Heights University Hospital

All Charges

Charge

Type

Setting

Price

VRE SCREEN

Facility

$390.00

Service Code	HCPCS 87081
Hospital Charge Code	3036051
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VRTBR CRPCTMY,CERV EA ADTL SGM

Facility

$19,892.30

Service Code	HCPCS 63082
Hospital Charge Code	160000224
Hospital Revenue Code	360
Min. Negotiated Rate	$257.31
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$5,967.69
Rate for Payer: Aetna Medicare Advantage	$5,967.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,072.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,072.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,072.54
Rate for Payer: Cigna Commercial	$257.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,586.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.84
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

VRTBR CRPCTMY,CERV EA ADTL SGM

Facility

$19,892.30

Service Code	HCPCS 63082
Hospital Charge Code	160000224
Hospital Revenue Code	360
Min. Negotiated Rate	$2,983.84
Max. Negotiated Rate	$2,983.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.84

V TIPS ENDOPROSTHESIS

Facility

$19,990.00

Hospital Charge Code	2709007355
Hospital Revenue Code	272
Min. Negotiated Rate	$2,998.50
Max. Negotiated Rate	$2,998.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50

V TIPS ENDOPROSTHESIS

Facility

$19,990.00

Hospital Charge Code	2709007355
Hospital Revenue Code	272
Min. Negotiated Rate	$2,598.70
Max. Negotiated Rate	$9,995.00
Rate for Payer: Aetna Commercial	$5,997.00
Rate for Payer: Aetna Medicare Advantage	$5,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,097.45
Rate for Payer: Cigna Commercial	$9,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,598.70
Rate for Payer: Oxford Commercial	$9,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50
Rate for Payer: UnitedHealthcare Commercial	$9,995.00

V TIPS ENDOPROSTHESIS 12MMX8CM

Facility

$19,990.00

Hospital Charge Code	2709007356
Hospital Revenue Code	272
Min. Negotiated Rate	$2,998.50
Max. Negotiated Rate	$2,998.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50

V TIPS ENDOPROSTHESIS 12MMX8CM

Facility

$19,990.00

Hospital Charge Code	2709007356
Hospital Revenue Code	272
Min. Negotiated Rate	$2,598.70
Max. Negotiated Rate	$9,995.00
Rate for Payer: Aetna Commercial	$5,997.00
Rate for Payer: Aetna Medicare Advantage	$5,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,097.45
Rate for Payer: Cigna Commercial	$9,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,598.70
Rate for Payer: Oxford Commercial	$9,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50
Rate for Payer: UnitedHealthcare Commercial	$9,995.00

VUCAN PROBE ABLATOR #910003

Facility

$697.00

Hospital Charge Code	270335610
Hospital Revenue Code	272
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

VUCAN PROBE ABLATOR #910003

Facility

$697.00

Hospital Charge Code	270335610
Hospital Revenue Code	272
Min. Negotiated Rate	$90.61
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$209.10
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.61
Rate for Payer: Oxford Commercial	$348.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Commercial	$348.50

VUCAN PROBE ELECTROTHERMAL

Facility

$697.00

Hospital Charge Code	270335601
Hospital Revenue Code	272
Min. Negotiated Rate	$90.61
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$209.10
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.61
Rate for Payer: Oxford Commercial	$348.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Commercial	$348.50

VUCAN PROBE ELECTROTHERMAL

Facility

$697.00

Hospital Charge Code	270335601
Hospital Revenue Code	272
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

VUCAN PROBE LIGAMENT CHISEL

Facility

$272.00

Hospital Charge Code	270335611
Hospital Revenue Code	272
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

VUCAN PROBE LIGAMENT CHISEL

Facility

$272.00

Hospital Charge Code	270335611
Hospital Revenue Code	272
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Commercial	$81.60
Rate for Payer: Aetna Medicare Advantage	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$136.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$136.00

VUE POWERPORT 6 FR

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270654983
Hospital Revenue Code	278
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$1,645.00
Rate for Payer: Aetna Commercial	$987.00
Rate for Payer: Aetna Medicare Advantage	$987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.95
Rate for Payer: Cigna Commercial	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

VUE POWERPORT 6 FR

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270654983
Hospital Revenue Code	278
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$796.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

VZ AB IGM

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900387
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
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	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

VZ AB IGM

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900387
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VZV AB (IGG),EIA

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900258
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VZV AB (IGG),EIA

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900258
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
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	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

WADA ACTIVATION

Facility

$5,700.00

Service Code	HCPCS 95958
Hospital Charge Code	411095958
Hospital Revenue Code	740
Min. Negotiated Rate	$557.75
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$557.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

WADA ACTIVATION

Facility

$5,700.00

Service Code	HCPCS 95958
Hospital Charge Code	411095958
Hospital Revenue Code	740
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

WAFER DURAHESIVE FLANGE 2-14

Facility

$6.60

Hospital Charge Code	270647419
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

WAFER DURAHESIVE FLANGE 2-14

Facility

$6.60

Hospital Charge Code	270647419
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$3.30
Rate for Payer: Aetna Commercial	$1.98
Rate for Payer: Aetna Medicare Advantage	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.68
Rate for Payer: Cigna Commercial	$3.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.86
Rate for Payer: Oxford Commercial	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$3.30

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$21.38
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$35.62
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$35.62

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

Know your out-of-pocket cost for care.

All Charges