Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSERT PELV FIXATION DEVICE

Facility

$1,610.24

Service Code	HCPCS 22848
Hospital Charge Code	16000809
Hospital Revenue Code	360
Min. Negotiated Rate	$241.54
Max. Negotiated Rate	$241.54
Rate for Payer: Qualcare PPO/HMO/WC	$241.54

INSERT PELV FIXATION DEVICE

Facility

$1,610.24

Service Code	HCPCS 22848
Hospital Charge Code	16000809
Hospital Revenue Code	360
Min. Negotiated Rate	$209.33
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$483.07
Rate for Payer: Aetna Medicare Advantage	$483.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.61
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	$410.61
Rate for Payer: Cigna Commercial	$344.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.54
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	411036573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	404236573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	366836573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	404636573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	404236573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	321036573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	321036573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	366236573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	366236573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	366836573
Hospital Revenue Code	361
Min. Negotiated Rate	$961.76
Max. Negotiated Rate	$961.76
Rate for Payer: Qualcare PPO/HMO/WC	$961.76

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	404636573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC >5YRS W IMAGING

Facility

$6,411.73

Service Code	HCPCS 36573
Hospital Charge Code	411036573
Hospital Revenue Code	361
Min. Negotiated Rate	$833.52
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,923.52
Rate for Payer: Aetna Medicare Advantage	$1,923.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,634.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,634.99
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	$1,634.99
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$833.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$961.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSERT PICC W/O IMAGING > 5YRS

Facility

$7,852.40

Service Code	HCPCS 36569
Hospital Charge Code	5790100
Hospital Revenue Code	450
Min. Negotiated Rate	$1,177.86
Max. Negotiated Rate	$1,177.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.86

INSERT PICC W/O IMAGING > 5YRS

Facility

$7,852.40

Service Code	HCPCS 36569
Hospital Charge Code	5790100
Hospital Revenue Code	450
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$2,355.72
Rate for Payer: Aetna Medicare Advantage	$2,355.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,002.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,002.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,002.36
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.86

INSERT PLEUAL CATH-LT

Facility

$17,259.20

Service Code	HCPCS 32550LT
Hospital Charge Code	321032550L
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INSERT PLEUAL CATH-LT

Facility

$9,055.00

Service Code	HCPCS 32550LT
Hospital Charge Code	7411883
Hospital Revenue Code	361
Min. Negotiated Rate	$1,358.25
Max. Negotiated Rate	$1,358.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,358.25

INSERT PLEUAL CATH-LT

Facility

$17,259.20

Service Code	HCPCS 32550LT
Hospital Charge Code	2691060
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INSERT PLEUAL CATH-LT

Facility

$17,259.20

Service Code	HCPCS 32550LT
Hospital Charge Code	2691060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,629.60
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,629.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INSERT PLEUAL CATH-LT

Facility

$17,259.20

Service Code	HCPCS 32550LT
Hospital Charge Code	321032550L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,629.60
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,629.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INSERT PLEUAL CATH-LT

Facility

$9,055.00

Service Code	HCPCS 32550LT
Hospital Charge Code	7411883
Hospital Revenue Code	361
Min. Negotiated Rate	$1,177.15
Max. Negotiated Rate	$4,527.50
Rate for Payer: Aetna Commercial	$2,716.50
Rate for Payer: Aetna Medicare Advantage	$2,716.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,309.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,309.03
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	$2,309.03
Rate for Payer: Cigna Commercial	$4,527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,358.25

INSERT PLEURAL CATH

Facility

$9,976.00

Service Code	HCPCS 32550
Hospital Charge Code	1600000689
Hospital Revenue Code	360
Min. Negotiated Rate	$1,496.40
Max. Negotiated Rate	$1,496.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.40

INSERT PLEURAL CATH

Facility

$9,976.00

Service Code	HCPCS 32550
Hospital Charge Code	1600000689
Hospital Revenue Code	360
Min. Negotiated Rate	$1,296.88
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$2,992.80
Rate for Payer: Aetna Medicare Advantage	$2,992.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.88
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	$2,543.88
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,296.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.40
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INSERT POLYETHYLENE 10 DEGR 36

Facility

$4,836.25

Service Code	HCPCS C1776
Hospital Charge Code	270676582
Hospital Revenue Code	278
Min. Negotiated Rate	$725.44
Max. Negotiated Rate	$2,418.12
Rate for Payer: Aetna Commercial	$1,450.88
Rate for Payer: Aetna Medicare Advantage	$1,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,233.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,233.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$967.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,233.24
Rate for Payer: Cigna Commercial	$2,418.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.37
Rate for Payer: Qualcare PPO/HMO/WC	$725.44

Know your out-of-pocket cost for care.

All Charges