Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

EXERCISE UNMONITORED PHASE III

Facility

$393.30

Service Code	HCPCS 93799
Hospital Charge Code	5200035
Hospital Revenue Code	943
Min. Negotiated Rate	$51.13
Max. Negotiated Rate	$1,132.00
Rate for Payer: Aetna Commercial	$117.99
Rate for Payer: Aetna Medicare Advantage	$117.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.29
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.13
Rate for Payer: Oxford Commercial	$997.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.99
Rate for Payer: UnitedHealthcare Commercial	$1,132.00

EXERCISE UNMONITORED PHASE III

Facility

$393.30

Service Code	HCPCS 93799
Hospital Charge Code	5200035
Hospital Revenue Code	943
Min. Negotiated Rate	$58.99
Max. Negotiated Rate	$58.99
Rate for Payer: Qualcare PPO/HMO/WC	$58.99

EXERCISE W/HEMODYNAMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93464
Hospital Charge Code	411093464
Hospital Revenue Code	480
Min. Negotiated Rate	$159.44
Max. Negotiated Rate	$3,607.80
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$252.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

EXERCISE W/HEMODYNAMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93464
Hospital Charge Code	411093464
Hospital Revenue Code	480
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

EXOSEAL W ABSORB PGA PLUG 5F

Facility

$1,025.00

Service Code	HCPCS C1760
Hospital Charge Code	270699377S
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

EXOSEAL W ABSORB PGA PLUG 5F

Facility

$1,025.00

Service Code	HCPCS C1760
Hospital Charge Code	270699377S
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

EXOSEAL W ABSORB PGA PLUG 6F

Facility

$1,025.00

Service Code	HCPCS C1760
Hospital Charge Code	270699378S
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

EXOSEAL W ABSORB PGA PLUG 6F

Facility

$1,025.00

Service Code	HCPCS C1760
Hospital Charge Code	270699378S
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

EXPANDABLE CAGE

Facility

$25,000.00

Hospital Charge Code	270703018
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

EXPANDABLE CAGE

Facility

$25,000.00

Hospital Charge Code	270703018
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

EXPANDABLE LAMINOPLASTY PLATE

Facility

$14,975.00

Hospital Charge Code	270702375
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

EXPANDABLE LAMINOPLASTY PLATE

Facility

$14,975.00

Hospital Charge Code	270702375
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$4,492.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

EXPANDER BREAST 550cc LOW

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER BREAST 550cc LOW

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$2,542.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER BREAST 650cc LOW 9100

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679519
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER BREAST 650cc LOW 9100

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679519
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$2,542.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER BREAST TISSUE 350CC

Facility

$9,875.00

Service Code	HCPCS C1789
Hospital Charge Code	270694200
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

EXPANDER BREAST TISSUE 350CC

Facility

$9,875.00

Service Code	HCPCS C1789
Hospital Charge Code	270694200
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$2,962.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

EXPANDERS BREAST 450 CC LOW T

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDERS BREAST 450 CC LOW T

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270679517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$2,542.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDERS TISSUE 360-430CC

Facility

$9,375.00

Service Code	HCPCS C1789
Hospital Charge Code	270696265
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

EXPANDERS TISSUE 360-430CC

Facility

$9,375.00

Service Code	HCPCS C1789
Hospital Charge Code	270696265
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$2,812.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

EXPANDER TIS 800 CONTR 3546216

Facility

$6,572.00

Hospital Charge Code	270633937
Hospital Revenue Code	278
Min. Negotiated Rate	$985.80
Max. Negotiated Rate	$1,590.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,314.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,590.42
Rate for Payer: Qualcare PPO/HMO/WC	$985.80

EXPANDER TIS 800 CONTR 3546216

Facility

$6,572.00

Hospital Charge Code	270633937
Hospital Revenue Code	278
Min. Negotiated Rate	$985.80
Max. Negotiated Rate	$3,286.00
Rate for Payer: Aetna Commercial	$1,971.60
Rate for Payer: Aetna Medicare Advantage	$1,971.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,675.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,675.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,314.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,675.86
Rate for Payer: Cigna Commercial	$3,286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,590.42
Rate for Payer: Qualcare PPO/HMO/WC	$985.80

Know your out-of-pocket cost for care.

All Charges