Heights University Hospital

All Charges

Charge

Type

Setting

Price

INJECTION THERAPY OF VEINS

Facility

$1,243.20

Service Code	HCPCS 36471
Hospital Charge Code	1600000779
Hospital Revenue Code	360
Min. Negotiated Rate	$186.48
Max. Negotiated Rate	$186.48
Rate for Payer: Qualcare PPO/HMO/WC	$186.48

INJECTION TREATMENT OF NERVE

Facility

$4,216.24

Service Code	HCPCS 64620
Hospital Charge Code	1600000781
Hospital Revenue Code	360
Min. Negotiated Rate	$632.44
Max. Negotiated Rate	$632.44
Rate for Payer: Qualcare PPO/HMO/WC	$632.44

INJECTION TREATMENT OF NERVE

Facility

$5,111.97

Service Code	HCPCS 64640
Hospital Charge Code	321564640
Hospital Revenue Code	361
Min. Negotiated Rate	$664.56
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Better Health Medicaid	$2,266.41
Rate for Payer: Aetna Commercial	$1,533.59
Rate for Payer: Aetna Medicare Advantage	$1,533.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.55
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	$1,303.55
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.56
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$766.80
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

INJECTION TREATMENT OF NERVE

Facility

$11,498.50

Service Code	HCPCS 64605
Hospital Charge Code	1600000527
Hospital Revenue Code	360
Min. Negotiated Rate	$1,494.81
Max. Negotiated Rate	$5,656.68
Rate for Payer: Aetna Better Health Medicaid	$5,545.76
Rate for Payer: Aetna Commercial	$3,449.55
Rate for Payer: Aetna Medicare Advantage	$3,449.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.12
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	$2,932.12
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,494.81
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,724.78
Rate for Payer: UnitedHealthcare Commercial	$5,529.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5,545.76

INJECTION TREATMENT OF NERVE

Facility

$4,216.24

Service Code	HCPCS 64620
Hospital Charge Code	1600000781
Hospital Revenue Code	360
Min. Negotiated Rate	$548.11
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Better Health Medicaid	$2,266.41
Rate for Payer: Aetna Commercial	$1,264.87
Rate for Payer: Aetna Medicare Advantage	$1,264.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,075.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,075.14
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	$1,075.14
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.11
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$632.44
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

INJECTION TREATMENT OF NERVE

Facility

$11,498.50

Service Code	HCPCS 64605
Hospital Charge Code	1600000527
Hospital Revenue Code	360
Min. Negotiated Rate	$1,724.78
Max. Negotiated Rate	$1,724.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,724.78

INJECTION TREATMENT OF NERVE

Facility

$5,111.97

Service Code	HCPCS 64640
Hospital Charge Code	321564640
Hospital Revenue Code	361
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$766.80
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

INJECTOR BONE CEMENT

Facility

$205.00

Hospital Charge Code	270600344
Hospital Revenue Code	272
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

INJECTOR BONE CEMENT

Facility

$205.00

Hospital Charge Code	270600344
Hospital Revenue Code	272
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$102.50
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$102.50

INJECTOR CT SYRINGE FL DUAL

Facility

$71.94

Hospital Charge Code	270690349
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$10.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.79

INJECTOR CT SYRINGE FL DUAL

Facility

$71.94

Hospital Charge Code	270690349
Hospital Revenue Code	272
Min. Negotiated Rate	$9.35
Max. Negotiated Rate	$35.97
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna Medicare Advantage	$21.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$35.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.35
Rate for Payer: Oxford Commercial	$35.97
Rate for Payer: Qualcare PPO/HMO/WC	$10.79
Rate for Payer: UnitedHealthcare Commercial	$35.97

INJECTOR CT SYRINGE FL SINGLE

Facility

$35.80

Hospital Charge Code	270690350
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$17.90
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.13
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.65
Rate for Payer: Oxford Commercial	$17.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$17.90

INJECTOR CT SYRINGE FL SINGLE

Facility

$35.80

Hospital Charge Code	270690350
Hospital Revenue Code	272
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.37

INJECTOR FOR STAR LENS MSI-PR

Facility

$145.00

Hospital Charge Code	270638365
Hospital Revenue Code	276
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

INJECTOR FOR STAR LENS MSI-PR

Facility

$145.00

Hospital Charge Code	270638365
Hospital Revenue Code	276
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

INJECTOR INLINE *******

Facility

$43.00

Hospital Charge Code	8003188
Hospital Revenue Code	279
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

INJECTOR INLINE *******

Facility

$43.00

Hospital Charge Code	8003188
Hospital Revenue Code	279
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

INJECTOR RESTRICTOR MIL

Facility

$218.45

Hospital Charge Code	270600230
Hospital Revenue Code	272
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$32.77
Rate for Payer: Qualcare PPO/HMO/WC	$32.77

INJECTOR RESTRICTOR MIL

Facility

$218.45

Hospital Charge Code	270600230
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$109.22
Rate for Payer: Aetna Commercial	$65.53
Rate for Payer: Aetna Medicare Advantage	$65.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.70
Rate for Payer: Cigna Commercial	$109.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.40
Rate for Payer: Oxford Commercial	$109.22
Rate for Payer: Qualcare PPO/HMO/WC	$32.77
Rate for Payer: UnitedHealthcare Commercial	$109.22

INJECTOR SYRINGE FASTLOAD MR

Facility

$66.00

Hospital Charge Code	270690351
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

INJECTOR SYRINGE FASTLOAD MR

Facility

$66.00

Hospital Charge Code	270690351
Hospital Revenue Code	272
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

INJECT R VENTR/ATRIAL ANGIO

Facility

$6,070.00

Service Code	HCPCS 93566
Hospital Charge Code	411093566
Hospital Revenue Code	481
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
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	$1,547.85
Rate for Payer: Cigna Commercial	$24.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INJECT R VENTR/ATRIAL ANGIO

Facility

$6,070.00

Service Code	HCPCS 93566
Hospital Charge Code	411093566
Hospital Revenue Code	481
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

INJECT SACROILIAC JOINT

Facility

$12,825.00

Service Code	HCPCS 27096
Hospital Charge Code	16000706
Hospital Revenue Code	360
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$3,847.50
Rate for Payer: Aetna Commercial	$3,847.50
Rate for Payer: Aetna Medicare Advantage	$3,847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,270.38
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	$3,270.38
Rate for Payer: Cigna Commercial	$80.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,667.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,923.75
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INJECT SACROILIAC JOINT

Facility

$12,825.00

Service Code	HCPCS 27096
Hospital Charge Code	16000706
Hospital Revenue Code	360
Min. Negotiated Rate	$1,923.75
Max. Negotiated Rate	$1,923.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,923.75

Know your out-of-pocket cost for care.

All Charges