Heights University Hospital

All Charges

Charge

Type

Setting

Price

DX-ERCP COMMON BILE DUCT

Facility

$1,927.00

Service Code	HCPCS 74328
Hospital Charge Code	2007001
Hospital Revenue Code	320
Min. Negotiated Rate	$217.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$578.10
Rate for Payer: Aetna Medicare Advantage	$578.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.38
Rate for Payer: Cigna Commercial	$963.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.05
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX-ERCP COMMON BILE DUCT

Facility

$1,927.00

Service Code	HCPCS 74328
Hospital Charge Code	2007001
Hospital Revenue Code	320
Min. Negotiated Rate	$289.05
Max. Negotiated Rate	$289.05
Rate for Payer: Qualcare PPO/HMO/WC	$289.05

DX ERCP PANCREATIC

Facility

$1,927.00

Service Code	HCPCS 74329
Hospital Charge Code	2011535
Hospital Revenue Code	320
Min. Negotiated Rate	$238.61
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$578.10
Rate for Payer: Aetna Medicare Advantage	$578.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.38
Rate for Payer: Cigna Commercial	$963.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.51
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.05
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ERCP PANCREATIC

Facility

$1,927.00

Service Code	HCPCS 74329
Hospital Charge Code	2011535
Hospital Revenue Code	320
Min. Negotiated Rate	$289.05
Max. Negotiated Rate	$289.05
Rate for Payer: Qualcare PPO/HMO/WC	$289.05

DX ER ELBOW 3 VIEWS BILA

Facility

$250.00

Service Code	HCPCS 7308050
Hospital Charge Code	94270081
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ELBOW 3 VIEWS BILA

Facility

$250.00

Service Code	HCPCS 7308050
Hospital Charge Code	94270081
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

DX ER ELBOW 3 VIEWS LT

Facility

$306.00

Service Code	HCPCS 73080LT
Hospital Charge Code	94270147
Hospital Revenue Code	320
Min. Negotiated Rate	$39.78
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$91.80
Rate for Payer: Aetna Medicare Advantage	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.03
Rate for Payer: Cigna Commercial	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.90
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ELBOW 3 VIEWS LT

Facility

$306.00

Service Code	HCPCS 73080LT
Hospital Charge Code	94270147
Hospital Revenue Code	320
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Qualcare PPO/HMO/WC	$45.90

DX ER ELBOW 3 VIEWS RT

Facility

$306.00

Service Code	HCPCS 73080RT
Hospital Charge Code	94270149
Hospital Revenue Code	320
Min. Negotiated Rate	$39.78
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$91.80
Rate for Payer: Aetna Medicare Advantage	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.03
Rate for Payer: Cigna Commercial	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.90
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ELBOW 3 VIEWS RT

Facility

$306.00

Service Code	HCPCS 73080RT
Hospital Charge Code	94270149
Hospital Revenue Code	320
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$45.90
Rate for Payer: Qualcare PPO/HMO/WC	$45.90

DX ER FACIAL BONES

Facility

$631.00

Service Code	HCPCS 70150
Hospital Charge Code	94270005
Hospital Revenue Code	320
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$309.88
Rate for Payer: Aetna Commercial	$189.30
Rate for Payer: Aetna Medicare Advantage	$189.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.91
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.03
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08

DX ER FACIAL BONES

Facility

$631.00

Service Code	HCPCS 70150
Hospital Charge Code	94270005
Hospital Revenue Code	320
Min. Negotiated Rate	$94.65
Max. Negotiated Rate	$94.65
Rate for Payer: Qualcare PPO/HMO/WC	$94.65

DX ER FACIAL BONES <3VIEW

Facility

$396.00

Service Code	HCPCS 70140
Hospital Charge Code	94270003
Hospital Revenue Code	320
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$118.80
Rate for Payer: Aetna Medicare Advantage	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.98
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.40
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

DX ER FACIAL BONES <3VIEW

Facility

$396.00

Service Code	HCPCS 70140
Hospital Charge Code	94270003
Hospital Revenue Code	320
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$59.40

DX ER FEMUR AP & LAT BILA

Facility

$250.00

Hospital Charge Code	94270093
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

DX ER FEMUR AP & LAT BILA

Facility

$250.00

Hospital Charge Code	94270093
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER FEMUR AP & LAT LT

Facility

$332.00

Hospital Charge Code	94270199
Hospital Revenue Code	320
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

DX ER FEMUR AP & LAT LT

Facility

$332.00

Hospital Charge Code	94270199
Hospital Revenue Code	320
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$99.60
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.16
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER FEMUR AP & LAT RT

Facility

$332.00

Hospital Charge Code	94270201
Hospital Revenue Code	320
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

DX ER FEMUR AP & LAT RT

Facility

$332.00

Hospital Charge Code	94270201
Hospital Revenue Code	320
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$99.60
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.16
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER FINGER LT 2ND DIGIT

Facility

$251.00

Service Code	HCPCS 73140F1
Hospital Charge Code	94270171
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

DX ER FINGER LT 2ND DIGIT

Facility

$251.00

Service Code	HCPCS 73140F1
Hospital Charge Code	94270171
Hospital Revenue Code	320
Min. Negotiated Rate	$32.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.30
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER FINGER LT 3RD DIGIT

Facility

$251.00

Service Code	HCPCS 73140F2
Hospital Charge Code	94270173
Hospital Revenue Code	320
Min. Negotiated Rate	$32.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.30
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER FINGER LT 3RD DIGIT

Facility

$251.00

Service Code	HCPCS 73140F2
Hospital Charge Code	94270173
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

DX ER FINGER LT 4TH DIGIT

Facility

$251.00

Service Code	HCPCS 73140F3
Hospital Charge Code	94270175
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

Know your out-of-pocket cost for care.

All Charges