Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXCHANGE BILIARY DRG CATH

Facility

$17,067.55

Service Code	HCPCS 47536
Hospital Charge Code	411047536
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

EXCHANGE BILIARY DR TUBE S&I

Facility

$1,287.05

Service Code	HCPCS 75984
Hospital Charge Code	5100509
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$386.12
Rate for Payer: Aetna Medicare Advantage	$386.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.20
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.06
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXCHANGE BILIARY DR TUBE S&I

Facility

$1,287.05

Service Code	HCPCS 75984
Hospital Charge Code	5100509
Hospital Revenue Code	320
Min. Negotiated Rate	$193.06
Max. Negotiated Rate	$193.06
Rate for Payer: Qualcare PPO/HMO/WC	$193.06

EXCHANGE NEPHROSTOMY CATH

Facility

$10,187.80

Service Code	HCPCS 50435
Hospital Charge Code	2600227
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH

Facility

$3,090.18

Service Code	HCPCS 50435
Hospital Charge Code	2709010
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH

Facility

$8,875.68

Service Code	HCPCS 50435
Hospital Charge Code	366850435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,153.84
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,662.70
Rate for Payer: Aetna Medicare Advantage	$2,662.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.30
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	$2,263.30
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,153.84
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH

Facility

$10,187.80

Service Code	HCPCS 50435
Hospital Charge Code	321050435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH

Facility

$10,187.80

Service Code	HCPCS 50435
Hospital Charge Code	2600227
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

EXCHANGE NEPHROSTOMY CATH

Facility

$8,875.68

Service Code	HCPCS 50435
Hospital Charge Code	411050435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,153.84
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,662.70
Rate for Payer: Aetna Medicare Advantage	$2,662.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.30
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	$2,263.30
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,153.84
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH

Facility

$8,875.68

Service Code	HCPCS 50435
Hospital Charge Code	411050435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

EXCHANGE NEPHROSTOMY CATH

Facility

$8,875.68

Service Code	HCPCS 50435
Hospital Charge Code	366850435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

EXCHANGE NEPHROSTOMY CATH

Facility

$3,090.18

Service Code	HCPCS 50435
Hospital Charge Code	2709010
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH

Facility

$3,090.18

Service Code	HCPCS 50435
Hospital Charge Code	2101192
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH

Facility

$10,187.80

Service Code	HCPCS 50435
Hospital Charge Code	321050435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

EXCHANGE NEPHROSTOMY CATH

Facility

$3,090.18

Service Code	HCPCS 50435
Hospital Charge Code	2101192
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXCHANGE NEPHROSTOMY CATH BI

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	7411611
Hospital Revenue Code	361
Min. Negotiated Rate	$590.04
Max. Negotiated Rate	$590.04
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH BI

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	7411611
Hospital Revenue Code	361
Min. Negotiated Rate	$511.37
Max. Negotiated Rate	$1,966.80
Rate for Payer: Aetna Commercial	$1,180.08
Rate for Payer: Aetna Medicare Advantage	$1,180.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.07
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	$1,003.07
Rate for Payer: Cigna Commercial	$1,966.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.37
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH BIL

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	2101156
Hospital Revenue Code	361
Min. Negotiated Rate	$511.37
Max. Negotiated Rate	$1,966.80
Rate for Payer: Aetna Commercial	$1,180.08
Rate for Payer: Aetna Medicare Advantage	$1,180.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.07
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	$1,003.07
Rate for Payer: Cigna Commercial	$1,966.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.37
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH BIL

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	2011575
Hospital Revenue Code	361
Min. Negotiated Rate	$511.37
Max. Negotiated Rate	$1,966.80
Rate for Payer: Aetna Commercial	$1,180.08
Rate for Payer: Aetna Medicare Advantage	$1,180.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.07
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	$1,003.07
Rate for Payer: Cigna Commercial	$1,966.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.37
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH BIL

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	2011575
Hospital Revenue Code	361
Min. Negotiated Rate	$590.04
Max. Negotiated Rate	$590.04
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH BIL

Facility

$3,933.60

Service Code	HCPCS 5043550
Hospital Charge Code	2101156
Hospital Revenue Code	361
Min. Negotiated Rate	$590.04
Max. Negotiated Rate	$590.04
Rate for Payer: Qualcare PPO/HMO/WC	$590.04

EXCHANGE NEPHROSTOMY CATH LT

Facility

$3,090.18

Service Code	HCPCS 50435LT
Hospital Charge Code	7412037
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH LT

Facility

$3,090.18

Service Code	HCPCS 50435LT
Hospital Charge Code	2101162
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH LT

Facility

$3,090.18

Service Code	HCPCS 50435LT
Hospital Charge Code	7412037
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH LT

Facility

$3,090.18

Service Code	HCPCS 50435LT
Hospital Charge Code	2011590
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

Know your out-of-pocket cost for care.

All Charges