Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTODE 22FR MONO ROLLER

Facility

$560.00

Hospital Charge Code	270678696
Hospital Revenue Code	272
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$280.00

ELECTODE 22FR MONO ROLLER

Facility

$560.00

Hospital Charge Code	270678696
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ELECTODE LEEP FISHER

Facility

$585.00

Hospital Charge Code	270690458
Hospital Revenue Code	272
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

ELECTODE LEEP FISHER

Facility

$585.00

Hospital Charge Code	270690458
Hospital Revenue Code	272
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$292.50
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$292.50

ELECTRDE WRE JTIP 28CM E277228

Facility

$205.05

Hospital Charge Code	270641087
Hospital Revenue Code	272
Min. Negotiated Rate	$26.66
Max. Negotiated Rate	$102.53
Rate for Payer: Aetna Commercial	$61.52
Rate for Payer: Aetna Medicare Advantage	$61.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$102.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.66
Rate for Payer: Oxford Commercial	$102.53
Rate for Payer: Qualcare PPO/HMO/WC	$30.76
Rate for Payer: UnitedHealthcare Commercial	$102.53

ELECTRDE WRE JTIP 28CM E277228

Facility

$205.05

Hospital Charge Code	270641087
Hospital Revenue Code	272
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$30.76
Rate for Payer: Qualcare PPO/HMO/WC	$30.76

ELECTRICAL BONE STIMULATION

Facility

$617.50

Service Code	HCPCS 20974
Hospital Charge Code	1600000868
Hospital Revenue Code	360
Min. Negotiated Rate	$56.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$185.25
Rate for Payer: Aetna Medicare Advantage	$185.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.46
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	$157.46
Rate for Payer: Cigna Commercial	$56.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.28
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.62
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ELECTRICAL BONE STIMULATION

Facility

$617.50

Service Code	HCPCS 20974
Hospital Charge Code	1600000868
Hospital Revenue Code	360
Min. Negotiated Rate	$92.62
Max. Negotiated Rate	$92.62
Rate for Payer: Qualcare PPO/HMO/WC	$92.62

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	1008140
Hospital Revenue Code	420
Min. Negotiated Rate	$26.78
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$61.80
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.78
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	9108060
Hospital Revenue Code	420
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	1008140
Hospital Revenue Code	420
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	9108060
Hospital Revenue Code	420
Min. Negotiated Rate	$26.78
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$61.80
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.78
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GO
Hospital Charge Code	74203083
Hospital Revenue Code	430
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	1008380
Hospital Revenue Code	420
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GP
Hospital Charge Code	9108075
Hospital Revenue Code	420
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Hospital Charge Code	1008375
Hospital Revenue Code	430
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Hospital Charge Code	1008375
Hospital Revenue Code	430
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GP
Hospital Charge Code	9108075
Hospital Revenue Code	420
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	1008380
Hospital Revenue Code	420
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GO
Hospital Charge Code	74203083
Hospital Revenue Code	430
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$45.84
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$105.79
Rate for Payer: Aetna Medicare Advantage	$105.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.92
Rate for Payer: Cigna Commercial	$176.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.84
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$52.90
Max. Negotiated Rate	$52.90
Rate for Payer: Qualcare PPO/HMO/WC	$52.90

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	94053025
Hospital Revenue Code	730
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$615.00
Rate for Payer: Aetna Commercial	$615.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$603.00

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	94053025
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5300017
Hospital Revenue Code	730
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$615.00
Rate for Payer: Aetna Commercial	$615.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$603.00

Know your out-of-pocket cost for care.

All Charges