Heights University Hospital

All Charges

Charge

Type

Setting

Price

CARTRIDGE CURVTEK MED 906750

Facility

$3,578.45

Hospital Charge Code	270615868
Hospital Revenue Code	272
Min. Negotiated Rate	$536.77
Max. Negotiated Rate	$536.77
Rate for Payer: Qualcare PPO/HMO/WC	$536.77

CARTRIDGE HI-SORB 641208000

Facility

$343.25

Hospital Charge Code	270606197
Hospital Revenue Code	270
Min. Negotiated Rate	$44.62
Max. Negotiated Rate	$171.62
Rate for Payer: Aetna Commercial	$102.97
Rate for Payer: Aetna Medicare Advantage	$102.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.53
Rate for Payer: Cigna Commercial	$171.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.62
Rate for Payer: Oxford Commercial	$171.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.49
Rate for Payer: UnitedHealthcare Commercial	$171.62

CARTRIDGE HI-SORB 641208000

Facility

$343.25

Hospital Charge Code	270606197
Hospital Revenue Code	270
Min. Negotiated Rate	$51.49
Max. Negotiated Rate	$51.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.49

CARTRIDGE, MONARCH II IOL

Facility

$1,000.00

Hospital Charge Code	270655285
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CARTRIDGE, MONARCH II IOL

Facility

$1,000.00

Hospital Charge Code	270655285
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CARTRIDGE PAPER & INK ENDOSCOP

Facility

$6,583.50

Hospital Charge Code	270655839
Hospital Revenue Code	278
Min. Negotiated Rate	$987.52
Max. Negotiated Rate	$1,593.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,316.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.21
Rate for Payer: Qualcare PPO/HMO/WC	$987.52

CARTRIDGE PAPER & INK ENDOSCOP

Facility

$6,583.50

Hospital Charge Code	270655839
Hospital Revenue Code	278
Min. Negotiated Rate	$987.52
Max. Negotiated Rate	$3,291.75
Rate for Payer: Aetna Commercial	$1,975.05
Rate for Payer: Aetna Medicare Advantage	$1,975.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,678.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,678.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,316.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,678.79
Rate for Payer: Cigna Commercial	$3,291.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.21
Rate for Payer: Qualcare PPO/HMO/WC	$987.52

CARTRIDGE RELOAD THICK TISSUE

Facility

$599.00

Hospital Charge Code	270334714
Hospital Revenue Code	272
Min. Negotiated Rate	$89.85
Max. Negotiated Rate	$89.85
Rate for Payer: Qualcare PPO/HMO/WC	$89.85

CARTRIDGE RELOAD THICK TISSUE

Facility

$599.00

Hospital Charge Code	270334714
Hospital Revenue Code	272
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$299.50
Rate for Payer: Aetna Commercial	$179.70
Rate for Payer: Aetna Medicare Advantage	$179.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.75
Rate for Payer: Cigna Commercial	$299.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.87
Rate for Payer: Oxford Commercial	$299.50
Rate for Payer: Qualcare PPO/HMO/WC	$89.85
Rate for Payer: UnitedHealthcare Commercial	$299.50

CARTRIDGE TVX

Facility

$107.33

Hospital Charge Code	270656296
Hospital Revenue Code	271
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$16.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.10

CARTRIDGE TVX

Facility

$107.33

Hospital Charge Code	270656296
Hospital Revenue Code	271
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$53.66
Rate for Payer: Aetna Commercial	$32.20
Rate for Payer: Aetna Medicare Advantage	$32.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.37
Rate for Payer: Cigna Commercial	$53.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: Oxford Commercial	$53.66
Rate for Payer: Qualcare PPO/HMO/WC	$16.10
Rate for Payer: UnitedHealthcare Commercial	$53.66

CARVEDILOL 12.5 MG TAB

Facility

$126.03

Service Code	NDC 80725014120
Hospital Charge Code	60628811
Hospital Revenue Code	250
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$63.02
Rate for Payer: Aetna Commercial	$37.81
Rate for Payer: Aetna Medicare Advantage	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.14
Rate for Payer: Cigna Commercial	$63.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$63.02
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$63.02

CARVEDILOL 12.5 MG TAB

Facility

$126.03

Service Code	NDC 80725014120
Hospital Charge Code	60628811
Hospital Revenue Code	250
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CARVEDILOL 25 MG TAB

Facility

$126.03

Service Code	NDC 80725014220
Hospital Charge Code	60628812
Hospital Revenue Code	250
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$63.02
Rate for Payer: Aetna Commercial	$37.81
Rate for Payer: Aetna Medicare Advantage	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.14
Rate for Payer: Cigna Commercial	$63.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$63.02
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$63.02

CARVEDILOL 25 MG TAB

Facility

$126.03

Service Code	NDC 80725014220
Hospital Charge Code	60628812
Hospital Revenue Code	250
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CARVEDILOL 3.125 MG TAB

Facility

$126.03

Service Code	NDC 80725013920
Hospital Charge Code	60627623
Hospital Revenue Code	250
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$63.02
Rate for Payer: Aetna Commercial	$37.81
Rate for Payer: Aetna Medicare Advantage	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.14
Rate for Payer: Cigna Commercial	$63.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$63.02
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$63.02

CARVEDILOL 3.125 MG TAB

Facility

$126.03

Service Code	NDC 80725013920
Hospital Charge Code	60627623
Hospital Revenue Code	250
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CARVEDILOL 6.25 MG TAB

Facility

$126.03

Service Code	NDC 80725014020
Hospital Charge Code	60628586
Hospital Revenue Code	250
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$63.02
Rate for Payer: Aetna Commercial	$37.81
Rate for Payer: Aetna Medicare Advantage	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.14
Rate for Payer: Cigna Commercial	$63.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$63.02
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$63.02

CARVEDILOL 6.25 MG TAB

Facility

$126.03

Service Code	NDC 80725014020
Hospital Charge Code	60628586
Hospital Revenue Code	250
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CARVEDILOL TAB 3.125MG

Facility

$10.90

Hospital Charge Code	6018006
Hospital Revenue Code	252
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

CARVEDILOL TAB 3.125MG

Facility

$10.90

Hospital Charge Code	6018006
Hospital Revenue Code	252
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

CA SAIL PLUS5x40x130SAE0500401

Facility

$1,413.65

Hospital Charge Code	270635690V
Hospital Revenue Code	278
Min. Negotiated Rate	$212.05
Max. Negotiated Rate	$706.83
Rate for Payer: Aetna Commercial	$424.10
Rate for Payer: Aetna Medicare Advantage	$424.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.48
Rate for Payer: Cigna Commercial	$706.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.05

CA SAIL PLUS5x40x130SAE0500401

Facility

$1,413.65

Hospital Charge Code	270635690
Hospital Revenue Code	278
Min. Negotiated Rate	$212.05
Max. Negotiated Rate	$706.83
Rate for Payer: Cigna Commercial	$706.83
Rate for Payer: Aetna Commercial	$424.10
Rate for Payer: Aetna Medicare Advantage	$424.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.05

CA SAIL PLUS5x40x130SAE0500401

Facility

$1,413.65

Hospital Charge Code	270635690V
Hospital Revenue Code	278
Min. Negotiated Rate	$212.05
Max. Negotiated Rate	$342.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.05

CA SAIL PLUS5x40x130SAE0500401

Facility

$1,413.65

Hospital Charge Code	270635690
Hospital Revenue Code	278
Min. Negotiated Rate	$212.05
Max. Negotiated Rate	$342.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.10
Rate for Payer: Qualcare PPO/HMO/WC	$212.05

Know your out-of-pocket cost for care.

All Charges