Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ABD PELV VASC SEL CATH ADDL

Facility

$414.45

Service Code	HCPCS 36248
Hospital Charge Code	7411433
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR ABD PELV VASC SEL CATH ADDL

Facility

$484.00

Service Code	HCPCS 36248
Hospital Charge Code	321036248
Hospital Revenue Code	361
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-ABD/RETROPERIT MASS

Facility

$4,709.90

Service Code	HCPCS 49180
Hospital Charge Code	2009020
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-ABD/RETROPERIT MASS

Facility

$4,709.90

Service Code	HCPCS 49180
Hospital Charge Code	2009020
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-ABD RETROPERITONEAL BIOPSY

Facility

$4,709.90

Service Code	HCPCS 49180
Hospital Charge Code	7411578
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-ABD RETROPERITONEAL BIOPSY

Facility

$4,709.90

Service Code	HCPCS 49180
Hospital Charge Code	7411578
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-ABD RETROPERITONEAL BIOPSY

Facility

$8,054.80

Service Code	HCPCS 49180
Hospital Charge Code	321049180
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-ABD RETROPERITONEAL BIOPSY

Facility

$8,054.80

Service Code	HCPCS 49180
Hospital Charge Code	2670155
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-ABD RETROPERITONEAL BIOPSY

Facility

$8,054.80

Service Code	HCPCS 49180
Hospital Charge Code	321049180
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-ABD RETROPERITONEAL BIOPSY

Facility

$8,054.80

Service Code	HCPCS 49180
Hospital Charge Code	2670155
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR ABSC DRNGE PERC LIVER

Facility

$6,769.70

Service Code	HCPCS 49405
Hospital Charge Code	411049405
Hospital Revenue Code	361
Min. Negotiated Rate	$880.06
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,030.91
Rate for Payer: Aetna Medicare Advantage	$2,030.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.27
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	$1,726.27
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.06
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.46
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSC DRNGE PERC LIVER

Facility

$6,769.70

Service Code	HCPCS 49405
Hospital Charge Code	366849405
Hospital Revenue Code	361
Min. Negotiated Rate	$1,015.46
Max. Negotiated Rate	$1,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.46

IR ABSC DRNGE PERC LIVER

Facility

$3,410.10

Service Code	HCPCS 49405
Hospital Charge Code	7411580
Hospital Revenue Code	361
Min. Negotiated Rate	$443.31
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,023.03
Rate for Payer: Aetna Medicare Advantage	$1,023.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.58
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	$869.58
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.31
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.51
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSC DRNGE PERC LIVER

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	321049405
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR ABSC DRNGE PERC LIVER

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2003077
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSC DRNGE PERC LIVER

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2003077
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR ABSC DRNGE PERC LIVER

Facility

$3,410.10

Service Code	HCPCS 49405
Hospital Charge Code	7411580
Hospital Revenue Code	361
Min. Negotiated Rate	$511.51
Max. Negotiated Rate	$511.51
Rate for Payer: Qualcare PPO/HMO/WC	$511.51

IR ABSC DRNGE PERC LIVER

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	321049405
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSC DRNGE PERC LIVER

Facility

$6,769.70

Service Code	HCPCS 49405
Hospital Charge Code	411049405
Hospital Revenue Code	361
Min. Negotiated Rate	$1,015.46
Max. Negotiated Rate	$1,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.46

IR ABSC DRNGE PERC LIVER

Facility

$6,769.70

Service Code	HCPCS 49405
Hospital Charge Code	366849405
Hospital Revenue Code	361
Min. Negotiated Rate	$880.06
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,030.91
Rate for Payer: Aetna Medicare Advantage	$2,030.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.27
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	$1,726.27
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.06
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.46
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSCESS DRAINAGE

Facility

$5,100.00

Service Code	HCPCS 75989
Hospital Charge Code	411075989
Hospital Revenue Code	320
Min. Negotiated Rate	$126.54
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$126.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ABSCESS DRAINAGE

Facility

$5,100.00

Service Code	HCPCS 75989
Hospital Charge Code	2002327
Hospital Revenue Code	320
Min. Negotiated Rate	$126.54
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$126.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ABSCESS DRAINAGE

Facility

$5,100.00

Service Code	HCPCS 75989
Hospital Charge Code	2002327
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR ABSCESS DRAINAGE

Facility

$5,100.00

Service Code	HCPCS 75989
Hospital Charge Code	411075989
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR ABSCESS DRAINAGE

Facility

$5,100.00

Service Code	HCPCS 75989
Hospital Charge Code	366875989
Hospital Revenue Code	320
Min. Negotiated Rate	$126.54
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$126.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges