Heights University Hospital

All Charges

Charge

Type

Setting

Price

COMPLETE BLOOD COUNT (CBC)

Facility

$861.62

Service Code	HCPCS 85025
Hospital Charge Code	3005402
Hospital Revenue Code	305
Min. Negotiated Rate	$129.24
Max. Negotiated Rate	$129.24
Rate for Payer: Qualcare PPO/HMO/WC	$129.24

COMPLETE BLOOD COUNT (CBC) RPT

Facility

$909.02

Service Code	HCPCS 8502591
Hospital Charge Code	3005402R
Hospital Revenue Code	305
Min. Negotiated Rate	$136.35
Max. Negotiated Rate	$136.35
Rate for Payer: Qualcare PPO/HMO/WC	$136.35

COMPLETE BLOOD COUNT (CBC) RPT

Facility

$531.04

Service Code	HCPCS 8502591
Hospital Charge Code	3005405
Hospital Revenue Code	305
Min. Negotiated Rate	$69.04
Max. Negotiated Rate	$265.52
Rate for Payer: Aetna Commercial	$159.31
Rate for Payer: Aetna Medicare Advantage	$159.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.42
Rate for Payer: Cigna Commercial	$265.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.66
Rate for Payer: UnitedHealthcare Commercial	$114.00

COMPLETE BLOOD COUNT (CBC) RPT

Facility

$909.02

Service Code	HCPCS 8502591
Hospital Charge Code	3005402R
Hospital Revenue Code	305
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$454.51
Rate for Payer: Aetna Commercial	$272.71
Rate for Payer: Aetna Medicare Advantage	$272.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.80
Rate for Payer: Cigna Commercial	$454.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

COMPLETE BLOOD COUNT (CBC) RPT

Facility

$531.04

Service Code	HCPCS 8502591
Hospital Charge Code	3005405
Hospital Revenue Code	305
Min. Negotiated Rate	$79.66
Max. Negotiated Rate	$79.66
Rate for Payer: Qualcare PPO/HMO/WC	$79.66

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	5100144
Hospital Revenue Code	481
Min. Negotiated Rate	$2,104.70
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$4,857.00
Rate for Payer: Aetna Medicare Advantage	$4,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.45
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	366893453
Hospital Revenue Code	481
Min. Negotiated Rate	$2,104.70
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$4,857.00
Rate for Payer: Aetna Medicare Advantage	$4,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.45
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	366893453
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	5100144
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	74110017
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

COMPLETE HEART CATH

Facility

$16,190.00

Service Code	HCPCS 93453
Hospital Charge Code	74110017
Hospital Revenue Code	481
Min. Negotiated Rate	$2,104.70
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$4,857.00
Rate for Payer: Aetna Medicare Advantage	$4,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.45
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,104.70
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COMPLETER GUIDE FOR

Facility

$977.30

Hospital Charge Code	27065910
Hospital Revenue Code	271
Min. Negotiated Rate	$146.59
Max. Negotiated Rate	$146.59
Rate for Payer: Qualcare PPO/HMO/WC	$146.59

COMPLETER GUIDE FOR

Facility

$977.30

Hospital Charge Code	27065910
Hospital Revenue Code	271
Min. Negotiated Rate	$127.05
Max. Negotiated Rate	$488.65
Rate for Payer: Aetna Commercial	$293.19
Rate for Payer: Aetna Medicare Advantage	$293.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.21
Rate for Payer: Cigna Commercial	$488.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Oxford Commercial	$488.65
Rate for Payer: Qualcare PPO/HMO/WC	$146.59
Rate for Payer: UnitedHealthcare Commercial	$488.65

COMPLEX AORTIC ARCH PROCEDURES

Facility

$381,668.58

Service Code	MSDRG 209
Min. Negotiated Rate	$107,780.27
Max. Negotiated Rate	$381,668.58
Rate for Payer: Aetna Commercial	$381,668.58
Rate for Payer: Aetna Medicare Advantage	$123,517.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$113,452.92
Rate for Payer: Cigna Commercial	$243,591.89
Rate for Payer: Cigna Medicare Advantage	$113,452.92
Rate for Payer: Clover Medicare Advantage	$107,780.27
Rate for Payer: EmblemHealth Commercial	$340,358.76
Rate for Payer: Humana Medicare Advantage	$116,856.51
Rate for Payer: Oxford Commercial	$152,237.86
Rate for Payer: UnitedHealthcare Commercial	$172,804.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$113,452.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$120,260.10
Rate for Payer: Wellcare Medicare Advantage	$113,452.92

COMPL EXC 5TH METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28113
Hospital Charge Code	16000513
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

COMPL EXC 5TH METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28113
Hospital Charge Code	16000513
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

COMPL EXC 5TH METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28113
Hospital Charge Code	1600000624
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

COMPL EXC 5TH METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28113
Hospital Charge Code	1600000624
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

COMPL EXC OTHR METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28112
Hospital Charge Code	16000450
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

