Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLUORO EXAM OF G/COLON TUBE

Facility

$929.24

Service Code	HCPCS 49465
Hospital Charge Code	16000752
Hospital Revenue Code	360
Min. Negotiated Rate	$120.80
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$278.77
Rate for Payer: Aetna Medicare Advantage	$278.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.96
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	$236.96
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.39
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FLUORO EXAM OF G/COLON TUBE

Facility

$929.24

Service Code	HCPCS 49465
Hospital Charge Code	16000752
Hospital Revenue Code	360
Min. Negotiated Rate	$139.39
Max. Negotiated Rate	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$139.39

FLUORO GUIDED NEEDLE PLCMT

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	5100827
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$138.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUORO GUIDED NEEDLE PLCMT

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	5100827
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FLUOROGUIDE FOR SPINE INJ

Facility

$457.84

Service Code	HCPCS 77001
Hospital Charge Code	1600000590
Hospital Revenue Code	360
Min. Negotiated Rate	$59.52
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$137.35
Rate for Payer: Aetna Medicare Advantage	$137.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.75
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	$116.75
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.52
Rate for Payer: Qualcare PPO/HMO/WC	$68.68

FLUOROGUIDE FOR SPINE INJ

Facility

$457.84

Service Code	HCPCS 77001
Hospital Charge Code	1600000590
Hospital Revenue Code	360
Min. Negotiated Rate	$68.68
Max. Negotiated Rate	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$68.68

FLUOROMETHALONE 0.25%

Facility

$122.25

Hospital Charge Code	6007355
Hospital Revenue Code	251
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$18.34
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

FLUOROMETHALONE 0.25%

Facility

$122.25

Hospital Charge Code	6007355
Hospital Revenue Code	251
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$36.67
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: Oxford Commercial	$61.12
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Commercial	$61.12

FLUOROMETHOLONE OPH SSP 0.1%

Facility

$170.45

Hospital Charge Code	60628038
Hospital Revenue Code	250
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

FLUOROMETHOLONE OPH SSP 0.1%

Facility

$170.45

Hospital Charge Code	60628038
Hospital Revenue Code	250
Min. Negotiated Rate	$22.16
Max. Negotiated Rate	$85.22
Rate for Payer: Aetna Commercial	$51.13
Rate for Payer: Aetna Medicare Advantage	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$85.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.16
Rate for Payer: Oxford Commercial	$85.22
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
Rate for Payer: UnitedHealthcare Commercial	$85.22

FLUOROMETHOLONE OPH SSP 0.25%

Facility

$60.00

Hospital Charge Code	60628039
Hospital Revenue Code	250
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

FLUOROMETHOLONE OPH SSP 0.25%

Facility

$60.00

Hospital Charge Code	60628039
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

FLUOROSCOPE EXAM EXTENSIVE

Facility

$1,005.00

Service Code	HCPCS 76001
Hospital Charge Code	411076001
Hospital Revenue Code	320
Min. Negotiated Rate	$150.75
Max. Negotiated Rate	$150.75
Rate for Payer: Qualcare PPO/HMO/WC	$150.75

FLUOROSCOPE EXAM EXTENSIVE

Facility

$1,005.00

Service Code	HCPCS 76001
Hospital Charge Code	411076001
Hospital Revenue Code	320
Min. Negotiated Rate	$130.65
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$301.50
Rate for Payer: Aetna Medicare Advantage	$301.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.27
Rate for Payer: Cigna Commercial	$502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.75
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPE EXAM EXTENSIVE

Facility

$1,005.00

Service Code	HCPCS 76001
Hospital Charge Code	366876001
Hospital Revenue Code	320
Min. Negotiated Rate	$150.75
Max. Negotiated Rate	$150.75
Rate for Payer: Qualcare PPO/HMO/WC	$150.75

FLUOROSCOPE EXAM EXTENSIVE

Facility

$1,005.00

Service Code	HCPCS 76001
Hospital Charge Code	366876001
Hospital Revenue Code	320
Min. Negotiated Rate	$130.65
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$301.50
Rate for Payer: Aetna Medicare Advantage	$301.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.27
Rate for Payer: Cigna Commercial	$502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.75
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	411076496
Hospital Revenue Code	320
Min. Negotiated Rate	$38.23
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	366876496
Hospital Revenue Code	320
Min. Negotiated Rate	$38.23
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	411076496
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	366876946
Hospital Revenue Code	320
Min. Negotiated Rate	$38.23
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	366876946
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FLUOROSCOPIC PROCEDURE

Facility

$5,100.00

Service Code	HCPCS 76946
Hospital Charge Code	366876496
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FLUOROSCOPY

Facility

$5,100.00

Service Code	HCPCS 76000
Hospital Charge Code	366876000
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

FLUOROSCOPY

Facility

$5,100.00

Service Code	HCPCS 76000
Hospital Charge Code	7411167
Hospital Revenue Code	320
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FLUOROSCOPY

Facility

$5,100.00

Service Code	HCPCS 76000
Hospital Charge Code	366876000
Hospital Revenue Code	320
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges