Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-MEASUR KIDNEY PRESS-LT

Facility

$316.00

Service Code	HCPCS 50396LT
Hospital Charge Code	7411970
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	2691645
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	7411971
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	2691645
Hospital Revenue Code	361
Min. Negotiated Rate	$41.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$94.80
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.08
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	7411971
Hospital Revenue Code	361
Min. Negotiated Rate	$41.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$94.80
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.08
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Hospital Charge Code	2692126
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Hospital Charge Code	2692126
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Service Code	HCPCS 62305
Hospital Charge Code	7411657
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Service Code	HCPCS 62305
Hospital Charge Code	7411657
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Service Code	HCPCS 62302
Hospital Charge Code	7411654
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Hospital Charge Code	2692122
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Hospital Charge Code	2692122
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Service Code	HCPCS 62302
Hospital Charge Code	7411654
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	2670220
Hospital Revenue Code	361
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$101.70
Rate for Payer: Qualcare PPO/HMO/WC	$101.70

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	2670220
Hospital Revenue Code	361
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$203.40
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
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	$172.89
Rate for Payer: Cigna Commercial	$77.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	7411652
Hospital Revenue Code	361
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$101.70
Rate for Payer: Qualcare PPO/HMO/WC	$101.70

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	7411652
Hospital Revenue Code	361
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$203.40
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
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	$172.89
Rate for Payer: Cigna Commercial	$77.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Service Code	HCPCS 62304
Hospital Charge Code	7411656
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Hospital Charge Code	2692124
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Hospital Charge Code	2692124
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Service Code	HCPCS 62304
Hospital Charge Code	7411656
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM THORACIC

Facility

$3,939.00

Service Code	HCPCS 62303
Hospital Charge Code	7411655
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM THORACIC

Facility

$3,939.00

Service Code	HCPCS 62303
Hospital Charge Code	7411655
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR MYELOGRAM THORACIC

Facility

$3,939.00

Hospital Charge Code	2692123
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM THORACIC

Facility

$3,939.00

Hospital Charge Code	2692123
Hospital Revenue Code	361
Min. Negotiated Rate	$512.07
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,181.70
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.07
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

Know your out-of-pocket cost for care.

All Charges