Heights University Hospital

All Charges

Charge

Type

Setting

Price

HOLISTER/PLASTIBILL 1.5***

Facility

$8.00

Hospital Charge Code	1800044
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HOLMIUM 1000MICRON LASER FIBER

Facility

$1,610.00

Hospital Charge Code	270632053
Hospital Revenue Code	272
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$241.50
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

HOLMIUM 1000MICRON LASER FIBER

Facility

$1,610.00

Hospital Charge Code	270632053
Hospital Revenue Code	272
Min. Negotiated Rate	$209.30
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$483.00
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.30
Rate for Payer: Oxford Commercial	$805.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Commercial	$805.00

HOLMIUM FIBER

Facility

$1,610.00

Hospital Charge Code	270684297
Hospital Revenue Code	272
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$241.50
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

HOLMIUM FIBER

Facility

$1,610.00

Hospital Charge Code	270684297
Hospital Revenue Code	272
Min. Negotiated Rate	$209.30
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$483.00
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.30
Rate for Payer: Oxford Commercial	$805.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Commercial	$805.00

HOLMIUM FIBER 1000 MICRON

Facility

$1,500.00

Hospital Charge Code	270683939
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$750.00

HOLMIUM FIBER 1000 MICRON

Facility

$1,500.00

Hospital Charge Code	270683939
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

HOLMIUM LASER FIBER 200 M/USE

Facility

$3,187.50

Hospital Charge Code	270658585
Hospital Revenue Code	272
Min. Negotiated Rate	$478.12
Max. Negotiated Rate	$478.12
Rate for Payer: Qualcare PPO/HMO/WC	$478.12

HOLMIUM LASER FIBER 200 M/USE

Facility

$3,187.50

Hospital Charge Code	270658585
Hospital Revenue Code	272
Min. Negotiated Rate	$414.38
Max. Negotiated Rate	$1,593.75
Rate for Payer: Aetna Commercial	$956.25
Rate for Payer: Aetna Medicare Advantage	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$812.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$812.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$812.81
Rate for Payer: Cigna Commercial	$1,593.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.38
Rate for Payer: Oxford Commercial	$1,593.75
Rate for Payer: Qualcare PPO/HMO/WC	$478.12
Rate for Payer: UnitedHealthcare Commercial	$1,593.75

HOLTER MONITOR RECORDING

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	3654000
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR RECORDING

Facility

$1,007.00

Service Code	HCPCS 93225
Hospital Charge Code	36540008
Hospital Revenue Code	731
Min. Negotiated Rate	$151.05
Max. Negotiated Rate	$151.05
Rate for Payer: Qualcare PPO/HMO/WC	$151.05

HOLTER MONITOR RECORDING

Facility

$1,007.00

Service Code	HCPCS 93225
Hospital Charge Code	36540008
Hospital Revenue Code	731
Min. Negotiated Rate	$130.91
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$302.10
Rate for Payer: Aetna Medicare Advantage	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.79
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.91
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.05
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR RECORDING

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	3654000
Hospital Revenue Code	731
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCAN ANALYS RPT

Facility

$1,776.00

Service Code	HCPCS 93226
Hospital Charge Code	36540007
Hospital Revenue Code	731
Min. Negotiated Rate	$266.40
Max. Negotiated Rate	$266.40
Rate for Payer: Qualcare PPO/HMO/WC	$266.40

HOLTER MONITOR SCAN ANALYS RPT

Facility

$1,776.00

Service Code	HCPCS 93226
Hospital Charge Code	36540007
Hospital Revenue Code	731
Min. Negotiated Rate	$140.48
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$532.80
Rate for Payer: Aetna Medicare Advantage	$532.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.88
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.88
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.40
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74115013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	5300042
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74116013
Hospital Revenue Code	731
Min. Negotiated Rate	$140.48
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	5300042
Hospital Revenue Code	731
Min. Negotiated Rate	$140.48
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCANNING & RPT

Facility

$300.85

Service Code	HCPCS 93226
Hospital Charge Code	94053055
Hospital Revenue Code	731
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$45.13
Rate for Payer: Qualcare PPO/HMO/WC	$45.13

HOLTER MONITOR SCANNING & RPT

Facility

$300.85

Service Code	HCPCS 93226
Hospital Charge Code	94053055
Hospital Revenue Code	731
Min. Negotiated Rate	$39.11
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$90.25
Rate for Payer: Aetna Medicare Advantage	$90.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.72
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.11
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.13
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74117013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74116013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74115013
Hospital Revenue Code	731
Min. Negotiated Rate	$140.48
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74117013
Hospital Revenue Code	731
Min. Negotiated Rate	$140.48
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

Know your out-of-pocket cost for care.

All Charges