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.54
Rate for Payer: Cigna Commercial	$11.61
Rate for Payer: Cigna Medicare Advantage	$5.80
Rate for Payer: Clover Medicare Advantage	$11.03
Rate for Payer: EmblemHealth Commercial	$34.83
Rate for Payer: Humana Medicare Advantage	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.31
Rate for Payer: Wellcare Medicare Advantage	$11.61

VITAMIN A (RETINOL)

Facility

$236.00

Service Code	HCPCS 84590
Hospital Charge Code	38472680
Hospital Revenue Code	301
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

VITAMIN A (RETINOL)

Facility

$128.00

Service Code	HCPCS 84590
Hospital Charge Code	3007747
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

Know your out-of-pocket cost for care.

All Charges