Heights University Hospital

All Charges

Charge

Type

Setting

Price

DUPLEX SCAN ABD PELVIS RETR

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74116048
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

DUPLEX SCAN ABD PELVIS RETR

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2692155
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN ABD PELVIS RETR

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74115048
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

DUPLEX SCAN ABD PELVIS RETR

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74116048
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN ABD PELVIS RETR

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74117048
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN ABD PELVIS RETR

Facility

$789.00

Service Code	HCPCS 93971
Hospital Charge Code	74115048
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN ABD PELVIS RETR

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2692155
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

DUPLEX SCAN EXTREMITY UNI LTD

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	421593971
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

DUPLEX SCAN EXTREMITY UNI LTD

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	421593971
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN EXTREM VEINS COMPL

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	411093970
Hospital Revenue Code	921
Min. Negotiated Rate	$518.65
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN EXTREM VEINS COMPL

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	411093970
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

DUPLEX SCAN FL ABD PEL ORGANS

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	411093976
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN FL ABD PEL ORGANS

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	411093976
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74117056
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74116056
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN HEMO ACCESS

Facility

$17,200.00

Service Code	HCPCS 93990
Hospital Charge Code	2692100
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74117056
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74115056
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74115056
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

DUPLEX SCAN HEMO ACCESS

Facility

$17,200.00

Service Code	HCPCS 93990
Hospital Charge Code	2692100
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

DUPLEX SCAN HEMO ACCESS

Facility

$789.00

Service Code	HCPCS 93990
Hospital Charge Code	74116056
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

DUPLEX SCAN HEMO COMP BIL

Facility

$1,364.48

Service Code	HCPCS 93985
Hospital Charge Code	404293985
Hospital Revenue Code	920
Min. Negotiated Rate	$204.67
Max. Negotiated Rate	$204.67
Rate for Payer: Qualcare PPO/HMO/WC	$204.67

DUPLEX SCAN HEMO COMP BIL

Facility

$1,364.48

Service Code	HCPCS 93985
Hospital Charge Code	404293985
Hospital Revenue Code	920
Min. Negotiated Rate	$177.38
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$409.34
Rate for Payer: Aetna Medicare Advantage	$409.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.94
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.38
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.67
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DUPLEX SCAN HEMO COMP UNI

Facility

$656.27

Service Code	HCPCS 93986
Hospital Charge Code	404293986
Hospital Revenue Code	920
Min. Negotiated Rate	$85.32
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$196.88
Rate for Payer: Aetna Medicare Advantage	$196.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.35
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.44
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DUPLEX SCAN HEMO COMP UNI

Facility

$656.27

Service Code	HCPCS 93986
Hospital Charge Code	404293986
Hospital Revenue Code	920
Min. Negotiated Rate	$98.44
Max. Negotiated Rate	$98.44
Rate for Payer: Qualcare PPO/HMO/WC	$98.44

Know your out-of-pocket cost for care.

All Charges