Heights University Hospital

All Charges

Charge

Type

Setting

Price

VON WILLEFRAND FACTOR VIII***

Facility

$27.00

Hospital Charge Code	3032547
Hospital Revenue Code	309
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

VON WILLEFRAND FACTOR VIII***

Facility

$27.00

Hospital Charge Code	3032547
Hospital Revenue Code	309
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

VON WILLIBRAND FACTOR AG

Facility

$390.00

Service Code	HCPCS 85246
Hospital Charge Code	39900510
Hospital Revenue Code	305
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.33
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.05
Rate for Payer: Cigna Commercial	$22.94
Rate for Payer: Cigna Medicare Advantage	$11.47
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
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	$22.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.32
Rate for Payer: Wellcare Medicare Advantage	$22.94

VON WILLIBRAND FACTOR AG

Facility

$390.00

Service Code	HCPCS 85246
Hospital Charge Code	39900510
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VORICONAZOLE 200 MG TAB

Facility

$592.62

Service Code	NDC 49318030
Hospital Charge Code	60629938
Hospital Revenue Code	250
Min. Negotiated Rate	$88.89
Max. Negotiated Rate	$88.89
Rate for Payer: Qualcare PPO/HMO/WC	$88.89

VORICONAZOLE 200 MG TAB

Facility

$592.62

Service Code	NDC 49318030
Hospital Charge Code	60629938
Hospital Revenue Code	250
Min. Negotiated Rate	$77.04
Max. Negotiated Rate	$296.31
Rate for Payer: Aetna Commercial	$177.79
Rate for Payer: Aetna Medicare Advantage	$177.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.12
Rate for Payer: Cigna Commercial	$296.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.04
Rate for Payer: Oxford Commercial	$296.31
Rate for Payer: Qualcare PPO/HMO/WC	$88.89
Rate for Payer: UnitedHealthcare Commercial	$296.31

VORICONAZOLE 200 MG VIAL

Facility

$1,199.50

Service Code	HCPCS J3465
Hospital Charge Code	60629297
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$359.85
Rate for Payer: Aetna Commercial	$359.85
Rate for Payer: Aetna Medicare Advantage	$359.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.87
Rate for Payer: Cigna Commercial	$0.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.28
Rate for Payer: Qualcare PPO/HMO/WC	$179.93

VORICONAZOLE 200 MG VIAL

Facility

$1,199.50

Service Code	HCPCS J3465
Hospital Charge Code	60629297
Hospital Revenue Code	636
Min. Negotiated Rate	$179.93
Max. Negotiated Rate	$290.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.28
Rate for Payer: Qualcare PPO/HMO/WC	$179.93

VORICONAZOLE LC MS MS

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	401080299
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VORICONAZOLE LC MS MS

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	401080299
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
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	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

VORTEX VACUUM MIXING SYSTEM

Facility

$5,547.40

Hospital Charge Code	270686907
Hospital Revenue Code	272
Min. Negotiated Rate	$721.16
Max. Negotiated Rate	$2,773.70
Rate for Payer: Aetna Commercial	$1,664.22
Rate for Payer: Aetna Medicare Advantage	$1,664.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,414.59
Rate for Payer: Cigna Commercial	$2,773.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Oxford Commercial	$2,773.70
Rate for Payer: Qualcare PPO/HMO/WC	$832.11
Rate for Payer: UnitedHealthcare Commercial	$2,773.70

VORTEX VACUUM MIXING SYSTEM

Facility

$5,547.40

Hospital Charge Code	270686907
Hospital Revenue Code	272
Min. Negotiated Rate	$832.11
Max. Negotiated Rate	$832.11
Rate for Payer: Qualcare PPO/HMO/WC	$832.11

VOSOL HC OTIC/10ML

Facility

$414.00

Hospital Charge Code	60634168
Hospital Revenue Code	250
Min. Negotiated Rate	$53.82
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	$53.82
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$207.00

VOSOL HC OTIC/10ML

Facility

$414.00

Hospital Charge Code	60634168
Hospital Revenue Code	250
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

VOSOL OTIC

Facility

$256.65

Hospital Charge Code	6008403
Hospital Revenue Code	251
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.50

VOSOL OTIC

Facility

$256.65

Hospital Charge Code	6008403
Hospital Revenue Code	251
Min. Negotiated Rate	$33.36
Max. Negotiated Rate	$128.32
Rate for Payer: Aetna Commercial	$77.00
Rate for Payer: Aetna Medicare Advantage	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.45
Rate for Payer: Cigna Commercial	$128.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.36
Rate for Payer: Oxford Commercial	$128.32
Rate for Payer: Qualcare PPO/HMO/WC	$38.50
Rate for Payer: UnitedHealthcare Commercial	$128.32

VOSOL OTIC/10ML

Facility

$181.00

Hospital Charge Code	60634631
Hospital Revenue Code	250
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.53
Rate for Payer: Oxford Commercial	$90.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$90.50

VOSOL OTIC/10ML

Facility

$181.00

Hospital Charge Code	60634631
Hospital Revenue Code	250
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

VPC SCREW 4.0X40MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686589
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$585.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

VPC SCREW 4.0X40MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686589
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

VPRWIRE ADVGDFRMWIRE 0.017 TIP

Facility

$850.00

Hospital Charge Code	2709003742
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

VPRWIRE ADVGDFRMWIRE 0.017 TIP

Facility

$850.00

Hospital Charge Code	2709003742
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

VRBLE SLF DRILLING SCHOOL 14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694167
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

VRBLE SLF DRILLING SCHOOL 14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694167
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

VRE SCREEN

Facility

$390.00

Service Code	HCPCS 87081
Hospital Charge Code	3036051
Hospital Revenue Code	309
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.48
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.29
Rate for Payer: Cigna Commercial	$6.63
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
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	$6.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.03
Rate for Payer: Wellcare Medicare Advantage	$6.63

Know your out-of-pocket cost for care.

All Charges