Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$793.27
Max. Negotiated Rate	$793.27
Rate for Payer: Qualcare PPO/HMO/WC	$793.27

CT THORAX LUNG CA SCR

Facility

$488.65

Service Code	HCPCS 71271
Hospital Charge Code	404371271
Hospital Revenue Code	352
Min. Negotiated Rate	$73.30
Max. Negotiated Rate	$73.30
Rate for Payer: Qualcare PPO/HMO/WC	$73.30

CT THORAX LUNG CA SCR

Facility

$488.65

Service Code	HCPCS 71271
Hospital Charge Code	404371271
Hospital Revenue Code	352
Min. Negotiated Rate	$63.52
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$146.59
Rate for Payer: Aetna Medicare Advantage	$146.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.61
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.52
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.30
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT THYROID BIOPSY PERC CORE

Facility

$9,500.00

Service Code	HCPCS 60100
Hospital Charge Code	2101142
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 THYROID BIOPSY PERC CORE

Facility

$9,500.00

Service Code	HCPCS 60100
Hospital Charge Code	2101142
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	$1,686.34
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 TIBIA/FIBLA W/O CNTRST LEFT

Facility

$1,120.75

Service Code	HCPCS 73700
Hospital Charge Code	2205435
Hospital Revenue Code	352
Min. Negotiated Rate	$168.11
Max. Negotiated Rate	$168.11
Rate for Payer: Qualcare PPO/HMO/WC	$168.11

CT TIBIA/FIBLA W/O CNTRST LEFT

Facility

$1,120.75

Service Code	HCPCS 73700
Hospital Charge Code	2205435
Hospital Revenue Code	352
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	$233.75
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 TIBIA/FIBLA W/O CNTST RIGHT

Facility

$1,120.75

Service Code	HCPCS 73700
Hospital Charge Code	2205436
Hospital Revenue Code	352
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	$233.75
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 TIBIA/FIBLA W/O CNTST RIGHT

Facility

$1,120.75

Service Code	HCPCS 73700
Hospital Charge Code	2205436
Hospital Revenue Code	352
Min. Negotiated Rate	$168.11
Max. Negotiated Rate	$168.11
Rate for Payer: Qualcare PPO/HMO/WC	$168.11

CT TIBIA/FIBLA W&W/O CNTST LFT

Facility

$1,810.20

Service Code	HCPCS 73702LT
Hospital Charge Code	2205429
Hospital Revenue Code	352
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CT TIBIA/FIBLA W&W/O CNTST LFT

Facility

$1,810.20

Service Code	HCPCS 73702LT
Hospital Charge Code	2205429
Hospital Revenue Code	352
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) PPO	$461.60
Rate for Payer: Cigna Commercial	$905.10
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 TIBIA/FIBLA W&W/O CNTST RGT

Facility

$1,810.20

Service Code	HCPCS 73702RT
Hospital Charge Code	2205430
Hospital Revenue Code	352
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CT TIBIA/FIBLA W&W/O CNTST RGT

Facility

$1,810.20

Service Code	HCPCS 73702RT
Hospital Charge Code	2205430
Hospital Revenue Code	352
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) PPO	$461.60
Rate for Payer: Cigna Commercial	$905.10
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 TIBIA/FIBULA W/ CNTRST LEFT

Facility

$1,810.20

Service Code	HCPCS 73701LT
Hospital Charge Code	2205432
Hospital Revenue Code	352
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) PPO	$461.60
Rate for Payer: Cigna Commercial	$905.10
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 TIBIA/FIBULA W/ CNTRST LEFT

Facility

$1,810.20

Service Code	HCPCS 73701LT
Hospital Charge Code	2205432
Hospital Revenue Code	352
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CT TIBIA/FIBULA W/ CNTRST RGHT

Facility

$1,810.20

Service Code	HCPCS 73701RT
Hospital Charge Code	2205433
Hospital Revenue Code	352
Min. Negotiated Rate	$271.53
Max. Negotiated Rate	$271.53
Rate for Payer: Qualcare PPO/HMO/WC	$271.53

CT TIBIA/FIBULA W/ CNTRST RGHT

Facility

$1,810.20

Service Code	HCPCS 73701RT
Hospital Charge Code	2205433
Hospital Revenue Code	352
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) PPO	$461.60
Rate for Payer: Cigna Commercial	$905.10
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 TIBIA/FIBULA W/ CNTST BLTRL

Facility

$3,620.40

Service Code	HCPCS 7370150
Hospital Charge Code	2205431
Hospital Revenue Code	352
Min. Negotiated Rate	$470.65
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$1,086.12
Rate for Payer: Aetna Medicare Advantage	$1,086.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$923.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$923.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$923.20
Rate for Payer: Cigna Commercial	$1,810.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.65
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.06
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT TIBIA/FIBULA W/ CNTST BLTRL

Facility

$3,620.40

Service Code	HCPCS 7370150
Hospital Charge Code	2205431
Hospital Revenue Code	352
Min. Negotiated Rate	$543.06
Max. Negotiated Rate	$543.06
Rate for Payer: Qualcare PPO/HMO/WC	$543.06

CT TIBIA/FIB W&W/O CNTST BLTRL

Facility

$3,620.40

Service Code	HCPCS 7370250
Hospital Charge Code	2205428
Hospital Revenue Code	352
Min. Negotiated Rate	$470.65
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$1,086.12
Rate for Payer: Aetna Medicare Advantage	$1,086.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$923.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$923.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$923.20
Rate for Payer: Cigna Commercial	$1,810.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.65
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.06
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT TIBIA/FIB W&W/O CNTST BLTRL

Facility

$3,620.40

Service Code	HCPCS 7370250
Hospital Charge Code	2205428
Hospital Revenue Code	352
Min. Negotiated Rate	$543.06
Max. Negotiated Rate	$543.06
Rate for Payer: Qualcare PPO/HMO/WC	$543.06

CT TISSUE ABLATION MONITORING

Facility

$1,605.00

Service Code	HCPCS 77013
Hospital Charge Code	2690275
Hospital Revenue Code	350
Min. Negotiated Rate	$240.75
Max. Negotiated Rate	$240.75
Rate for Payer: Qualcare PPO/HMO/WC	$240.75

CT TISSUE ABLATION MONITORING

Facility

$1,605.00

Service Code	HCPCS 77013
Hospital Charge Code	2690275
Hospital Revenue Code	350
Min. Negotiated Rate	$80.50
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	$80.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.27
Rate for Payer: Cigna Commercial	$802.50
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 TX PROX HUMERAL FX,W MANIP

Facility

$14,872.30

Service Code	HCPCS 23605
Hospital Charge Code	1600000531
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$4,461.69
Rate for Payer: Aetna Medicare Advantage	$4,461.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,792.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,792.44
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	$3,792.44
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.40
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,230.84
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CT TX PROX HUMERAL FX,W MANIP

Facility

$14,872.30

Service Code	HCPCS 23605
Hospital Charge Code	1600000531
Hospital Revenue Code	360
Min. Negotiated Rate	$2,230.84
Max. Negotiated Rate	$2,230.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,230.84

Know your out-of-pocket cost for care.

All Charges