Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$67.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,551.09
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$67.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$67.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,551.09
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$67.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRVU

Facility

$2,750.00

Hospital Charge Code	270705987
Hospital Revenue Code	279
Min. Negotiated Rate	$357.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.50
Rate for Payer: Oxford Commercial	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$1,375.00

INTRVU

Facility

$2,750.00

Hospital Charge Code	270705987
Hospital Revenue Code	279
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,975.44
Rate for Payer: Aetna Commercial	$4,975.44
Rate for Payer: Aetna Medicare Advantage	$4,975.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,229.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,229.12
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	$4,229.12
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,156.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$2,487.72
Max. Negotiated Rate	$2,487.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72

INTUBATING AIRWAY FIBEROPTIC O

Facility

$32.50

Hospital Charge Code	270662677
Hospital Revenue Code	270
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

INTUBATING AIRWAY FIBEROPTIC O

Facility

$32.50

Hospital Charge Code	270662677
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$16.25
Rate for Payer: Aetna Commercial	$9.75
Rate for Payer: Aetna Medicare Advantage	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.29
Rate for Payer: Cigna Commercial	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$16.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$16.25

INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	74110063
Hospital Revenue Code	361
Min. Negotiated Rate	$117.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$270.98
Rate for Payer: Aetna Medicare Advantage	$270.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.33
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	$230.33
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.42
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.49
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$166.16
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$383.44
Rate for Payer: Aetna Medicare Advantage	$383.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.93
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	$325.93
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.16
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$166.16
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$383.44
Rate for Payer: Aetna Medicare Advantage	$383.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.93
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	$325.93
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.16
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	74110063
Hospital Revenue Code	361
Min. Negotiated Rate	$135.49
Max. Negotiated Rate	$135.49
Rate for Payer: Qualcare PPO/HMO/WC	$135.49

INTUBATION,ENDOTRACH EMERG****

Facility

$672.00

Service Code	HCPCS 31500
Hospital Charge Code	5700035
Hospital Revenue Code	361
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
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	$171.36
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION,ENDOTRACH EMERG****

Facility

$672.00

Service Code	HCPCS 31500
Hospital Charge Code	5700035
Hospital Revenue Code	361
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

INTUBATION ET EMERGENT

Facility

$1,991.00

Service Code	HCPCS 31500
Hospital Charge Code	1600000667
Hospital Revenue Code	360
Min. Negotiated Rate	$258.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$597.30
Rate for Payer: Aetna Medicare Advantage	$597.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$507.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$507.70
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	$507.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$298.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	T
Hospital Revenue Code	360
Min. Negotiated Rate	$258.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$597.30
Rate for Payer: Aetna Medicare Advantage	$597.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$507.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$507.71
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	$507.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$298.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ET EMERGENT

Facility

$1,991.00

Service Code	HCPCS 31500
Hospital Charge Code	1600000667
Hospital Revenue Code	360
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$298.65
Rate for Payer: Qualcare PPO/HMO/WC	$298.65

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	T
Hospital Revenue Code	360
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$298.65
Rate for Payer: Qualcare PPO/HMO/WC	$298.65

INVEGA HSP 3MG TAB

Facility

$54.00

Hospital Charge Code	60635648
Hospital Revenue Code	250
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

INVEGA HSP 3MG TAB

Facility

$54.00

Hospital Charge Code	60635648
Hospital Revenue Code	250
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$27.00

INVEGA HSP 6MG TAB

Facility

$58.00

Hospital Charge Code	60635671
Hospital Revenue Code	250
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

Know your out-of-pocket cost for care.

All Charges