Heights University Hospital

All Charges

Charge

Type

Setting

Price

CT SINUS W/ CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70487
Hospital Charge Code	2205426
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	$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 SINUS W/ CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70487
Hospital Charge Code	2205426
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 SINUS W HEADSET

Facility

$9,500.00

Service Code	HCPCS 70486
Hospital Charge Code	2250423
Hospital Revenue Code	351
Min. Negotiated Rate	$248.96
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	$257.12
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 SINUS W HEADSET

Facility

$9,500.00

Service Code	HCPCS 70486
Hospital Charge Code	2250423
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 SINUS W/O CONTRAST

Facility

$1,120.75

Service Code	HCPCS 70486
Hospital Charge Code	2205427
Hospital Revenue Code	351
Min. Negotiated Rate	$168.11
Max. Negotiated Rate	$168.11
Rate for Payer: Qualcare PPO/HMO/WC	$168.11

CT SINUS W/O CONTRAST

Facility

$1,120.75

Service Code	HCPCS 70486
Hospital Charge Code	2205427
Hospital Revenue Code	351
Min. Negotiated Rate	$145.70
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$336.23
Rate for Payer: Aetna Medicare Advantage	$336.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.79
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	$285.79
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.70
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.11
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT SINUS W/O HEADSET

Facility

$9,500.00

Service Code	HCPCS 70486
Hospital Charge Code	2250422
Hospital Revenue Code	351
Min. Negotiated Rate	$248.96
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	$257.12
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 SINUS W/O HEADSET

Facility

$9,500.00

Service Code	HCPCS 70486
Hospital Charge Code	2250422
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 SINUS W&W/O CONTRAST

Facility

$1,217.65

Service Code	HCPCS 70487
Hospital Charge Code	2200270
Hospital Revenue Code	351
Min. Negotiated Rate	$158.29
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$365.30
Rate for Payer: Aetna Medicare Advantage	$365.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.50
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	$310.50
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.29
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.65
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT SINUS W&W/O CONTRAST

Facility

$1,217.65

Service Code	HCPCS 70487
Hospital Charge Code	2200270
Hospital Revenue Code	351
Min. Negotiated Rate	$182.65
Max. Negotiated Rate	$182.65
Rate for Payer: Qualcare PPO/HMO/WC	$182.65

CT SINUS W/ & W/O CONTRAST

Facility

$1,810.20

Service Code	HCPCS 70488
Hospital Charge Code	2205425
Hospital Revenue Code	351
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CT SINUS W/ & W/O CONTRAST

Facility

$1,810.20

Service Code	HCPCS 70488
Hospital Charge Code	2205425
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 SOFT TIISUE NECK W CONT

Facility

$9,500.00

Service Code	HCPCS 70491
Hospital Charge Code	2205288
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 SOFT TIISUE NECK W CONT

Facility

$9,500.00

Service Code	HCPCS 70491
Hospital Charge Code	2205288
Hospital Revenue Code	351
Min. Negotiated Rate	$276.33
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	$276.33
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 SOFT TISSUE NECK W & WO CON

Facility

$9,500.00

Service Code	HCPCS 70492
Hospital Charge Code	2205290
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 SOFT TISSUE NECK W & WO CON

Facility

$9,500.00

Service Code	HCPCS 70492
Hospital Charge Code	2205290
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 THORACENTESIS FOR ASP INIT

Facility

$9,500.00

Service Code	HCPCS 32555
Hospital Charge Code	2205144
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.00
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$1,493.86
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 THORACENTESIS FOR ASP INIT

Facility

$9,500.00

Service Code	HCPCS 32555
Hospital Charge Code	2205144
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 THORACENTESIS/TUBE INSERT

Facility

$2,422.65

Hospital Charge Code	2205312
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

CT THORACENTESIS/TUBE INSERT

Facility

$2,422.65

Hospital Charge Code	2205312
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
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	$617.78
Rate for Payer: Cigna Commercial	$1,211.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

CT THORACIC SPINE W/CONTR

Facility

$9,500.00

Service Code	HCPCS 72129
Hospital Charge Code	2205151
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT THORACIC SPINE W/CONTR

Facility

$9,500.00

Service Code	HCPCS 72129
Hospital Charge Code	2205151
Hospital Revenue Code	352
Min. Negotiated Rate	$318.24
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Better Health Medicaid	$940.08
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	$318.24
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88

CT THORACIC SPINE W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 72128
Hospital Charge Code	2200129
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT THORACIC SPINE W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 72128
Hospital Charge Code	2200129
Hospital Revenue Code	352
Min. Negotiated Rate	$233.75
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Better Health Medicaid	$399.68
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.67

CT THORACIC SPINE W & WO CONT

Facility

$5,288.50

Service Code	HCPCS 72130
Hospital Charge Code	2205286
Hospital Revenue Code	352
Min. Negotiated Rate	$327.25
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	$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

Know your out-of-pocket cost for care.

All Charges