Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER INSERTION BLADDER CATH-TEMP

Facility

$226.23

Service Code	HCPCS 51702
Hospital Charge Code	5700290
Hospital Revenue Code	450
Min. Negotiated Rate	$33.93
Max. Negotiated Rate	$33.93
Rate for Payer: Qualcare PPO/HMO/WC	$33.93

ER INSERTION BLADDER CATH-TEMP

Facility

$226.23

Service Code	HCPCS 51702
Hospital Charge Code	5700290
Hospital Revenue Code	450
Min. Negotiated Rate	$29.41
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$67.87
Rate for Payer: Aetna Medicare Advantage	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.69
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.41
Rate for Payer: Qualcare PPO/HMO/WC	$33.93

ER INSERTION STRAIGHT CATH

Facility

$345.75

Service Code	HCPCS 51701
Hospital Charge Code	5700289
Hospital Revenue Code	450
Min. Negotiated Rate	$51.86
Max. Negotiated Rate	$51.86
Rate for Payer: Qualcare PPO/HMO/WC	$51.86

ER INSERTION STRAIGHT CATH

Facility

$345.75

Service Code	HCPCS 51701
Hospital Charge Code	5700289
Hospital Revenue Code	450
Min. Negotiated Rate	$36.06
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$103.72
Rate for Payer: Aetna Medicare Advantage	$103.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.17
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.95
Rate for Payer: Qualcare PPO/HMO/WC	$51.86

ER INSERTION SUPRAPUBIC CATHET

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700798
Hospital Revenue Code	450
Min. Negotiated Rate	$1,642.90
Max. Negotiated Rate	$1,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90

ER INSERTION SUPRAPUBIC CATHET

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700798
Hospital Revenue Code	450
Min. Negotiated Rate	$1,423.85
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$3,285.81
Rate for Payer: Aetna Medicare Advantage	$3,285.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,792.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,792.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,792.94
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,423.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90

ER-INSERT PIN SKL TRCT-BI

Facility

$5,352.00

Hospital Charge Code	5790310
Hospital Revenue Code	450
Min. Negotiated Rate	$695.76
Max. Negotiated Rate	$2,676.00
Rate for Payer: Aetna Commercial	$1,605.60
Rate for Payer: Aetna Medicare Advantage	$1,605.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,364.76
Rate for Payer: Cigna Commercial	$2,676.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.76
Rate for Payer: Qualcare PPO/HMO/WC	$802.80

ER-INSERT PIN SKL TRCT-BI

Facility

$5,352.00

Hospital Charge Code	5790310
Hospital Revenue Code	450
Min. Negotiated Rate	$802.80
Max. Negotiated Rate	$802.80
Rate for Payer: Qualcare PPO/HMO/WC	$802.80

ER INSERT PLEURAL CATH

Facility

$13,564.25

Service Code	HCPCS 32550
Hospital Charge Code	5700627
Hospital Revenue Code	450
Min. Negotiated Rate	$2,034.64
Max. Negotiated Rate	$2,034.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64

ER INSERT PLEURAL CATH

Facility

$13,564.25

Service Code	HCPCS 32550
Hospital Charge Code	5700627
Hospital Revenue Code	450
Min. Negotiated Rate	$1,763.35
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$4,069.28
Rate for Payer: Aetna Medicare Advantage	$4,069.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,458.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,458.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,458.88
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,763.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64

ER-INS TEMP PACEMAKR DUAL

Facility

$14,681.00

Service Code	HCPCS 33211
Hospital Charge Code	5790085
Hospital Revenue Code	450
Min. Negotiated Rate	$196.65
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$4,404.30
Rate for Payer: Aetna Medicare Advantage	$4,404.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,743.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,743.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,743.66
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,908.53
Rate for Payer: Qualcare PPO/HMO/WC	$2,202.15

ER-INS TEMP PACEMAKR DUAL

Facility

$14,681.00

Service Code	HCPCS 33211
Hospital Charge Code	5790085
Hospital Revenue Code	450
Min. Negotiated Rate	$2,202.15
Max. Negotiated Rate	$2,202.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,202.15

