Heights University Hospital

All Charges

Charge

Type

Setting

Price

INJECT-INTRA-ARTERIL ONLY

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500057
Hospital Revenue Code	260
Min. Negotiated Rate	$12.12
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$77.10
Rate for Payer: Aetna Medicare Advantage	$77.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.53
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.41
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECT-INTRA-ARTERIL ONLY

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500057
Hospital Revenue Code	260
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

INJECTION CEFRIAXONE*****

Facility

$11.26

Service Code	HCPCS J0696
Hospital Charge Code	9600027
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$0.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

INJECTION CEFRIAXONE*****

Facility

$11.26

Service Code	HCPCS J0696
Hospital Charge Code	9600027
Hospital Revenue Code	636
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$2.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

INJECTION CORTICOTROPIN 500 MG

Facility

$154.25

Hospital Charge Code	6001358
Hospital Revenue Code	636
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$37.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

INJECTION CORTICOTROPIN 500 MG

Facility

$154.25

Hospital Charge Code	6001358
Hospital Revenue Code	636
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

INJECTION CORTICOTROPIN 80 U/M

Facility

$229.80

Hospital Charge Code	6001366
Hospital Revenue Code	636
Min. Negotiated Rate	$34.47
Max. Negotiated Rate	$55.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.47

INJECTION CORTICOTROPIN 80 U/M

Facility

$229.80

Hospital Charge Code	6001366
Hospital Revenue Code	636
Min. Negotiated Rate	$34.47
Max. Negotiated Rate	$114.90
Rate for Payer: Aetna Commercial	$68.94
Rate for Payer: Aetna Medicare Advantage	$68.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.60
Rate for Payer: Cigna Commercial	$114.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.47

INJECTION DIAZOXIDE 300MG/2ML

Facility

$666.90

Hospital Charge Code	6001887
Hospital Revenue Code	636
Min. Negotiated Rate	$100.03
Max. Negotiated Rate	$161.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.39
Rate for Payer: Qualcare PPO/HMO/WC	$100.03

INJECTION DIAZOXIDE 300MG/2ML

Facility

$666.90

Hospital Charge Code	6001887
Hospital Revenue Code	636
Min. Negotiated Rate	$100.03
Max. Negotiated Rate	$333.45
Rate for Payer: Aetna Commercial	$200.07
Rate for Payer: Aetna Medicare Advantage	$200.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.06
Rate for Payer: Cigna Commercial	$333.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.39
Rate for Payer: Qualcare PPO/HMO/WC	$100.03

INJECTION ENOXAPARIN 30MG

Facility

$97.30

Hospital Charge Code	6010599
Hospital Revenue Code	250
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.60

INJECTION ENOXAPARIN 30MG

Facility

$97.30

Hospital Charge Code	6010599
Hospital Revenue Code	250
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$48.65
Rate for Payer: Aetna Commercial	$29.19
Rate for Payer: Aetna Medicare Advantage	$29.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.81
Rate for Payer: Cigna Commercial	$48.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.65
Rate for Payer: Oxford Commercial	$48.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.60
Rate for Payer: UnitedHealthcare Commercial	$48.65

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	366847531
Hospital Revenue Code	361
Min. Negotiated Rate	$1,860.78
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$4,294.11
Rate for Payer: Aetna Medicare Advantage	$4,294.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,649.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,649.99
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	$3,649.99
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	7412075
Hospital Revenue Code	361
Min. Negotiated Rate	$2,147.05
Max. Negotiated Rate	$2,147.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	2011600
Hospital Revenue Code	361
Min. Negotiated Rate	$2,147.05
Max. Negotiated Rate	$2,147.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	2011600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,860.78
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$4,294.11
Rate for Payer: Aetna Medicare Advantage	$4,294.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,649.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,649.99
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	$3,649.99
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	7412075
Hospital Revenue Code	361
Min. Negotiated Rate	$1,860.78
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$4,294.11
Rate for Payer: Aetna Medicare Advantage	$4,294.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,649.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,649.99
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	$3,649.99
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INJECTION FOR CHOLANGIOGRAM

Facility

$11,644.64

Service Code	HCPCS 47531
Hospital Charge Code	16000982
Hospital Revenue Code	360
Min. Negotiated Rate	$1,513.80
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$3,493.39
Rate for Payer: Aetna Medicare Advantage	$3,493.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,969.38
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	$2,969.38
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,513.80
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,746.70
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	366847531
Hospital Revenue Code	361
Min. Negotiated Rate	$2,147.05
Max. Negotiated Rate	$2,147.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05

INJECTION FOR CHOLANGIOGRAM

Facility

$11,644.64

Service Code	HCPCS 47531
Hospital Charge Code	16000982
Hospital Revenue Code	360
Min. Negotiated Rate	$1,746.70
Max. Negotiated Rate	$1,746.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,746.70

INJECTION FOR HEART X-RAYS

Facility

$1,600.00

Service Code	HCPCS 93566
Hospital Charge Code	5100590
Hospital Revenue Code	481
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

INJECTION FOR HEART X-RAYS

Facility

$1,600.00

Service Code	HCPCS 93566
Hospital Charge Code	5100590
Hospital Revenue Code	481
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$24.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INJECTION FOR LUNG ANGIOGRAM

Facility

$1,280.00

Service Code	HCPCS 93541
Hospital Charge Code	5100093
Hospital Revenue Code	481
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

INJECTION FOR LUNG ANGIOGRAM

Facility

$1,280.00

Service Code	HCPCS 93541
Hospital Charge Code	5100093
Hospital Revenue Code	481
Min. Negotiated Rate	$166.40
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$384.00
Rate for Payer: Aetna Medicare Advantage	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.40
Rate for Payer: Cigna Commercial	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.40
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

INJECTION IA NON-CHEMO

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	3400257
Hospital Revenue Code	260
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges