Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC TR-EXT MAL+MARG 2.1-3 CM

Facility

$7,917.64

Service Code	HCPCS 11603
Hospital Charge Code	16000492
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.29
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$2,375.29
Rate for Payer: Aetna Medicare Advantage	$2,375.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.00
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	$2,019.00
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC TR-EXT MAL+MARG 2.1-3 CM

Facility

$7,917.64

Service Code	HCPCS 11603
Hospital Charge Code	16000492
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.65
Max. Negotiated Rate	$1,187.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65

EXC TR-EXT MAL+MARG 3.1-4 CM

Facility

$7,612.30

Service Code	HCPCS 11604
Hospital Charge Code	16000436
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

EXC TR-EXT MAL+MARG 3.1-4 CM

Facility

$7,612.30

Service Code	HCPCS 11604
Hospital Charge Code	16000436
Hospital Revenue Code	360
Min. Negotiated Rate	$989.60
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$2,283.69
Rate for Payer: Aetna Medicare Advantage	$2,283.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,941.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,941.14
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	$1,941.14
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC TR-EXT MAL+MARG >4 CM

Facility

$6,929.84

Service Code	HCPCS 11606
Hospital Charge Code	16000419
Hospital Revenue Code	360
Min. Negotiated Rate	$900.88
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,078.95
Rate for Payer: Aetna Medicare Advantage	$2,078.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.11
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	$1,767.11
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.88
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.48
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC TR-EXT MAL+MARG >4 CM

Facility

$6,929.84

Service Code	HCPCS 11606
Hospital Charge Code	16000419
Hospital Revenue Code	360
Min. Negotiated Rate	$1,039.48
Max. Negotiated Rate	$1,039.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.48

EXC TROCHANTEC BURSA/CAL RT

Facility

$21,422.50

Service Code	HCPCS 27062
Hospital Charge Code	16000705
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,426.75
Rate for Payer: Aetna Medicare Advantage	$6,426.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,462.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,462.74
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	$5,462.74
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,784.93
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,213.38
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC TROCHANTEC BURSA/CAL RT

Facility

$21,422.50

Service Code	HCPCS 27062
Hospital Charge Code	16000705
Hospital Revenue Code	360
Min. Negotiated Rate	$3,213.38
Max. Negotiated Rate	$3,213.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,213.38

EXERCISE BAND RESISTANCE 1

Facility

$8.20

Hospital Charge Code	270667803
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

EXERCISE BAND RESISTANCE 1

Facility

$8.20

Hospital Charge Code	270667803
Hospital Revenue Code	270
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$4.10
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna Medicare Advantage	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.09
Rate for Payer: Cigna Commercial	$4.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: Oxford Commercial	$4.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$4.10

EXERCISE BAND RESISTANCE 2

Facility

$9.30

Hospital Charge Code	270667802
Hospital Revenue Code	270
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$4.65
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.37
Rate for Payer: Cigna Commercial	$4.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.21
Rate for Payer: Oxford Commercial	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$4.65

EXERCISE BAND RESISTANCE 2

Facility

$9.30

Hospital Charge Code	270667802
Hospital Revenue Code	270
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

EXERCISE BAND RESISTANCE 3

Facility

$11.50

Hospital Charge Code	270667801
Hospital Revenue Code	270
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.73

EXERCISE BAND RESISTANCE 3

Facility

$11.50

Hospital Charge Code	270667801
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$5.75
Rate for Payer: Aetna Commercial	$3.45
Rate for Payer: Aetna Medicare Advantage	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.93
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$5.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.73
Rate for Payer: UnitedHealthcare Commercial	$5.75

EXERCISE BAND RESISTANCE 4

Facility

$13.50

Hospital Charge Code	270667800
Hospital Revenue Code	270
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna Medicare Advantage	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$6.75

EXERCISE BAND RESISTANCE 4

Facility

$13.50

Hospital Charge Code	270667800
Hospital Revenue Code	270
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

EXERCISE BAND RESISTANCE 5

Facility

$17.00

Hospital Charge Code	270667799
Hospital Revenue Code	270
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

EXERCISE BAND RESISTANCE 5

Facility

$17.00

Hospital Charge Code	270667799
Hospital Revenue Code	270
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

EXERCISE GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246290
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

EXERCISE GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246290
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

EXERCISE MONITORED PHASE II

Facility

$3,900.00

Service Code	HCPCS 93798
Hospital Charge Code	5200027
Hospital Revenue Code	943
Min. Negotiated Rate	$78.20
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$1,170.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$306.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$507.00
Rate for Payer: Oxford Commercial	$997.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Commercial	$1,132.00

EXERCISE MONITORED PHASE II

Facility

$3,900.00

Service Code	HCPCS 93798
Hospital Charge Code	5200027
Hospital Revenue Code	943
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$585.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

EXERCISER VOLUMETRIC PEDS

Facility

$20.03

Hospital Charge Code	270632372
Hospital Revenue Code	270
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.02
Rate for Payer: Aetna Commercial	$6.01
Rate for Payer: Aetna Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.11
Rate for Payer: Cigna Commercial	$10.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.02

EXERCISER VOLUMETRIC PEDS

Facility

$20.03

Hospital Charge Code	270632372
Hospital Revenue Code	270
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

EXERCISE TEST BRONCHOSPASM

Facility

$6,100.00

Service Code	HCPCS 94617
Hospital Charge Code	95090388
Hospital Revenue Code	460
Min. Negotiated Rate	$51.11
Max. Negotiated Rate	$1,830.00
Rate for Payer: Aetna Commercial	$1,830.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

Know your out-of-pocket cost for care.

All Charges