ER INS THROMB HEMORRHOID EXT

Facility

$1,638.25

Service Code	HCPCS 46083
Hospital Charge Code	5700650
Hospital Revenue Code	450
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$594.98
Rate for Payer: Aetna Commercial	$491.48
Rate for Payer: Aetna Medicare Advantage	$491.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.75
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.97
Rate for Payer: Qualcare PPO/HMO/WC	$245.74

ER INS THROMB HEMORRHOID EXT

Facility

$1,638.25

Service Code	HCPCS 46083
Hospital Charge Code	5700650
Hospital Revenue Code	450
Min. Negotiated Rate	$245.74
Max. Negotiated Rate	$245.74
Rate for Payer: Qualcare PPO/HMO/WC	$245.74

ER INTERMEDIATE - III

Facility

$13,269.54

Service Code	HCPCS 99283
Hospital Charge Code	5700083
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$3,980.86
Rate for Payer: Aetna Commercial	$3,980.86
Rate for Payer: Aetna Medicare Advantage	$3,980.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,383.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,383.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,383.73
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.43
Rate for Payer: UnitedHealthcare Commercial	$1,718.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE - III

Facility

$13,269.54

Service Code	HCPCS 99283
Hospital Charge Code	5700083
Hospital Revenue Code	450
Min. Negotiated Rate	$1,990.43
Max. Negotiated Rate	$1,990.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.43

ER INTERMEDIATE - III W/O MF

Facility

$8,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700082
Hospital Revenue Code	450
Min. Negotiated Rate	$1,237.90
Max. Negotiated Rate	$1,237.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.90

ER INTERMEDIATE - III W/O MF

Facility

$8,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700082
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$2,475.81
Rate for Payer: Aetna Commercial	$2,475.81
Rate for Payer: Aetna Medicare Advantage	$2,475.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,104.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,104.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,104.44
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.90
Rate for Payer: UnitedHealthcare Commercial	$1,718.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER-INTERMEDIATE JOINT-BIL

Facility

$697.00

Hospital Charge Code	5790300
Hospital Revenue Code	450
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

ER-INTERMEDIATE JOINT-BIL

Facility

$697.00

Hospital Charge Code	5790300
Hospital Revenue Code	450
Min. Negotiated Rate	$90.61
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$209.10
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.61
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

ER INTERMEDIATE - PP III

Facility

$1,252.70

Service Code	HCPCS 9928325
Hospital Charge Code	5700224
Hospital Revenue Code	450
Min. Negotiated Rate	$162.85
Max. Negotiated Rate	$626.35
Rate for Payer: Aetna Commercial	$375.81
Rate for Payer: Aetna Medicare Advantage	$375.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.44
Rate for Payer: Cigna Commercial	$626.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.85
Rate for Payer: Qualcare PPO/HMO/WC	$187.91
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE - PP III

Facility

$1,252.70

Service Code	HCPCS 9928325
Hospital Charge Code	5700224
Hospital Revenue Code	450
Min. Negotiated Rate	$187.91
Max. Negotiated Rate	$187.91
Rate for Payer: Qualcare PPO/HMO/WC	$187.91

ER INTERMEDIATE- PP III W/O MF

Facility

$1,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700223
Hospital Revenue Code	450
Min. Negotiated Rate	$187.91
Max. Negotiated Rate	$1,718.00
Rate for Payer: Aetna Commercial	$375.81
Rate for Payer: Aetna Medicare Advantage	$375.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.44
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.91
Rate for Payer: UnitedHealthcare Commercial	$1,718.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE- PP III W/O MF

Facility

$1,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700223
Hospital Revenue Code	450
Min. Negotiated Rate	$187.91
Max. Negotiated Rate	$187.91
Rate for Payer: Qualcare PPO/HMO/WC	$187.91

ER-INTRA-AORTIC BALLOON CATH

Facility

$22,823.38

Service Code	HCPCS 33967
Hospital Charge Code	5780180
Hospital Revenue Code	361
Min. Negotiated Rate	$242.11
Max. Negotiated Rate	$13,243.00
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Aetna Commercial	$6,847.01
Rate for Payer: Aetna Medicare Advantage	$6,847.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,819.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,819.96
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	$5,819.96
Rate for Payer: Cigna Commercial	$242.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,967.04
Rate for Payer: Qualcare PPO/HMO/WC	$3,423.51
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

Know your out-of-pocket cost for care.

All Charges