Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-PERC FNA PLEURA-RT

Facility

$1,364.00

Service Code	HCPCS 10022RT
Hospital Charge Code	7411858
Hospital Revenue Code	361
Min. Negotiated Rate	$204.60
Max. Negotiated Rate	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$204.60

IR-PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2690865
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR-PERC FNA PLEURA-RT

Facility

$1,364.00

Service Code	HCPCS 10022RT
Hospital Charge Code	7411858
Hospital Revenue Code	361
Min. Negotiated Rate	$177.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$409.20
Rate for Payer: Aetna Medicare Advantage	$409.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.82
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	$347.82
Rate for Payer: Cigna Commercial	$682.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.32
Rate for Payer: Qualcare PPO/HMO/WC	$204.60

IR-PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2690865
Hospital Revenue Code	361
Min. Negotiated Rate	$312.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$720.96
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.42
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR-PERC INJ RENAL CYST-BI

Facility

$1,541.00

Service Code	HCPCS 5039050
Hospital Charge Code	7411823
Hospital Revenue Code	761
Min. Negotiated Rate	$200.33
Max. Negotiated Rate	$770.50
Rate for Payer: Aetna Commercial	$462.30
Rate for Payer: Aetna Medicare Advantage	$462.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.95
Rate for Payer: Cigna Commercial	$770.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.33
Rate for Payer: Oxford Commercial	$770.50
Rate for Payer: Qualcare PPO/HMO/WC	$231.15
Rate for Payer: UnitedHealthcare Commercial	$770.50

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	321050390B
Hospital Revenue Code	761
Min. Negotiated Rate	$918.43
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,119.45
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.43
Rate for Payer: Oxford Commercial	$3,532.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Commercial	$3,532.43

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2690630
Hospital Revenue Code	761
Min. Negotiated Rate	$918.43
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,119.45
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.43
Rate for Payer: Oxford Commercial	$3,532.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Commercial	$3,532.43

IR-PERC INJ RENAL CYST-BI

Facility

$1,541.00

Service Code	HCPCS 5039050
Hospital Charge Code	7411823
Hospital Revenue Code	761
Min. Negotiated Rate	$231.15
Max. Negotiated Rate	$231.15
Rate for Payer: Qualcare PPO/HMO/WC	$231.15

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2690630
Hospital Revenue Code	761
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	3668503905
Hospital Revenue Code	361
Min. Negotiated Rate	$918.43
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,119.45
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
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	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	321050390B
Hospital Revenue Code	761
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	411050390B
Hospital Revenue Code	361
Min. Negotiated Rate	$918.43
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,119.45
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
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	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	3668503905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	411050390B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	321050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$1,541.00

Service Code	HCPCS 50390LT
Hospital Charge Code	7411966
Hospital Revenue Code	761
Min. Negotiated Rate	$231.15
Max. Negotiated Rate	$231.15
Rate for Payer: Qualcare PPO/HMO/WC	$231.15

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	411050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	2691590
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	366850390L
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	321050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$1,541.00

Service Code	HCPCS 50390LT
Hospital Charge Code	7411966
Hospital Revenue Code	761
Min. Negotiated Rate	$200.33
Max. Negotiated Rate	$770.50
Rate for Payer: Aetna Commercial	$462.30
Rate for Payer: Aetna Medicare Advantage	$462.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.95
Rate for Payer: Cigna Commercial	$770.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.33
Rate for Payer: Oxford Commercial	$770.50
Rate for Payer: Qualcare PPO/HMO/WC	$231.15
Rate for Payer: UnitedHealthcare Commercial	$770.50

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	411050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,412.97
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	366850390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	2691590
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	321050390R
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

Know your out-of-pocket cost for care.

All Charges