Heights University Hospital

All Charges

Charge

Type

Setting

Price

EST ACCES BRACH ART-BI

Facility

$154.00

Service Code	HCPCS 3612050
Hospital Charge Code	7411069
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES BRACH ART-LT

Facility

$154.00

Service Code	HCPCS 36120LT
Hospital Charge Code	7411071
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES BRACH ART-LT

Facility

$154.00

Service Code	HCPCS 36120LT
Hospital Charge Code	7411071
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES BRACH ART-RT

Facility

$154.00

Service Code	HCPCS 36120RT
Hospital Charge Code	7411067
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES BRACH ART-RT

Facility

$154.00

Service Code	HCPCS 36120RT
Hospital Charge Code	7411067
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-BI

Facility

$154.00

Service Code	HCPCS 3614050
Hospital Charge Code	7411075
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-BI

Facility

$154.00

Service Code	HCPCS 3614050
Hospital Charge Code	7411075
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-LT

Facility

$154.00

Service Code	HCPCS 36140LT
Hospital Charge Code	7411073
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-LT

Facility

$154.00

Service Code	HCPCS 36140LT
Hospital Charge Code	7411073
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-RT

Facility

$154.00

Service Code	HCPCS 36140RT
Hospital Charge Code	7411077
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

EST ACCES EXTRE ART-RT

Facility

$154.00

Service Code	HCPCS 36140RT
Hospital Charge Code	7411077
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

ESTBLISH PAT OV-LIMITED

Facility

$446.00

Service Code	HCPCS 99212
Hospital Charge Code	83653185
Hospital Revenue Code	514
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

ESTBLISH PAT OV-LIMITED

Facility

$446.00

Service Code	HCPCS 99212
Hospital Charge Code	83653185
Hospital Revenue Code	514
Min. Negotiated Rate	$33.58
Max. Negotiated Rate	$133.80
Rate for Payer: Aetna Commercial	$133.80
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

ESTECH FEM VASC DILATOR KIT

Facility

$1,000.00

Hospital Charge Code	2703110Y
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ESTECH FEM VASC DILATOR KIT

Facility

$1,000.00

Hospital Charge Code	2703110Y
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

ESTECH FEM VEN CANN 23/25

Facility

$2,025.00

Hospital Charge Code	2703110W
Hospital Revenue Code	272
Min. Negotiated Rate	$263.25
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$607.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.25
Rate for Payer: Oxford Commercial	$1,012.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Commercial	$1,012.50

ESTECH FEM VEN CANN 23/25

Facility

$2,025.00

Hospital Charge Code	2703110W
Hospital Revenue Code	272
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$303.75
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

ESTERASE NONSPECIFIC STAIN

Facility

$363.25

Service Code	HCPCS 88319
Hospital Charge Code	3030756
Hospital Revenue Code	310
Min. Negotiated Rate	$54.49
Max. Negotiated Rate	$54.49
Rate for Payer: Qualcare PPO/HMO/WC	$54.49

ESTERASE NONSPECIFIC STAIN

Facility

$363.25

Service Code	HCPCS 88319
Hospital Charge Code	3030756
Hospital Revenue Code	310
Min. Negotiated Rate	$47.22
Max. Negotiated Rate	$1,918.64
Rate for Payer: Aetna Commercial	$108.97
Rate for Payer: Aetna Medicare Advantage	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.63
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$75.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.49
Rate for Payer: UnitedHealthcare Commercial	$114.00

E- STIM UNATTENDED/CHRONIC STA

Facility

$91.00

Service Code	HCPCS G0281GO
Hospital Charge Code	74203081
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

E- STIM UNATTENDED/CHRONIC STA

Facility

$91.00

Service Code	HCPCS G0281GO
Hospital Charge Code	74203081
Hospital Revenue Code	430
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

E-STIM UNATTENDED CQ

Facility

$91.25

Service Code	HCPCS G0281GP
Hospital Charge Code	904170281Q
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

E-STIM UNATTENDED CQ

Facility

$91.25

Service Code	HCPCS G0281GP
Hospital Charge Code	904170281Q
Hospital Revenue Code	420
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
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	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$686.00

E-STIM UNATTENDED NON WND CQ

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	904170283Q
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

E-STIM UNATTENDED NON WND CQ

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	904170283Q
Hospital Revenue Code	420
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
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	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges