Heights University Hospital

All Charges

Charge

Type

Setting

Price

DILATE BILIARY DUCT/AMPULLA

Facility

$8,460.00

Service Code	HCPCS 47543
Hospital Charge Code	321047543
Hospital Revenue Code	361
Min. Negotiated Rate	$1,269.00
Max. Negotiated Rate	$1,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,269.00

DILATE BILIARY DUCT/AMPULLA

Facility

$8,460.00

Service Code	HCPCS 47543
Hospital Charge Code	321047543
Hospital Revenue Code	361
Min. Negotiated Rate	$132.07
Max. Negotiated Rate	$2,538.00
Rate for Payer: Aetna Commercial	$2,538.00
Rate for Payer: Aetna Medicare Advantage	$2,538.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,157.30
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	$2,157.30
Rate for Payer: Cigna Commercial	$132.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,099.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,269.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

DILATE IC VASOSPASM INIT

Facility

$61,616.39

Service Code	HCPCS 61640
Hospital Charge Code	411061640
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

DILATE IC VASOSPASM INIT

Facility

$61,616.39

Service Code	HCPCS 61640
Hospital Charge Code	411061640
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DILATE IC VSPSM EA DIFF TERR

Facility

$61,616.39

Service Code	HCPCS 61642
Hospital Charge Code	411061642
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DILATE IC VSPSM EA DIFF TERR

Facility

$61,616.39

Service Code	HCPCS 61642
Hospital Charge Code	411061642
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

DILATE IC VSPSM EA VSL SM TER

Facility

$61,616.39

Service Code	HCPCS 61641
Hospital Charge Code	411061641
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DILATE IC VSPSM EA VSL SM TER

Facility

$61,616.39

Service Code	HCPCS 61641
Hospital Charge Code	411061641
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$35,451.40

Service Code	APR-DRG 5174
Min. Negotiated Rate	$33,260.44
Max. Negotiated Rate	$35,451.40
Rate for Payer: Aetna Better Health Medicaid	$33,260.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,925.65
Rate for Payer: Wellpoint Medicaid Managed Care	$35,451.40

DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$19,202.14

Service Code	APR-DRG 5173
Min. Negotiated Rate	$15,066.47
Max. Negotiated Rate	$19,202.14
Rate for Payer: Aetna Better Health Medicaid	$18,825.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,202.14
Rate for Payer: Wellpoint Medicaid Managed Care	$15,066.47

DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$9,631.28

Service Code	APR-DRG 5171
Min. Negotiated Rate	$6,527.45
Max. Negotiated Rate	$9,631.28
Rate for Payer: Aetna Better Health Medicaid	$9,442.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,631.28
Rate for Payer: Wellpoint Medicaid Managed Care	$6,527.45

DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES

Facility

$11,907.76

Service Code	APR-DRG 5172
Min. Negotiated Rate	$8,212.57
Max. Negotiated Rate	$11,907.76
Rate for Payer: Aetna Better Health Medicaid	$11,674.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,907.76
Rate for Payer: Wellpoint Medicaid Managed Care	$8,212.57

DILATIONS SYS ENTERAL ACCES 24

Facility

$493.75

Hospital Charge Code	270683432
Hospital Revenue Code	272
Min. Negotiated Rate	$74.06
Max. Negotiated Rate	$74.06
Rate for Payer: Qualcare PPO/HMO/WC	$74.06

DILATIONS SYS ENTERAL ACCES 24

Facility

$493.75

Hospital Charge Code	270683432
Hospital Revenue Code	272
Min. Negotiated Rate	$64.19
Max. Negotiated Rate	$246.88
Rate for Payer: Aetna Commercial	$148.12
Rate for Payer: Aetna Medicare Advantage	$148.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.91
Rate for Payer: Cigna Commercial	$246.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.19
Rate for Payer: Oxford Commercial	$246.88
Rate for Payer: Qualcare PPO/HMO/WC	$74.06
Rate for Payer: UnitedHealthcare Commercial	$246.88

DILATION SYSTEM ENTERAL ACCESS

Facility

$493.75

Hospital Charge Code	270672030N
Hospital Revenue Code	272
Min. Negotiated Rate	$74.06
Max. Negotiated Rate	$74.06
Rate for Payer: Qualcare PPO/HMO/WC	$74.06

DILATION SYSTEM ENTERAL ACCESS

Facility

$501.25

Hospital Charge Code	270672030
Hospital Revenue Code	272
Min. Negotiated Rate	$65.16
Max. Negotiated Rate	$250.62
Rate for Payer: Aetna Commercial	$150.38
Rate for Payer: Aetna Medicare Advantage	$150.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.82
Rate for Payer: Cigna Commercial	$250.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.16
Rate for Payer: Oxford Commercial	$250.62
Rate for Payer: Qualcare PPO/HMO/WC	$75.19
Rate for Payer: UnitedHealthcare Commercial	$250.62

DILATION SYSTEM ENTERAL ACCESS

Facility

$501.25

Hospital Charge Code	270672030
Hospital Revenue Code	272
Min. Negotiated Rate	$75.19
Max. Negotiated Rate	$75.19
Rate for Payer: Qualcare PPO/HMO/WC	$75.19

DILATION SYSTEM ENTERAL ACCESS

Facility

$493.75

Hospital Charge Code	270672030N
Hospital Revenue Code	272
Min. Negotiated Rate	$64.19
Max. Negotiated Rate	$246.88
Rate for Payer: Aetna Commercial	$148.12
Rate for Payer: Aetna Medicare Advantage	$148.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.91
Rate for Payer: Cigna Commercial	$246.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.19
Rate for Payer: Oxford Commercial	$246.88
Rate for Payer: Qualcare PPO/HMO/WC	$74.06
Rate for Payer: UnitedHealthcare Commercial	$246.88

DILATOR 4FR .035

Facility

$27.61

Hospital Charge Code	270630843
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

DILATOR 4FR .035

Facility

$27.61

Hospital Charge Code	270630843
Hospital Revenue Code	272
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$13.80

DILATOR 4FR .035 48-149

Facility

$27.61

Hospital Charge Code	270630843C
Hospital Revenue Code	272
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$13.80

DILATOR 4FR .035 48-149

Facility

$27.61

Hospital Charge Code	270630843C
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270651985
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270651985
Hospital Revenue Code	272
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$13.80

DILATOR 7FR

Facility

$22.52

Hospital Charge Code	270651988
Hospital Revenue Code	270
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$11.26
Rate for Payer: Aetna Commercial	$6.76
Rate for Payer: Aetna Medicare Advantage	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.93
Rate for Payer: Oxford Commercial	$11.26
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$11.26

Know your out-of-pocket cost for care.

All Charges