Heights University Hospital

All Charges

Charge

Type

Setting

Price

DEL L & D NURSE LOC W/NO PROC

Facility

$10,100.00

Service Code	HCPCS 99211
Hospital Charge Code	73190115
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL NON STRESS TEST 1+ HRS

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	73190019
Hospital Revenue Code	920
Min. Negotiated Rate	$246.79
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$569.52
Rate for Payer: Aetna Medicare Advantage	$569.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.09
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.79
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DEL NON STRESS TEST 1+ HRS

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	73190019
Hospital Revenue Code	920
Min. Negotiated Rate	$284.76
Max. Negotiated Rate	$284.76
Rate for Payer: Qualcare PPO/HMO/WC	$284.76

DEL OBSTETRICAL CARE

Facility

$216.00

Service Code	HCPCS 59400
Hospital Charge Code	73190031
Hospital Revenue Code	720
Min. Negotiated Rate	$28.08
Max. Negotiated Rate	$2,979.00
Rate for Payer: Aetna Commercial	$64.80
Rate for Payer: Aetna Medicare Advantage	$64.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.08
Rate for Payer: Cigna Commercial	$2,416.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.08
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
Rate for Payer: UnitedHealthcare Commercial	$2,979.00

DEL OBSTETRICAL CARE

Facility

$216.00

Service Code	HCPCS 59400
Hospital Charge Code	73190031
Hospital Revenue Code	720
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

DEL OB/US<14 WKS ADD'L FETUS

Facility

$349.00

Service Code	HCPCS 76802
Hospital Charge Code	73190055
Hospital Revenue Code	402
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$104.70
Rate for Payer: Aetna Medicare Advantage	$104.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.00
Rate for Payer: Cigna Commercial	$67.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.37
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.35
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

DEL OB/US<14 WKS ADD'L FETUS

Facility

$349.00

Service Code	HCPCS 76802
Hospital Charge Code	73190055
Hospital Revenue Code	402
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$52.35

DEL OB/US>/= 14WKS ADDL FETUS

Facility

$555.00

Service Code	HCPCS 76810
Hospital Charge Code	73190059
Hospital Revenue Code	402
Min. Negotiated Rate	$72.15
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$166.50
Rate for Payer: Aetna Medicare Advantage	$166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.53
Rate for Payer: Cigna Commercial	$99.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.15
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.25
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

DEL OB/US>/= 14WKS ADDL FETUS

Facility

$555.00

Service Code	HCPCS 76810
Hospital Charge Code	73190059
Hospital Revenue Code	402
Min. Negotiated Rate	$83.25
Max. Negotiated Rate	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$83.25

DEL OB/US<14 WKS SINGLE FETUS

Facility

$1,117.00

Service Code	HCPCS 76801
Hospital Charge Code	73190053
Hospital Revenue Code	402
Min. Negotiated Rate	$102.85
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$335.10
Rate for Payer: Aetna Medicare Advantage	$335.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.83
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.21
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.55
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

DEL OB/US<14 WKS SINGLE FETUS

Facility

$1,117.00

Service Code	HCPCS 76801
Hospital Charge Code	73190053
Hospital Revenue Code	402
Min. Negotiated Rate	$167.55
Max. Negotiated Rate	$167.55
Rate for Payer: Qualcare PPO/HMO/WC	$167.55

DEL OB/US>/= 14WKS SNGL FETUS

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	73190057
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

DEL OB/US>/= 14WKS SNGL FETUS

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	73190057
Hospital Revenue Code	402
Min. Negotiated Rate	$120.80
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

DEL OB/US DETAILED ADDL FETUS

Facility

$6,700.00

Service Code	HCPCS 76812
Hospital Charge Code	73190063
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

DEL OB/US DETAILED ADDL FETUS

Facility

$6,700.00

Service Code	HCPCS 76812
Hospital Charge Code	73190063
Hospital Revenue Code	402
Min. Negotiated Rate	$219.55
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$219.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

DEL OB/US DETAILED SNGL FETUS

Facility

$1,754.00

Service Code	HCPCS 76811
Hospital Charge Code	73190061
Hospital Revenue Code	402
Min. Negotiated Rate	$228.02
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$526.20
Rate for Payer: Aetna Medicare Advantage	$526.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.27
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.02
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$263.10
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

DEL OB/US DETAILED SNGL FETUS

Facility

$1,754.00

Service Code	HCPCS 76811
Hospital Charge Code	73190061
Hospital Revenue Code	402
Min. Negotiated Rate	$263.10
Max. Negotiated Rate	$263.10
Rate for Payer: Qualcare PPO/HMO/WC	$263.10

DEL OB/US FOLLOW UP PER FETUS

Facility

$913.00

Service Code	HCPCS 76816
Hospital Charge Code	73190071
Hospital Revenue Code	402
Min. Negotiated Rate	$136.95
Max. Negotiated Rate	$136.95
Rate for Payer: Qualcare PPO/HMO/WC	$136.95

DEL OB/US FOLLOW UP PER FETUS

Facility

$913.00

Service Code	HCPCS 76816
Hospital Charge Code	73190071
Hospital Revenue Code	402
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$399.68
Rate for Payer: Aetna Commercial	$273.90
Rate for Payer: Aetna Medicare Advantage	$273.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.81
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.69
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.95
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.67

DEL OB US-LIMITED

Facility

$331.00

Service Code	HCPCS 76815
Hospital Charge Code	73190069
Hospital Revenue Code	402
Min. Negotiated Rate	$49.65
Max. Negotiated Rate	$49.65
Rate for Payer: Qualcare PPO/HMO/WC	$49.65

DEL OB US-LIMITED

Facility

$331.00

Service Code	HCPCS 76815
Hospital Charge Code	73190069
Hospital Revenue Code	402
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$99.30
Rate for Payer: Aetna Medicare Advantage	$99.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.41
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.03
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.65
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

DEL OXYTOXIN TEST

Facility

$10,100.00

Service Code	HCPCS 59020
Hospital Charge Code	73190017
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL OXYTOXIN TEST

Facility

$10,100.00

Service Code	HCPCS 59020
Hospital Charge Code	73190017
Hospital Revenue Code	720
Min. Negotiated Rate	$45.64
Max. Negotiated Rate	$3,030.00
Rate for Payer: Aetna Commercial	$3,030.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,313.00
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$2,979.00

DEL ROUTINE VAG DEL 1ST HR

Facility

$10,100.00

Service Code	HCPCS 59409
Hospital Charge Code	73190033
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL ROUTINE VAG DEL 1ST HR

Facility

$10,100.00

Service Code	HCPCS 59409
Hospital Charge Code	73190033
Hospital Revenue Code	720
Min. Negotiated Rate	$480.67
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$3,030.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,313.00
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$2,979.00

Know your out-of-pocket cost for care.

All Charges