Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-INCISION BREAST LESION

Facility

$3,801.00

Service Code	HCPCS 19020
Hospital Charge Code	2690005
Hospital Revenue Code	361
Min. Negotiated Rate	$570.15
Max. Negotiated Rate	$570.15
Rate for Payer: Qualcare PPO/HMO/WC	$570.15

IR-INCISION BREAST LESION

Facility

$3,801.00

Service Code	HCPCS 19020
Hospital Charge Code	7411338
Hospital Revenue Code	361
Min. Negotiated Rate	$494.13
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$1,140.30
Rate for Payer: Aetna Medicare Advantage	$1,140.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$969.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$969.25
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	$969.25
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.13
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$570.15
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR INCISION OF GALL BLADDER

Facility

$10,885.55

Service Code	HCPCS 47490
Hospital Charge Code	7411558
Hospital Revenue Code	360
Min. Negotiated Rate	$1,415.12
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$3,265.66
Rate for Payer: Aetna Medicare Advantage	$3,265.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,775.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,775.82
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	$2,775.82
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.12
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR INCISION OF GALL BLADDER

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2011281
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

IR INCISION OF GALL BLADDER

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2011281
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

IR INCISION OF GALL BLADDER

Facility

$10,885.55

Service Code	HCPCS 47490
Hospital Charge Code	7411558
Hospital Revenue Code	360
Min. Negotiated Rate	$1,632.83
Max. Negotiated Rate	$1,632.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83

IR INFUSION THERAPY ANY METHOD

Facility

$2,998.75

Hospital Charge Code	2600089
Hospital Revenue Code	320
Min. Negotiated Rate	$389.84
Max. Negotiated Rate	$1,499.38
Rate for Payer: Aetna Commercial	$899.62
Rate for Payer: Aetna Medicare Advantage	$899.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.68
Rate for Payer: Cigna Commercial	$1,499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$449.81
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR INFUSION THERAPY ANY METHOD

Facility

$2,998.75

Hospital Charge Code	2600089
Hospital Revenue Code	320
Min. Negotiated Rate	$449.81
Max. Negotiated Rate	$449.81
Rate for Payer: Qualcare PPO/HMO/WC	$449.81

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	321075825
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	2001154
Hospital Revenue Code	320
Min. Negotiated Rate	$219.91
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	$219.91
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

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	2001154
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	321075825
Hospital Revenue Code	320
Min. Negotiated Rate	$219.91
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	$219.91
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

IR INITIAL CONSULT 20 MIN

Facility

$292.50

Service Code	HCPCS 99251
Hospital Charge Code	2011285
Hospital Revenue Code	949
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

IR INITIAL CONSULT 20 MIN

Facility

$292.50

Service Code	HCPCS 99251
Hospital Charge Code	2011285
Hospital Revenue Code	949
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$1,558.00
Rate for Payer: Aetna Commercial	$87.75
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.02
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$1,558.00

IR INIT INPAT CONSULT FOCUSED

Facility

$588.75

Service Code	HCPCS 99252
Hospital Charge Code	2011286
Hospital Revenue Code	949
Min. Negotiated Rate	$76.54
Max. Negotiated Rate	$1,558.00
Rate for Payer: Aetna Commercial	$176.62
Rate for Payer: Aetna Medicare Advantage	$176.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.13
Rate for Payer: Cigna Commercial	$294.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.54
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.31
Rate for Payer: UnitedHealthcare Commercial	$1,558.00

IR INIT INPAT CONSULT FOCUSED

Facility

$588.75

Service Code	HCPCS 99252
Hospital Charge Code	2011286
Hospital Revenue Code	949
Min. Negotiated Rate	$88.31
Max. Negotiated Rate	$88.31
Rate for Payer: Qualcare PPO/HMO/WC	$88.31

IR-INJ ANKLE ARTHRO-BIL

Facility

$578.00

Service Code	HCPCS 2764850
Hospital Charge Code	2690355
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-BIL

Facility

$578.00

Service Code	HCPCS 2764850
Hospital Charge Code	7411779
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-BIL

Facility

$578.00

Service Code	HCPCS 2764850
Hospital Charge Code	7411779
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-BIL

Facility

$578.00

Service Code	HCPCS 2764850
Hospital Charge Code	2690355
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-LT

Facility

$578.00

Service Code	HCPCS 27648LT
Hospital Charge Code	2690990
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-LT

Facility

$578.00

Service Code	HCPCS 27648LT
Hospital Charge Code	2690990
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-LT

Facility

$578.00

Service Code	HCPCS 27648LT
Hospital Charge Code	7411877
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-LT

Facility

$578.00

Service Code	HCPCS 27648LT
Hospital Charge Code	7411877
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-RT

Facility

$578.00

Service Code	HCPCS 27648RT
Hospital Charge Code	2690995
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

Know your out-of-pocket cost for care.

All Charges