Heights University Hospital

All Charges

Charge

Type

Setting

Price

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	404632408L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	321032408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	404632408R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	404632408L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	321032408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404332408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	321032408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404632408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	404632408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404232408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404632408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	404632408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404232408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	321032408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	321032408R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	321032408L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	404632408R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404332408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,104.87
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,549.70
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CORE NEEDLE BX EQUIPMENT

Facility

$237.00

Hospital Charge Code	2008135
Hospital Revenue Code	272
Min. Negotiated Rate	$30.81
Max. Negotiated Rate	$118.50
Rate for Payer: Aetna Commercial	$71.10
Rate for Payer: Aetna Medicare Advantage	$71.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.44
Rate for Payer: Cigna Commercial	$118.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.81
Rate for Payer: Oxford Commercial	$118.50
Rate for Payer: Qualcare PPO/HMO/WC	$35.55
Rate for Payer: UnitedHealthcare Commercial	$118.50

CORE NEEDLE BX EQUIPMENT

Facility

$237.00

Hospital Charge Code	2008135
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$35.55
Rate for Payer: Qualcare PPO/HMO/WC	$35.55

CORETRAK 40MM EXF

Facility

$11,710.00

Hospital Charge Code	270685123
Hospital Revenue Code	272
Min. Negotiated Rate	$1,522.30
Max. Negotiated Rate	$5,855.00
Rate for Payer: Aetna Commercial	$3,513.00
Rate for Payer: Aetna Medicare Advantage	$3,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,986.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,986.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,986.05
Rate for Payer: Cigna Commercial	$5,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,522.30
Rate for Payer: Oxford Commercial	$5,855.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,756.50
Rate for Payer: UnitedHealthcare Commercial	$5,855.00

CORETRAK 40MM EXF

Facility

$11,710.00

Hospital Charge Code	270685123
Hospital Revenue Code	272
Min. Negotiated Rate	$1,756.50
Max. Negotiated Rate	$1,756.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,756.50

CORETRAK STERIPACK D 40MM

Facility

$15,786.00

Hospital Charge Code	270702950
Hospital Revenue Code	270
Min. Negotiated Rate	$2,367.90
Max. Negotiated Rate	$2,367.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,367.90

CORETRAK STERIPACK D 40MM

Facility

$15,786.00

Hospital Charge Code	270702950
Hospital Revenue Code	270
Min. Negotiated Rate	$2,052.18
Max. Negotiated Rate	$7,893.00
Rate for Payer: Aetna Commercial	$4,735.80
Rate for Payer: Aetna Medicare Advantage	$4,735.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,025.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,025.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,025.43
Rate for Payer: Cigna Commercial	$7,893.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.18
Rate for Payer: Oxford Commercial	$7,893.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,367.90
Rate for Payer: UnitedHealthcare Commercial	$7,893.00

CORETRAK STERIPACK D 70MM

Facility

$18,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270699897
Hospital Revenue Code	278
Min. Negotiated Rate	$2,709.75
Max. Negotiated Rate	$9,032.50
Rate for Payer: Aetna Commercial	$5,419.50
Rate for Payer: Aetna Medicare Advantage	$5,419.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,606.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,606.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,613.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,606.57
Rate for Payer: Cigna Commercial	$9,032.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,371.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,709.75

Know your out-of-pocket cost for care.

All Charges