Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	7411874
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	2690975
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	2690695
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	7411832
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	7411832
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	2690695
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	7411986
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	2691730
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	7411986
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	2691730
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	2691735
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	7411987
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	7411987
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	2691735
Hospital Revenue Code	361
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$129.30
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	7412039
Hospital Revenue Code	361
Min. Negotiated Rate	$1,591.07
Max. Negotiated Rate	$1,591.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	2690605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,591.07
Max. Negotiated Rate	$1,591.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	7412039
Hospital Revenue Code	361
Min. Negotiated Rate	$1,378.92
Max. Negotiated Rate	$5,303.55
Rate for Payer: Aetna Commercial	$3,182.13
Rate for Payer: Aetna Medicare Advantage	$3,182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,704.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,704.81
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	$2,704.81
Rate for Payer: Cigna Commercial	$5,303.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,378.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

IR-BIOPSY KIDNEY-BI

Facility

$1,478.00

Service Code	HCPCS 5020050
Hospital Charge Code	7411818
Hospital Revenue Code	361
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$221.70
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	2690605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,378.92
Max. Negotiated Rate	$5,303.55
Rate for Payer: Aetna Commercial	$3,182.13
Rate for Payer: Aetna Medicare Advantage	$3,182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,704.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,704.81
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	$2,704.81
Rate for Payer: Cigna Commercial	$5,303.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,378.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

IR-BIOPSY KIDNEY-BI

Facility

$1,478.00

Service Code	HCPCS 5020050
Hospital Charge Code	7411818
Hospital Revenue Code	361
Min. Negotiated Rate	$192.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$443.40
Rate for Payer: Aetna Medicare Advantage	$443.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.89
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	$376.89
Rate for Payer: Cigna Commercial	$739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.14
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	321050200L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$4,027.40
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	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-LT

Facility

$1,478.00

Service Code	HCPCS 50200LT
Hospital Charge Code	7411956
Hospital Revenue Code	361
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$221.70
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2691540
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-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2691540
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$4,027.40
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	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2101202
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$4,027.40
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	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

Know your out-of-pocket cost for care.

All Charges