Heights University Hospital

All Charges

Charge

Type

Setting

Price

DIAGNOSTIC CATH 5FR JL5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658157S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

DIAGNOSTIC CATH 5FR JL5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658157S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

DIAGNOSTIC CATH 5FR JL5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658157N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

DIAGNOSTIC CATH 5FR JL5

Facility

$47.50

Service Code	HCPCS C1887
Hospital Charge Code	270658157N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	2709036
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	94061496
Hospital Revenue Code	401
Min. Negotiated Rate	$152.91
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$178.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	94061496
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	85000902
Hospital Revenue Code	401
Min. Negotiated Rate	$152.91
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$178.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	2709036
Hospital Revenue Code	401
Min. Negotiated Rate	$152.91
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$178.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	9406404
Hospital Revenue Code	401
Min. Negotiated Rate	$152.91
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$178.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	85000902
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO BILAT INC CAD

Facility

$4,500.00

Service Code	HCPCS 77066
Hospital Charge Code	9406404
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	2709035
Hospital Revenue Code	401
Min. Negotiated Rate	$120.54
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	9406403
Hospital Revenue Code	401
Min. Negotiated Rate	$120.54
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	94061495
Hospital Revenue Code	401
Min. Negotiated Rate	$120.54
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	94061495
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	85000901
Hospital Revenue Code	401
Min. Negotiated Rate	$120.54
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	85000901
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	2709035
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	9406403
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	1600000391
Hospital Revenue Code	360
Min. Negotiated Rate	$564.73
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,303.22
Rate for Payer: Aetna Medicare Advantage	$1,303.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,107.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,107.74
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	$1,107.74
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.73
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	411066479
Hospital Revenue Code	361
Min. Negotiated Rate	$651.61
Max. Negotiated Rate	$651.61
Rate for Payer: Qualcare PPO/HMO/WC	$651.61

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	411066479
Hospital Revenue Code	361
Min. Negotiated Rate	$564.73
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,303.22
Rate for Payer: Aetna Medicare Advantage	$1,303.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,107.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,107.74
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	$1,107.74
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.73
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	1600000391
Hospital Revenue Code	360
Min. Negotiated Rate	$651.61
Max. Negotiated Rate	$651.61
Rate for Payer: Qualcare PPO/HMO/WC	$651.61

DIALATION OF URETHRA

Facility

$18,162.80

Service Code	HCPCS 53665
Hospital Charge Code	1600000494
Hospital Revenue Code	360
Min. Negotiated Rate	$2,724.42
Max. Negotiated Rate	$2,724.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42

Know your out-of-pocket cost for care.

All Charges