COMPL EXC OTHR METATRSL HEAD

Facility

$19,998.60

Service Code	HCPCS 28112
Hospital Charge Code	16000450
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

COMPLICATED PEPTIC ULCER WITH CC

Facility

$43,271.61

Service Code	MSDRG 381
Min. Negotiated Rate	$11,823.78
Max. Negotiated Rate	$43,271.61
Rate for Payer: Aetna Commercial	$36,535.48
Rate for Payer: Aetna Medicare Advantage	$11,823.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,496.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,496.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,423.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,496.69
Rate for Payer: Cigna Commercial	$23,318.00
Rate for Payer: Cigna Medicare Advantage	$14,423.87
Rate for Payer: Clover Medicare Advantage	$13,702.68
Rate for Payer: EmblemHealth Commercial	$43,271.61
Rate for Payer: Humana Medicare Advantage	$14,856.59
Rate for Payer: Oxford Commercial	$14,573.08
Rate for Payer: UnitedHealthcare Commercial	$16,541.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,423.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15,289.30
Rate for Payer: Wellcare Medicare Advantage	$14,423.87

COMPLICATED PEPTIC ULCER WITH MCC

Facility

$68,776.53

Service Code	MSDRG 380
Min. Negotiated Rate	$21,412.67
Max. Negotiated Rate	$68,776.53
Rate for Payer: Aetna Commercial	$66,165.15
Rate for Payer: Aetna Medicare Advantage	$21,412.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,755.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,755.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,925.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,755.65
Rate for Payer: Cigna Commercial	$42,228.51
Rate for Payer: Cigna Medicare Advantage	$22,925.51
Rate for Payer: Clover Medicare Advantage	$21,779.23
Rate for Payer: EmblemHealth Commercial	$68,776.53
Rate for Payer: Humana Medicare Advantage	$23,613.28
Rate for Payer: Oxford Commercial	$26,391.59
Rate for Payer: UnitedHealthcare Commercial	$29,956.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,925.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24,301.04
Rate for Payer: Wellcare Medicare Advantage	$22,925.51

COMPLICATED PEPTIC ULCER WITHOUT CC/MCC

Facility

$35,060.22

Service Code	MSDRG 382
Min. Negotiated Rate	$8,736.61
Max. Negotiated Rate	$35,060.22
Rate for Payer: Aetna Commercial	$26,996.12
Rate for Payer: Aetna Medicare Advantage	$8,736.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,950.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,950.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,686.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,950.92
Rate for Payer: Cigna Commercial	$17,229.71
Rate for Payer: Cigna Medicare Advantage	$11,686.74
Rate for Payer: Clover Medicare Advantage	$11,102.40
Rate for Payer: EmblemHealth Commercial	$35,060.22
Rate for Payer: Humana Medicare Advantage	$12,037.34
Rate for Payer: Oxford Commercial	$10,768.07
Rate for Payer: UnitedHealthcare Commercial	$12,222.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,686.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,387.94
Rate for Payer: Wellcare Medicare Advantage	$11,686.74

COMPLICATIONS OF TREATMENT WITH CC

Facility

$40,914.72

Service Code	MSDRG 920
Min. Negotiated Rate	$10,937.68
Max. Negotiated Rate	$40,914.72
Rate for Payer: Aetna Commercial	$33,797.43
Rate for Payer: Aetna Medicare Advantage	$10,937.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,394.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,394.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,638.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,394.01
Rate for Payer: Cigna Commercial	$21,570.50
Rate for Payer: Cigna Medicare Advantage	$13,638.24
Rate for Payer: Clover Medicare Advantage	$12,956.33
Rate for Payer: EmblemHealth Commercial	$40,914.72
Rate for Payer: Humana Medicare Advantage	$14,047.39
Rate for Payer: Oxford Commercial	$13,480.93
Rate for Payer: UnitedHealthcare Commercial	$15,302.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,638.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,456.53
Rate for Payer: Wellcare Medicare Advantage	$13,638.24

COMPLICATIONS OF TREATMENT WITH MCC

Facility

$64,962.54

Service Code	MSDRG 919
Min. Negotiated Rate	$19,978.76
Max. Negotiated Rate	$64,962.54
Rate for Payer: Aetna Commercial	$61,734.37
Rate for Payer: Aetna Medicare Advantage	$19,978.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,171.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,171.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,654.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,171.94
Rate for Payer: Cigna Commercial	$39,400.65
Rate for Payer: Cigna Medicare Advantage	$21,654.18
Rate for Payer: Clover Medicare Advantage	$20,571.47
Rate for Payer: EmblemHealth Commercial	$64,962.54
Rate for Payer: Humana Medicare Advantage	$22,303.81
Rate for Payer: Oxford Commercial	$24,624.26
Rate for Payer: UnitedHealthcare Commercial	$27,950.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,654.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,953.43
Rate for Payer: Wellcare Medicare Advantage	$21,654.18

Know your out-of-pocket cost for care.

All Charges