Heights University Hospital

All Charges

Charge

Type

Setting

Price

CT NEEDLE BIOPSY PANCREAS PERC

Facility

$9,500.00

Service Code	HCPCS 48102
Hospital Charge Code	2205268
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT NEEDLE BIOPSY PLEURA PERC

Facility

$9,500.00

Service Code	HCPCS 32400
Hospital Charge Code	2205201
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 PLEURA PERC

Facility

$9,500.00

Service Code	HCPCS 32400
Hospital Charge Code	2205201
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 PROSTATE PERC

Facility

$5,244.50

Service Code	HCPCS 55700
Hospital Charge Code	2205284
Hospital Revenue Code	361
Min. Negotiated Rate	$681.78
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,573.35
Rate for Payer: Aetna Medicare Advantage	$1,573.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.35
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	$1,337.35
Rate for Payer: Cigna Commercial	$2,622.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$681.78
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$786.67
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CT NEEDLE BIOPSY PROSTATE PERC

Facility

$5,244.50

Service Code	HCPCS 55700
Hospital Charge Code	2205284
Hospital Revenue Code	361
Min. Negotiated Rate	$786.67
Max. Negotiated Rate	$786.67
Rate for Payer: Qualcare PPO/HMO/WC	$786.67

CT NEEDLE BIOPSY RENAL PERC

Facility

$9,500.00

Service Code	HCPCS 50200
Hospital Charge Code	2205276
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 RENAL PERC

Facility

$9,500.00

Service Code	HCPCS 50200
Hospital Charge Code	2205276
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 BX LYMPH NODES BI

Facility

$9,500.00

Service Code	HCPCS 3850550
Hospital Charge Code	2205491
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 BX LYMPH NODES BI

Facility

$9,500.00

Service Code	HCPCS 3850550
Hospital Charge Code	2205491
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 NEPHROSTOMY ST LOCALIZATION

Facility

$1,605.00

Service Code	HCPCS 77011
Hospital Charge Code	2200301
Hospital Revenue Code	350
Min. Negotiated Rate	$208.65
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$481.50
Rate for Payer: Aetna Medicare Advantage	$481.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.27
Rate for Payer: Cigna Commercial	$252.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.65
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.75
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT NEPHROSTOMY ST LOCALIZATION

Facility

$1,605.00

Service Code	HCPCS 77011
Hospital Charge Code	2200301
Hospital Revenue Code	350
Min. Negotiated Rate	$240.75
Max. Negotiated Rate	$240.75
Rate for Payer: Qualcare PPO/HMO/WC	$240.75

CT/NG RNA,TMA,PAP VIAL I

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39990116A
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

CT/NG RNA,TMA,PAP VIAL I

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39990116A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CT/NG RNA,TMA,PAP VIAL II

Facility

$390.00

Service Code	HCPCS 87591
Hospital Charge Code	39990116B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CT/NG RNA,TMA,PAP VIAL II

Facility

$390.00

Service Code	HCPCS 87591
Hospital Charge Code	39990116B
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

CTO DEVICE TRUEPATH

Facility

$9,600.00

Hospital Charge Code	672786
Hospital Revenue Code	278
Min. Negotiated Rate	$1,440.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Aetna Commercial	$2,880.00
Rate for Payer: Aetna Medicare Advantage	$2,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,448.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,448.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,448.00
Rate for Payer: Cigna Commercial	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,323.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,440.00

CTO DEVICE TRUEPATH

Facility

$9,600.00

Hospital Charge Code	672786
Hospital Revenue Code	278
Min. Negotiated Rate	$1,440.00
Max. Negotiated Rate	$2,323.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,323.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,440.00

CTO DEVICE TRUEPATH

Facility

$9,600.00

Service Code	HCPCS C1769
Hospital Charge Code	270672786
Hospital Revenue Code	278
Min. Negotiated Rate	$1,440.00
Max. Negotiated Rate	$2,323.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,323.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,440.00

CTO DEVICE TRUEPATH

Facility

$9,600.00

Service Code	HCPCS C1769
Hospital Charge Code	270672786
Hospital Revenue Code	278
Min. Negotiated Rate	$1,440.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Aetna Commercial	$2,880.00
Rate for Payer: Aetna Medicare Advantage	$2,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,448.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,448.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,448.00
Rate for Payer: Cigna Commercial	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,323.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,440.00

CT ORBIT SELA ETC W/+W/O CNTRT

Facility

$9,500.00

Service Code	HCPCS 70482
Hospital Charge Code	2205410
Hospital Revenue Code	351
Min. Negotiated Rate	$327.25
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	$327.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$417.70
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 ORBIT SELA ETC W/+W/O CNTRT

Facility

$9,500.00

Service Code	HCPCS 70482
Hospital Charge Code	2205410
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 ORBIT SELLA ETC W/ CONTRAST

Facility

$5,288.50

Service Code	HCPCS 70481
Hospital Charge Code	2205411
Hospital Revenue Code	351
Min. Negotiated Rate	$793.27
Max. Negotiated Rate	$793.27
Rate for Payer: Qualcare PPO/HMO/WC	$793.27

CT ORBIT SELLA ETC W/ CONTRAST

Facility

$5,288.50

Service Code	HCPCS 70481
Hospital Charge Code	2205411
Hospital Revenue Code	351
Min. Negotiated Rate	$233.75
Max. Negotiated Rate	$2,773.00
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	$233.75
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

CT ORBIT SELLA ETC W/O CONTRST

Facility

$3,235.85

Service Code	HCPCS 70480
Hospital Charge Code	2205412
Hospital Revenue Code	351
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$970.75
Rate for Payer: Aetna Medicare Advantage	$970.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$825.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$825.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$825.14
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.66
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$485.38
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT ORBIT SELLA ETC W/O CONTRST

Facility

$3,235.85

Service Code	HCPCS 70480
Hospital Charge Code	2205412
Hospital Revenue Code	351
Min. Negotiated Rate	$485.38
Max. Negotiated Rate	$485.38
Rate for Payer: Qualcare PPO/HMO/WC	$485.38

Know your out-of-pocket cost for care.

All Charges