Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR OPEN FEMRORAL ARTERY UNILAT

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	321034812
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR OPEN FEMRORAL ARTERY UNILAT

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	7411397
Hospital Revenue Code	361
Min. Negotiated Rate	$198.39
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$198.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR OPEN FEMRORAL ARTERY UNILAT

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	7411397
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR-OVARIAN CYST ASPIR-BI

Facility

$5,945.00

Service Code	HCPCS 5880550
Hospital Charge Code	7411833
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-BI

Facility

$5,945.00

Service Code	HCPCS 5880550
Hospital Charge Code	2690700
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-BI

Facility

$5,945.00

Service Code	HCPCS 5880550
Hospital Charge Code	7411833
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-BI

Facility

$5,945.00

Service Code	HCPCS 5880550
Hospital Charge Code	2690700
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-LT

Facility

$5,945.00

Service Code	HCPCS 58805LT
Hospital Charge Code	2691740
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-LT

Facility

$5,945.00

Service Code	HCPCS 58805LT
Hospital Charge Code	7411988
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-LT

Facility

$5,945.00

Service Code	HCPCS 58805LT
Hospital Charge Code	2691740
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-LT

Facility

$5,945.00

Service Code	HCPCS 58805LT
Hospital Charge Code	7411988
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-RT

Facility

$5,945.00

Service Code	HCPCS 58805RT
Hospital Charge Code	7411989
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-RT

Facility

$5,945.00

Service Code	HCPCS 58805RT
Hospital Charge Code	2691745
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-RT

Facility

$5,945.00

Service Code	HCPCS 58805RT
Hospital Charge Code	7411989
Hospital Revenue Code	361
Min. Negotiated Rate	$891.75
Max. Negotiated Rate	$891.75
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-OVARIAN CYST ASPIR-RT

Facility

$5,945.00

Service Code	HCPCS 58805RT
Hospital Charge Code	2691745
Hospital Revenue Code	361
Min. Negotiated Rate	$772.85
Max. Negotiated Rate	$2,972.50
Rate for Payer: Aetna Commercial	$1,783.50
Rate for Payer: Aetna Medicare Advantage	$1,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,515.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,515.97
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	$1,515.97
Rate for Payer: Cigna Commercial	$2,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.85
Rate for Payer: Qualcare PPO/HMO/WC	$891.75

IR-PANCREAS BIOPSY

Facility

$4,021.35

Service Code	HCPCS 48102
Hospital Charge Code	2670160
Hospital Revenue Code	361
Min. Negotiated Rate	$522.78
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,206.40
Rate for Payer: Aetna Medicare Advantage	$1,206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,025.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,025.44
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	$1,025.44
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.78
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$603.20
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-PANCREAS BIOPSY

Facility

$4,021.35

Service Code	HCPCS 48102
Hospital Charge Code	2670160
Hospital Revenue Code	361
Min. Negotiated Rate	$603.20
Max. Negotiated Rate	$603.20
Rate for Payer: Qualcare PPO/HMO/WC	$603.20

IR-PANCREAS BIOPSY

Facility

$4,021.35

Service Code	HCPCS 48102
Hospital Charge Code	7411574
Hospital Revenue Code	361
Min. Negotiated Rate	$603.20
Max. Negotiated Rate	$603.20
Rate for Payer: Qualcare PPO/HMO/WC	$603.20

IR-PANCREAS BIOPSY

Facility

$4,021.35

Service Code	HCPCS 48102
Hospital Charge Code	7411574
Hospital Revenue Code	361
Min. Negotiated Rate	$522.78
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,206.40
Rate for Payer: Aetna Medicare Advantage	$1,206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,025.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,025.44
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	$1,025.44
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.78
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$603.20
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PANCRS EXT.DRAING.PANC CYST

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2670200
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 PANCRS EXT.DRAING.PANC CYST

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2670200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
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	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PANCRS EXT.DRAING.PANC CYST

Facility

$6,420.00

Service Code	HCPCS 49405
Hospital Charge Code	7411581
Hospital Revenue Code	361
Min. Negotiated Rate	$963.00
Max. Negotiated Rate	$963.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

IR PANCRS EXT.DRAING.PANC CYST

Facility

$6,420.00

Service Code	HCPCS 49405
Hospital Charge Code	7411581
Hospital Revenue Code	361
Min. Negotiated Rate	$834.60
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,926.00
Rate for Payer: Aetna Medicare Advantage	$1,926.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.10
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	$1,637.10
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.60
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERC ABSC DRAINAGE RETROPER

Facility

$6,139.10

Hospital Charge Code	2004000
Hospital Revenue Code	361
Min. Negotiated Rate	$798.08
Max. Negotiated Rate	$3,069.55
Rate for Payer: Aetna Commercial	$1,841.73
Rate for Payer: Aetna Medicare Advantage	$1,841.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.47
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	$1,565.47
Rate for Payer: Cigna Commercial	$3,069.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.08
Rate for Payer: Qualcare PPO/HMO/WC	$920.87

IR PERC ABSC DRAINAGE RETROPER

Facility

$6,139.10

Hospital Charge Code	2004000
Hospital Revenue Code	361
Min. Negotiated Rate	$920.87
Max. Negotiated Rate	$920.87
Rate for Payer: Qualcare PPO/HMO/WC	$920.87

Know your out-of-pocket cost for care.

All Charges