Heights University Hospital

All Charges

Charge

Type

Setting

Price

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	94053105
Hospital Revenue Code	483
Min. Negotiated Rate	$1,190.78
Max. Negotiated Rate	$1,190.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	5300080
Hospital Revenue Code	483
Min. Negotiated Rate	$1,190.78
Max. Negotiated Rate	$1,190.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	94053105
Hospital Revenue Code	483
Min. Negotiated Rate	$680.80
Max. Negotiated Rate	$2,381.56
Rate for Payer: Aetna Commercial	$2,381.56
Rate for Payer: Aetna Medicare Advantage	$2,381.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,024.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,024.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$680.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,024.33
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,032.01
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	94053135
Hospital Revenue Code	483
Min. Negotiated Rate	$27.28
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$452.81
Rate for Payer: Aetna Medicare Advantage	$452.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.88
Rate for Payer: Cigna Commercial	$27.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.22
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.40
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	5300132
Hospital Revenue Code	483
Min. Negotiated Rate	$27.28
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$452.81
Rate for Payer: Aetna Medicare Advantage	$452.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.88
Rate for Payer: Cigna Commercial	$27.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.22
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.40
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	5300132
Hospital Revenue Code	483
Min. Negotiated Rate	$226.40
Max. Negotiated Rate	$226.40
Rate for Payer: Qualcare PPO/HMO/WC	$226.40

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	94053135
Hospital Revenue Code	483
Min. Negotiated Rate	$226.40
Max. Negotiated Rate	$226.40
Rate for Payer: Qualcare PPO/HMO/WC	$226.40

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	94053125
Hospital Revenue Code	483
Min. Negotiated Rate	$58.41
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$417.88
Rate for Payer: Aetna Medicare Advantage	$417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.20
Rate for Payer: Cigna Commercial	$58.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.08
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.94
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	5300108
Hospital Revenue Code	483
Min. Negotiated Rate	$208.94
Max. Negotiated Rate	$208.94
Rate for Payer: Qualcare PPO/HMO/WC	$208.94

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	5300108
Hospital Revenue Code	483
Min. Negotiated Rate	$58.41
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$417.88
Rate for Payer: Aetna Medicare Advantage	$417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.20
Rate for Payer: Cigna Commercial	$58.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.08
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.94
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	94053125
Hospital Revenue Code	483
Min. Negotiated Rate	$208.94
Max. Negotiated Rate	$208.94
Rate for Payer: Qualcare PPO/HMO/WC	$208.94

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93321
Hospital Charge Code	94053130
Hospital Revenue Code	483
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$352.33
Rate for Payer: Aetna Medicare Advantage	$352.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.48
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.68
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.17
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93321
Hospital Charge Code	5300086
Hospital Revenue Code	483
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93321
Hospital Charge Code	5300086
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93321
Hospital Charge Code	94053130
Hospital Revenue Code	483
Min. Negotiated Rate	$176.17
Max. Negotiated Rate	$176.17
Rate for Payer: Qualcare PPO/HMO/WC	$176.17

ECHO GUIDE FOR BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	421076942
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

ECHO GUIDE FOR BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	421076942
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
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	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$72.16
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

ECHO POR FMRL FPP NC 13X145MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

ECHO POR FMRL FPP NC 13X145MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

ECHO POR FMRL FPP NC 14 X 150

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690626
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHO POR FMRL FPP NC 14 X 150

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690626
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHOPOR FMRLLAT FPP NC 16X160M

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHOPOR FMRLLAT FPP NC 16X160M

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHO POR FMRL RPP NC 12 X 140

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691571
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHO POR FMRL RPP NC 12 X 140

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691571
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

Know your out-of-pocket cost for care.

All Charges