Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2670095
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$72.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	321076942
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2670095
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR DIR-VENOUS SAMPLING

Facility

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	2670025
Hospital Revenue Code	320
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$3,720.22
Rate for Payer: Aetna Medicare Advantage	$3,720.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,162.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,162.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,162.19
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR DIR-VENOUS SAMPLING

Facility

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	7411727
Hospital Revenue Code	320
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$3,720.22
Rate for Payer: Aetna Medicare Advantage	$3,720.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,162.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,162.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,162.19
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR DIR-VENOUS SAMPLING

Facility

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	7411727
Hospital Revenue Code	320
Min. Negotiated Rate	$1,860.11
Max. Negotiated Rate	$1,860.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11

IR DIR-VENOUS SAMPLING

Facility

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	2670025
Hospital Revenue Code	320
Min. Negotiated Rate	$1,860.11
Max. Negotiated Rate	$1,860.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	7411662
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$5,656.68
Rate for Payer: Aetna Better Health Medicaid	$5,545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	2680255
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	7411662
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	2680255
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$5,656.68
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$5,545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	321072295
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	7411663
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	366872295
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	411072295
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	2680260
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	411072295
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	2680260
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	321072295
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	7411663
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68

IR DISKOGRAPHY LUMBAR

Facility

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	366872295
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$4,650.22
Rate for Payer: Aetna Better Health Medicaid	$545.76
Rate for Payer: Aetna Commercial	$2,978.40
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68

IR DRAINAGE LIVER

Facility

$3,410.10

Hospital Charge Code	2600061
Hospital Revenue Code	361
Min. Negotiated Rate	$511.51
Max. Negotiated Rate	$511.51
Rate for Payer: Qualcare PPO/HMO/WC	$511.51

IR DRAINAGE LIVER

Facility

$3,410.10

Hospital Charge Code	2600061
Hospital Revenue Code	361
Min. Negotiated Rate	$443.31
Max. Negotiated Rate	$1,864.00
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	$1,705.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.31
Rate for Payer: Qualcare PPO/HMO/WC	$511.51

IR DRAINAGE LUNG BILATERAL

Facility

$1,139.65

Hospital Charge Code	2600062
Hospital Revenue Code	361
Min. Negotiated Rate	$170.95
Max. Negotiated Rate	$170.95
Rate for Payer: Qualcare PPO/HMO/WC	$170.95

IR DRAINAGE LUNG BILATERAL

Facility

$1,139.65

Hospital Charge Code	2600062
Hospital Revenue Code	361
Min. Negotiated Rate	$148.15
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$341.89
Rate for Payer: Aetna Medicare Advantage	$341.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.61
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	$290.61
Rate for Payer: Cigna Commercial	$569.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.15
Rate for Payer: Qualcare PPO/HMO/WC	$170.95

Know your out-of-pocket cost for care.

All Charges