Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ABSCESS DRAIN SUBDIA SUBPHR

Facility

$6,139.10

Hospital Charge Code	2004018
Hospital Revenue Code	361
Min. Negotiated Rate	$920.87
Max. Negotiated Rate	$920.87
Rate for Payer: Qualcare PPO/HMO/WC	$920.87

IR ABSCESS DRAIN SUBDIA SUBPHR

Facility

$6,139.10

Hospital Charge Code	2004018
Hospital Revenue Code	361
Min. Negotiated Rate	$798.08
Max. Negotiated Rate	$3,069.55
Rate for Payer: Aetna Commercial	$1,841.73
Rate for Payer: Aetna Medicare Advantage	$1,841.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.47
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	$1,565.47
Rate for Payer: Cigna Commercial	$3,069.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.08
Rate for Payer: Qualcare PPO/HMO/WC	$920.87

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	366849406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	411049406
Hospital Revenue Code	361
Min. Negotiated Rate	$919.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.42
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	366849406
Hospital Revenue Code	361
Min. Negotiated Rate	$919.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.42
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	411049406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	7411584
Hospital Revenue Code	361
Min. Negotiated Rate	$919.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.42
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	7411584
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	7411771
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	2690305
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	7411771
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	2690305
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	2690880
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	7411861
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	2690880
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	7411861
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	7411862
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	2690885
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	2690885
Hospital Revenue Code	361
Min. Negotiated Rate	$236.47
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$545.70
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.47
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	7411862
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	2690140
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$84.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	7411579
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	2690140
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	7411579
Hospital Revenue Code	361
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$84.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	2004851
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges