Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR BX LYMPH NODE LT

Facility

$6,202.00

Service Code	HCPCS 38505LT
Hospital Charge Code	2250431
Hospital Revenue Code	361
Min. Negotiated Rate	$806.26
Max. Negotiated Rate	$3,101.00
Rate for Payer: Aetna Commercial	$1,860.60
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.26
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR BX LYMPH NODE RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	23001105
Hospital Revenue Code	361
Min. Negotiated Rate	$806.26
Max. Negotiated Rate	$3,101.00
Rate for Payer: Aetna Commercial	$1,860.60
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.26
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR BX LYMPH NODE RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	2250430
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR BX LYMPH NODE RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	2250430
Hospital Revenue Code	361
Min. Negotiated Rate	$806.26
Max. Negotiated Rate	$3,101.00
Rate for Payer: Aetna Commercial	$1,860.60
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.26
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR BX LYMPH NODE RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	23001105
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR BX PROCEDURE TRAY

Facility

$37.00

Hospital Charge Code	4800960
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

IR BX PROCEDURE TRAY

Facility

$37.00

Hospital Charge Code	4800960
Hospital Revenue Code	272
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.81
Rate for Payer: Oxford Commercial	$18.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$18.50

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$7,457.80

Service Code	HCPCS 55700
Hospital Charge Code	7411634
Hospital Revenue Code	361
Min. Negotiated Rate	$969.51
Max. Negotiated Rate	$3,728.90
Rate for Payer: Aetna Commercial	$2,237.34
Rate for Payer: Aetna Medicare Advantage	$2,237.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,901.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,901.74
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	$1,901.74
Rate for Payer: Cigna Commercial	$3,728.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.51
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,118.67
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$7,457.80

Service Code	HCPCS 55700
Hospital Charge Code	7411634
Hospital Revenue Code	361
Min. Negotiated Rate	$1,118.67
Max. Negotiated Rate	$1,118.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,118.67

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	2670130
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	2670130
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55705
Hospital Charge Code	321055700
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55705
Hospital Charge Code	321055700
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-BX SOFT TISSUE-SUPR-BI

Facility

$1,916.00

Service Code	HCPCS 2704050
Hospital Charge Code	2690340
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-BI

Facility

$1,916.00

Service Code	HCPCS 2704050
Hospital Charge Code	7411776
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-BI

Facility

$1,916.00

Service Code	HCPCS 2704050
Hospital Charge Code	2690340
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-BI

Facility

$1,916.00

Service Code	HCPCS 2704050
Hospital Charge Code	7411776
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-LT

Facility

$1,916.00

Service Code	HCPCS 27040LT
Hospital Charge Code	2690960
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-LT

Facility

$1,916.00

Service Code	HCPCS 27040LT
Hospital Charge Code	2690960
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-LT

Facility

$1,916.00

Service Code	HCPCS 27040LT
Hospital Charge Code	7411871
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-LT

Facility

$1,916.00

Service Code	HCPCS 27040LT
Hospital Charge Code	7411871
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-RT

Facility

$1,916.00

Service Code	HCPCS 27040RT
Hospital Charge Code	2690965
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-RT

Facility

$1,916.00

Service Code	HCPCS 27040RT
Hospital Charge Code	7411872
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-RT

Facility

$1,916.00

Service Code	HCPCS 27040RT
Hospital Charge Code	2690965
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BX SOFT TISSUE-SUPR-RT

Facility

$1,916.00

Service Code	HCPCS 27040RT
Hospital Charge Code	7411872
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

Know your out-of-pocket cost for care.

All Charges