Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

$1,141.35

Service Code	HCPCS 10160
Hospital Charge Code	7411336
Hospital Revenue Code	361
Min. Negotiated Rate	$171.20
Max. Negotiated Rate	$171.20
Rate for Payer: Qualcare PPO/HMO/WC	$171.20

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	2670055
Hospital Revenue Code	361
Min. Negotiated Rate	$275.88
Max. Negotiated Rate	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$275.88

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	2670055
Hospital Revenue Code	361
Min. Negotiated Rate	$239.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$551.76
Rate for Payer: Aetna Medicare Advantage	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.00
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	$469.00
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.88
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	321010160
Hospital Revenue Code	361
Min. Negotiated Rate	$275.88
Max. Negotiated Rate	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$275.88

IR-PUNCTURE CLEAR LUNG-LT

Facility

$834.00

Hospital Charge Code	2691030
Hospital Revenue Code	761
Min. Negotiated Rate	$108.42
Max. Negotiated Rate	$417.00
Rate for Payer: Aetna Commercial	$250.20
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.42
Rate for Payer: Oxford Commercial	$417.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.10
Rate for Payer: UnitedHealthcare Commercial	$417.00

IR-PUNCTURE CLEAR LUNG-LT

Facility

$834.00

Hospital Charge Code	2691030
Hospital Revenue Code	761
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-PUNCTURE CLEAR LUNG-RT

Facility

$834.00

Hospital Charge Code	2691035
Hospital Revenue Code	361
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-PUNCTURE CLEAR LUNG-RT

Facility

$834.00

Hospital Charge Code	2691035
Hospital Revenue Code	361
Min. Negotiated Rate	$108.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$250.20
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
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	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.42
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR RAD EX ABCESS, FIST OR SINU

Facility

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	2002330
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$217.46
Rate for Payer: Aetna Medicare Advantage	$217.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.84
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.23
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR RAD EX ABCESS, FIST OR SINU

Facility

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	2002330
Hospital Revenue Code	320
Min. Negotiated Rate	$108.73
Max. Negotiated Rate	$108.73
Rate for Payer: Qualcare PPO/HMO/WC	$108.73

IRRADIATED LEUKO REDUCED PLTPH

Facility

$1,358.79

Hospital Charge Code	3100130
Hospital Revenue Code	390
Min. Negotiated Rate	$176.64
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$407.64
Rate for Payer: Aetna Medicare Advantage	$407.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.49
Rate for Payer: Cigna Commercial	$679.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.64
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$203.82
Rate for Payer: UnitedHealthcare Commercial	$756.00

IRRADIATED LEUKO REDUCED PLTPH

Facility

$1,358.79

Hospital Charge Code	3100130
Hospital Revenue Code	390
Min. Negotiated Rate	$203.82
Max. Negotiated Rate	$203.82
Rate for Payer: Qualcare PPO/HMO/WC	$203.82

IRRADIATION OF BLD OR BLD PROD

Facility

$182.00

Service Code	HCPCS 86945
Hospital Charge Code	38471079
Hospital Revenue Code	302
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

IRRADIATION OF BLD OR BLD PROD

Facility

$182.00

Service Code	HCPCS 86945
Hospital Charge Code	38471079
Hospital Revenue Code	302
Min. Negotiated Rate	$17.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.60
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

IRRADIATION PROC/BLD PROD

Facility

$96.85

Service Code	HCPCS 86945
Hospital Charge Code	3100229
Hospital Revenue Code	302
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$14.53

IRRADIATION PROC/BLD PROD

Facility

$96.85

Service Code	HCPCS 86945
Hospital Charge Code	3100229
Hospital Revenue Code	302
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$29.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.70
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.53
Rate for Payer: UnitedHealthcare Commercial	$114.00

IR-REM INT URET STENT-BI

Facility

$5,055.00

Service Code	HCPCS 5038450
Hospital Charge Code	7411820
Hospital Revenue Code	361
Min. Negotiated Rate	$758.25
Max. Negotiated Rate	$758.25
Rate for Payer: Qualcare PPO/HMO/WC	$758.25

IR-REM INT URET STENT-BI

Facility

$14,912.20

Service Code	HCPCS 5038450
Hospital Charge Code	321050384B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,456.10
Rate for Payer: Aetna Commercial	$4,473.66
Rate for Payer: Aetna Medicare Advantage	$4,473.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,802.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,802.61
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	$3,802.61
Rate for Payer: Cigna Commercial	$7,456.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.83

IR-REM INT URET STENT-BI

Facility

$14,912.20

Service Code	HCPCS 5038450
Hospital Charge Code	321050384B
Hospital Revenue Code	361
Min. Negotiated Rate	$2,236.83
Max. Negotiated Rate	$2,236.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.83

IR-REM INT URET STENT-BI

Facility

$14,912.20

Service Code	HCPCS 5038450
Hospital Charge Code	2690615
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,456.10
Rate for Payer: Aetna Commercial	$4,473.66
Rate for Payer: Aetna Medicare Advantage	$4,473.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,802.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,802.61
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	$3,802.61
Rate for Payer: Cigna Commercial	$7,456.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.83

IR-REM INT URET STENT-BI

Facility

$5,055.00

Service Code	HCPCS 5038450
Hospital Charge Code	7411820
Hospital Revenue Code	361
Min. Negotiated Rate	$657.15
Max. Negotiated Rate	$2,527.50
Rate for Payer: Aetna Commercial	$1,516.50
Rate for Payer: Aetna Medicare Advantage	$1,516.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,289.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,289.03
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	$1,289.03
Rate for Payer: Cigna Commercial	$2,527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.15
Rate for Payer: Qualcare PPO/HMO/WC	$758.25

IR-REM INT URET STENT-BI

Facility

$14,912.20

Service Code	HCPCS 5038450
Hospital Charge Code	2690615
Hospital Revenue Code	361
Min. Negotiated Rate	$2,236.83
Max. Negotiated Rate	$2,236.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.83

IR-REM INT URET STENT-LT

Facility

$5,475.00

Service Code	HCPCS 50384LT
Hospital Charge Code	7411960
Hospital Revenue Code	361
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$1,642.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
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	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.75
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

IR-REM INT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50384LT
Hospital Charge Code	2691560
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM INT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50384LT
Hospital Charge Code	321050384L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

Know your out-of-pocket cost for care.

All Charges