Heights University Hospital

All Charges

Charge

Type

Setting

Price

CT MAXILLOFACIAL W/+W/O CNTRST

Facility

$1,810.20

Service Code	HCPCS 70488
Hospital Charge Code	2205407
Hospital Revenue Code	351
Min. Negotiated Rate	$235.33
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$543.06
Rate for Payer: Aetna Medicare Advantage	$543.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.60
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	$461.60
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.33
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.53
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT MAXILLOFACIAL W/+W/O CNTRST

Facility

$1,810.20

Service Code	HCPCS 70488
Hospital Charge Code	2205407
Hospital Revenue Code	351
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CTM EXTRACELLULAR MATRIX 3X3CM

Facility

$15,015.00

Service Code	HCPCS C1762
Hospital Charge Code	270697515
Hospital Revenue Code	278
Min. Negotiated Rate	$2,252.25
Max. Negotiated Rate	$7,507.50
Rate for Payer: Aetna Commercial	$4,504.50
Rate for Payer: Aetna Medicare Advantage	$4,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,828.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,828.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,828.82
Rate for Payer: Cigna Commercial	$7,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,633.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,252.25

CTM EXTRACELLULAR MATRIX 3X3CM

Facility

$15,015.00

Service Code	HCPCS C1762
Hospital Charge Code	270697515
Hospital Revenue Code	278
Min. Negotiated Rate	$2,252.25
Max. Negotiated Rate	$3,633.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,003.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,633.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,252.25

CTM EXTRACELLULAR MATRIX 4X7CM

Facility

$20,615.00

Service Code	HCPCS C1762
Hospital Charge Code	270696863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,092.25
Max. Negotiated Rate	$10,307.50
Rate for Payer: Aetna Commercial	$6,184.50
Rate for Payer: Aetna Medicare Advantage	$6,184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,256.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,256.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,256.82
Rate for Payer: Cigna Commercial	$10,307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,988.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,092.25

CTM EXTRACELLULAR MATRIX 4X7CM

Facility

$20,615.00

Service Code	HCPCS C1762
Hospital Charge Code	270696863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,092.25
Max. Negotiated Rate	$4,988.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,123.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,988.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,092.25

CTM FLOW CONN TISSUE 4.0ML

Facility

$26,465.00

Service Code	HCPCS C1762
Hospital Charge Code	270697467
Hospital Revenue Code	278
Min. Negotiated Rate	$3,969.75
Max. Negotiated Rate	$13,232.50
Rate for Payer: Aetna Commercial	$7,939.50
Rate for Payer: Aetna Medicare Advantage	$7,939.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,748.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,748.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,748.57
Rate for Payer: Cigna Commercial	$13,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,404.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,969.75

CTM FLOW CONN TISSUE 4.0ML

Facility

$26,465.00

Service Code	HCPCS C1762
Hospital Charge Code	270697467
Hospital Revenue Code	278
Min. Negotiated Rate	$3,969.75
Max. Negotiated Rate	$6,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,404.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,969.75

CTM PASTE TISSUE MATRIX LARGE

Facility

$26,465.00

Service Code	HCPCS C1762
Hospital Charge Code	270697599
Hospital Revenue Code	278
Min. Negotiated Rate	$3,969.75
Max. Negotiated Rate	$13,232.50
Rate for Payer: Aetna Commercial	$7,939.50
Rate for Payer: Aetna Medicare Advantage	$7,939.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,748.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,748.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,748.57
Rate for Payer: Cigna Commercial	$13,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,404.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,969.75

CTM PASTE TISSUE MATRIX LARGE

Facility

$26,465.00

Service Code	HCPCS C1762
Hospital Charge Code	270697599
Hospital Revenue Code	278
Min. Negotiated Rate	$3,969.75
Max. Negotiated Rate	$6,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,404.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,969.75

CT NDL BIOPSY BONE DEEP PERC

Facility

$9,500.00

Service Code	HCPCS 20225
Hospital Charge Code	2205227
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NDL BIOPSY BONE DEEP PERC

Facility

$9,500.00

Service Code	HCPCS 20225
Hospital Charge Code	2205227
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$3,933.12
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CT NDL BIOPSY BONE SUPERFIC

Facility

$9,500.00

Service Code	HCPCS 20220
Hospital Charge Code	2205235
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NDL BIOPSY BONE SUPERFIC

Facility

$9,500.00

Service Code	HCPCS 20220
Hospital Charge Code	2205235
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$3,933.12
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

CT NECK WO C

Facility

$9,500.00

Service Code	HCPCS 70490
Hospital Charge Code	2200186
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NECK WO C

Facility

$9,500.00

Service Code	HCPCS 70490
Hospital Charge Code	2200186
Hospital Revenue Code	351
Min. Negotiated Rate	$233.75
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	$233.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$248.96
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 NEEDLE BIOPSY ABD/RETROPERI

Facility

$9,500.00

Service Code	HCPCS 49180
Hospital Charge Code	2205219
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NEEDLE BIOPSY ABD/RETROPERI

Facility

$9,500.00

Service Code	HCPCS 49180
Hospital Charge Code	2205219
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$3,933.12
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CT NEEDLE BIOPSY LIVER PERC

Facility

$9,500.00

Service Code	HCPCS 47000
Hospital Charge Code	2205243
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NEEDLE BIOPSY LIVER PERC

Facility

$9,500.00

Service Code	HCPCS 47000
Hospital Charge Code	2205243
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$3,933.12
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CT NEEDLE BIOPSY LUNG/MED PERC

Facility

$9,500.00

Service Code	HCPCS 32405
Hospital Charge Code	2205193
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$4,750.00
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NEEDLE BIOPSY LUNG/MED PERC

Facility

$9,500.00

Service Code	HCPCS 32405
Hospital Charge Code	2205193
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NEEDLE BIOPSY MUSCLE PERC

Facility

$4,709.90

Service Code	HCPCS 20206
Hospital Charge Code	2205250
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

CT NEEDLE BIOPSY MUSCLE PERC

Facility

$4,709.90

Service Code	HCPCS 20206
Hospital Charge Code	2205250
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CT NEEDLE BIOPSY PANCREAS PERC

Facility

$9,500.00

Service Code	HCPCS 48102
Hospital Charge Code	2205268
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
Max. Negotiated Rate	$3,933.12
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Know your out-of-pocket cost for care.

All Charges