Heights University Hospital

All Charges

Charge

Type

Setting

Price

CYSTOCATH 8FR *******

Facility

$166.00

Hospital Charge Code	8000424
Hospital Revenue Code	279
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$24.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

CYSTOCATH SUPRAPUBIC 12FR

Facility

$283.00

Service Code	HCPCS C2627
Hospital Charge Code	270331132
Hospital Revenue Code	278
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$141.50
Rate for Payer: Aetna Commercial	$84.90
Rate for Payer: Aetna Medicare Advantage	$84.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.17
Rate for Payer: Cigna Commercial	$141.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.49
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

CYSTOCATH SUPRAPUBIC 12FR

Facility

$283.00

Service Code	HCPCS C2627
Hospital Charge Code	270331132
Hospital Revenue Code	278
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$68.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.49
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

CYSTO RX BALO CATH URTL STRX

Facility

$29,933.90

Service Code	HCPCS 52284
Hospital Charge Code	1600000402
Hospital Revenue Code	360
Min. Negotiated Rate	$4,490.09
Max. Negotiated Rate	$4,490.09
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09

CYSTO RX BALO CATH URTL STRX

Facility

$29,933.90

Service Code	HCPCS 52284
Hospital Charge Code	1600000402
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,768.54
Rate for Payer: Aetna Commercial	$8,980.17
Rate for Payer: Aetna Medicare Advantage	$8,980.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,633.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,633.14
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	$7,633.14
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,891.41
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CYSTOSCOPE AND TREATMENT

Facility

$9,649.80

Service Code	HCPCS 53210
Hospital Charge Code	1600000441
Hospital Revenue Code	360
Min. Negotiated Rate	$1,447.47
Max. Negotiated Rate	$1,447.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.47

CYSTOSCOPE AND TREATMENT

Facility

$9,649.80

Service Code	HCPCS 53210
Hospital Charge Code	1600000441
Hospital Revenue Code	360
Min. Negotiated Rate	$1,254.47
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$2,894.94
Rate for Payer: Aetna Medicare Advantage	$2,894.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,460.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,460.70
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	$2,460.70
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.47
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.47
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

CYSTOSCOPY AND TREATMENT

Facility

$15,511.63

Service Code	HCPCS 52281
Hospital Charge Code	160000205
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$4,653.49
Rate for Payer: Aetna Medicare Advantage	$4,653.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,955.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,955.47
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	$3,955.47
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,016.51
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,326.74
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CYSTOSCOPY AND TREATMENT

Facility

$23,841.70

Service Code	HCPCS 52214
Hospital Charge Code	1600000274
Hospital Revenue Code	360
Min. Negotiated Rate	$3,576.26
Max. Negotiated Rate	$3,576.26
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26

CYSTOSCOPY AND TREATMENT

Facility

$23,841.70

Service Code	HCPCS 52214
Hospital Charge Code	1600000274
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$7,152.51
Rate for Payer: Aetna Medicare Advantage	$7,152.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,079.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,079.63
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	$6,079.63
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,099.42
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CYSTOSCOPY AND TREATMENT

Facility

$7,953.26

Service Code	HCPCS 52260
Hospital Charge Code	1600000489
Hospital Revenue Code	360
Min. Negotiated Rate	$1,192.99
Max. Negotiated Rate	$1,192.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.99

CYSTOSCOPY AND TREATMENT

Facility

$15,511.63

Service Code	HCPCS 52281
Hospital Charge Code	160000205
Hospital Revenue Code	360
Min. Negotiated Rate	$2,326.74
Max. Negotiated Rate	$2,326.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,326.74

CYSTOSCOPY AND TREATMENT

Facility

$7,953.26

Service Code	HCPCS 52260
Hospital Charge Code	1600000489
Hospital Revenue Code	360
Min. Negotiated Rate	$1,033.92
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,385.98
Rate for Payer: Aetna Medicare Advantage	$2,385.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,028.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,028.08
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	$2,028.08
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.92
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.99
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CYSTOSCOPY CHEMODENERVATION

Facility

$8,304.76

Service Code	HCPCS 52287
Hospital Charge Code	1600000819
Hospital Revenue Code	360
Min. Negotiated Rate	$1,079.62
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,491.43
Rate for Payer: Aetna Medicare Advantage	$2,491.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,117.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,117.71
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	$2,117.71
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.62
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CYSTOSCOPY CHEMODENERVATION

Facility

$8,304.76

Service Code	HCPCS 52287
Hospital Charge Code	1600000819
Hospital Revenue Code	360
Min. Negotiated Rate	$1,245.71
Max. Negotiated Rate	$1,245.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71

CYSTOSCOPY CHEMODENERVATION

Facility

$8,304.76

Service Code	HCPCS 52287
Hospital Charge Code	160000175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,245.71
Max. Negotiated Rate	$1,245.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71

CYSTOSCOPY CHEMODENERVATION

Facility

$8,304.76

Service Code	HCPCS 52287
Hospital Charge Code	160000175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,079.62
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,491.43
Rate for Payer: Aetna Medicare Advantage	$2,491.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,117.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,117.71
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	$2,117.71
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.62
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CYSTOSCOPY W/BIOPSY (S)

Facility

$23,841.70

Service Code	HCPCS 52204
Hospital Charge Code	16000998
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,152.51
Rate for Payer: Aetna Commercial	$7,152.51
Rate for Payer: Aetna Medicare Advantage	$7,152.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,079.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,079.63
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	$6,079.63
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,099.42
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CYSTOSCOPY W/BIOPSY (S)

Facility

$23,841.70

Service Code	HCPCS 52204
Hospital Charge Code	16000998
Hospital Revenue Code	360
Min. Negotiated Rate	$3,576.26
Max. Negotiated Rate	$3,576.26
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26

CYSTOSPAZ/0.15MG/TAB

Facility

$3.00

Hospital Charge Code	60632765
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

CYSTOSPAZ/0.15MG/TAB

Facility

$3.00

Hospital Charge Code	60632765
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CYSTOSTOMY CYSTOTOMY W DRAINAG

Facility

$8,304.76

Service Code	HCPCS 51040
Hospital Charge Code	1600000711
Hospital Revenue Code	360
Min. Negotiated Rate	$1,079.62
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$2,491.43
Rate for Payer: Aetna Medicare Advantage	$2,491.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,117.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,117.71
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	$2,117.71
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.62
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CYSTOSTOMY CYSTOTOMY W DRAINAG

Facility

$8,304.76

Service Code	HCPCS 51040
Hospital Charge Code	1600000711
Hospital Revenue Code	360
Min. Negotiated Rate	$1,245.71
Max. Negotiated Rate	$1,245.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.71

CYSTOTOME IRRIG 25G 120-25F-12

Facility

$16.95

Hospital Charge Code	270600229
Hospital Revenue Code	272
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.54

CYSTOTOME IRRIG 25G 120-25F-12

Facility

$16.95

Hospital Charge Code	270600229
Hospital Revenue Code	272
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$8.47
Rate for Payer: Aetna Commercial	$5.08
Rate for Payer: Aetna Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.32
Rate for Payer: Cigna Commercial	$8.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.20
Rate for Payer: Oxford Commercial	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.54
Rate for Payer: UnitedHealthcare Commercial	$8.47

Know your out-of-pocket cost for care.

All Charges