Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-PERC INJ RENAL CYST-RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	366850390R
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	411050390R
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-RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	2691595
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	$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-RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	2691595
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-RT

Facility

$1,541.00

Service Code	HCPCS 50390RT
Hospital Charge Code	7411967
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-RT

Facility

$1,541.00

Service Code	HCPCS 50390RT
Hospital Charge Code	7411967
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-RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	411050390R
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	366850390R
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 NEEDLE CORE BX BREAST

Facility

$1,901.69

Service Code	HCPCS 19100
Hospital Charge Code	7411339
Hospital Revenue Code	361
Min. Negotiated Rate	$247.22
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$570.51
Rate for Payer: Aetna Medicare Advantage	$570.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.93
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	$484.93
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.22
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.25
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERC NEEDLE CORE BX BREAST

Facility

$1,901.69

Service Code	HCPCS 19100
Hospital Charge Code	2670240
Hospital Revenue Code	361
Min. Negotiated Rate	$285.25
Max. Negotiated Rate	$285.25
Rate for Payer: Qualcare PPO/HMO/WC	$285.25

IR PERC NEEDLE CORE BX BREAST

Facility

$1,901.69

Service Code	HCPCS 19100
Hospital Charge Code	7411339
Hospital Revenue Code	361
Min. Negotiated Rate	$285.25
Max. Negotiated Rate	$285.25
Rate for Payer: Qualcare PPO/HMO/WC	$285.25

IR PERC NEEDLE CORE BX BREAST

Facility

$1,901.69

Service Code	HCPCS 19100
Hospital Charge Code	2670240
Hospital Revenue Code	361
Min. Negotiated Rate	$247.22
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$570.51
Rate for Payer: Aetna Medicare Advantage	$570.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.93
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	$484.93
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.22
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.25
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERC PCMT OF DRAIN CATH

Facility

$2,687.00

Hospital Charge Code	2008025
Hospital Revenue Code	320
Min. Negotiated Rate	$403.05
Max. Negotiated Rate	$403.05
Rate for Payer: Qualcare PPO/HMO/WC	$403.05

IR PERC PCMT OF DRAIN CATH

Facility

$2,687.00

Hospital Charge Code	2008025
Hospital Revenue Code	320
Min. Negotiated Rate	$349.31
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$806.10
Rate for Payer: Aetna Medicare Advantage	$806.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.18
Rate for Payer: Cigna Commercial	$1,343.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.31
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$403.05
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERC PLACE OF METALLIC CLIP

Facility

$270.60

Hospital Charge Code	26702046
Hospital Revenue Code	361
Min. Negotiated Rate	$35.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$81.18
Rate for Payer: Aetna Medicare Advantage	$81.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.00
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	$69.00
Rate for Payer: Cigna Commercial	$135.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.18
Rate for Payer: Qualcare PPO/HMO/WC	$40.59

IR PERC PLACE OF METALLIC CLIP

Facility

$270.60

Hospital Charge Code	26702046
Hospital Revenue Code	361
Min. Negotiated Rate	$40.59
Max. Negotiated Rate	$40.59
Rate for Payer: Qualcare PPO/HMO/WC	$40.59

IR PERC RF ABLATE RENAL TUMOR

Facility

$21,118.85

Service Code	HCPCS 50592
Hospital Charge Code	7411612
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,335.65
Rate for Payer: Aetna Medicare Advantage	$6,335.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.31
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	$5,385.31
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,745.45
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR PERC RF ABLATE RENAL TUMOR

Facility

$21,118.85

Service Code	HCPCS 50592
Hospital Charge Code	5600170
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,335.65
Rate for Payer: Aetna Medicare Advantage	$6,335.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.31
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	$5,385.31
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,745.45
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR PERC RF ABLATE RENAL TUMOR

Facility

$21,118.85

Service Code	HCPCS 50592
Hospital Charge Code	5600170
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

IR PERC RF ABLATE RENAL TUMOR

Facility

$21,118.85

Service Code	HCPCS 50592
Hospital Charge Code	7411612
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

IR PERC TRAN DIL BILIARY DUCTS

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411676
Hospital Revenue Code	320
Min. Negotiated Rate	$313.20
Max. Negotiated Rate	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$313.20

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	2000935
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	321074363
Hospital Revenue Code	320
Min. Negotiated Rate	$333.23
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	411074363
Hospital Revenue Code	320
Min. Negotiated Rate	$333.23
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges