Heights University Hospital

All Charges

Charge

Type

Setting

Price

CT CARDIAC CONGENITAL

Facility

$1,555.10

Service Code	HCPCS 75573
Hospital Charge Code	2208010
Hospital Revenue Code	352
Min. Negotiated Rate	$202.16
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$466.53
Rate for Payer: Aetna Medicare Advantage	$466.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.55
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.16
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CARDIAC CONGENITAL

Facility

$1,555.10

Service Code	HCPCS 75573
Hospital Charge Code	2208010
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CARDIAC CORONARY CALCIUM

Facility

$521.15

Service Code	HCPCS 75571
Hospital Charge Code	2208001
Hospital Revenue Code	352
Min. Negotiated Rate	$78.17
Max. Negotiated Rate	$78.17
Rate for Payer: Qualcare PPO/HMO/WC	$78.17

CT CARDIAC CORONARY CALCIUM

Facility

$521.15

Service Code	HCPCS 75571
Hospital Charge Code	2208001
Hospital Revenue Code	352
Min. Negotiated Rate	$67.75
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$156.34
Rate for Payer: Aetna Medicare Advantage	$156.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.89
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.75
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.17
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CARDIAC CORONARY CTA

Facility

$1,555.10

Service Code	HCPCS 75574
Hospital Charge Code	2207005
Hospital Revenue Code	352
Min. Negotiated Rate	$202.16
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$466.53
Rate for Payer: Aetna Medicare Advantage	$466.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$521.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.55
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.16
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CARDIAC CORONARY CTA

Facility

$1,555.10

Service Code	HCPCS 75574
Hospital Charge Code	2207005
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CARDIAC SCORING

Facility

$880.85

Service Code	HCPCS 71250
Hospital Charge Code	2200110
Hospital Revenue Code	352
Min. Negotiated Rate	$114.51
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$264.25
Rate for Payer: Aetna Medicare Advantage	$264.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.62
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.51
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.13
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CARDIAC SCORING

Facility

$880.85

Service Code	HCPCS 71250
Hospital Charge Code	2200110
Hospital Revenue Code	352
Min. Negotiated Rate	$132.13
Max. Negotiated Rate	$132.13
Rate for Payer: Qualcare PPO/HMO/WC	$132.13

CT CARDIAC SRUCT MORPHOLOGY

Facility

$1,555.10

Service Code	HCPCS 75572
Hospital Charge Code	2208005
Hospital Revenue Code	352
Min. Negotiated Rate	$202.16
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$466.53
Rate for Payer: Aetna Medicare Advantage	$466.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.55
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.16
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CARDIAC SRUCT MORPHOLOGY

Facility

$1,555.10

Service Code	HCPCS 75572
Hospital Charge Code	2208005
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CERE PRFU ALYS C+W/CT/CTA

Facility

$1,041.90

Service Code	HCPCS 70473
Hospital Charge Code	404370473
Hospital Revenue Code	359
Min. Negotiated Rate	$156.28
Max. Negotiated Rate	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$156.28

CT CERE PRFU ALYS C+W/CT/CTA

Facility

$1,041.90

Service Code	HCPCS 70473
Hospital Charge Code	404370473
Hospital Revenue Code	359
Min. Negotiated Rate	$135.45
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$312.57
Rate for Payer: Aetna Medicare Advantage	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.68
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.45
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.28
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CERE PRFU ALYSC+WCT/CTA

Facility

$1,041.90

Service Code	HCPCS 70472
Hospital Charge Code	404370472
Hospital Revenue Code	359
Min. Negotiated Rate	$156.28
Max. Negotiated Rate	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$156.28

CT CERE PRFU ALYSC+WCT/CTA

Facility

$1,041.90

Service Code	HCPCS 70472
Hospital Charge Code	404370472
Hospital Revenue Code	359
Min. Negotiated Rate	$126.69
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$312.57
Rate for Payer: Aetna Medicare Advantage	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.68
Rate for Payer: Cigna Commercial	$178.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.45
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.28
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CERVICAL SPINE W/O & W C

Facility

$5,288.50

Service Code	HCPCS 72127
Hospital Charge Code	2200139
Hospital Revenue Code	352
Min. Negotiated Rate	$793.27
Max. Negotiated Rate	$793.27
Rate for Payer: Qualcare PPO/HMO/WC	$793.27

CT CERVICAL SPINE W/O & W C

Facility

$5,288.50

Service Code	HCPCS 72127
Hospital Charge Code	2200139
Hospital Revenue Code	352
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Better Health Medicaid	$940.08
Rate for Payer: Aetna Commercial	$1,586.55
Rate for Payer: Aetna Medicare Advantage	$1,586.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,348.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,348.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,348.57
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$687.50
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$793.27
Rate for Payer: UnitedHealthcare Commercial	$2,773.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88

CT COLON SCREENING

Facility

$1,060.85

Service Code	HCPCS 74150
Hospital Charge Code	2205190
Hospital Revenue Code	352
Min. Negotiated Rate	$159.13
Max. Negotiated Rate	$159.13
Rate for Payer: Qualcare PPO/HMO/WC	$159.13

CT COLON SCREENING

Facility

$1,060.85

Service Code	HCPCS 74150
Hospital Charge Code	2205190
Hospital Revenue Code	352
Min. Negotiated Rate	$137.91
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$318.25
Rate for Payer: Aetna Medicare Advantage	$318.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.52
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.91
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.13
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT CYST ASPIRATION

Facility

$9,500.00

Service Code	HCPCS 77012
Hospital Charge Code	2200400
Hospital Revenue Code	350
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT CYST ASPIRATION

Facility

$9,500.00

Service Code	HCPCS 77012
Hospital Charge Code	2200400
Hospital Revenue Code	350
Min. Negotiated Rate	$137.54
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$137.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT DENTASCAN RECONTST

Facility

$1,194.45

Service Code	HCPCS 76376
Hospital Charge Code	2200442
Hospital Revenue Code	359
Min. Negotiated Rate	$179.17
Max. Negotiated Rate	$179.17
Rate for Payer: Qualcare PPO/HMO/WC	$179.17

CT DENTASCAN RECONTST

Facility

$1,194.45

Service Code	HCPCS 76376
Hospital Charge Code	2200442
Hospital Revenue Code	359
Min. Negotiated Rate	$28.74
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$358.33
Rate for Payer: Aetna Medicare Advantage	$358.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$304.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$304.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$304.58
Rate for Payer: Cigna Commercial	$28.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$179.17
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT DRAINAGE TRAY

Facility

$720.00

Hospital Charge Code	270669755R
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

CT DRAINAGE TRAY

Facility

$720.00

Hospital Charge Code	270669755
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

CT DRAINAGE TRAY

Facility

$650.00

Hospital Charge Code	270669755N
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

Know your out-of-pocket cost for care.

All Charges