Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-RENAL BIOPS,PERCT,TROCAR,ND

Facility

$7,071.40

Service Code	HCPCS 50200
Hospital Charge Code	7411602
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR-RENAL BIOPS,PERCT,TROCAR,ND

Facility

$7,071.40

Service Code	HCPCS 50200
Hospital Charge Code	2680205
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR RENAL CTHTER PERC PLCMT LFT

Facility

$2,217.65

Service Code	HCPCS 74475
Hospital Charge Code	2600108
Hospital Revenue Code	320
Min. Negotiated Rate	$332.65
Max. Negotiated Rate	$332.65
Rate for Payer: Qualcare PPO/HMO/WC	$332.65

IR RENAL CTHTER PERC PLCMT LFT

Facility

$2,217.65

Service Code	HCPCS 74475
Hospital Charge Code	2600108
Hospital Revenue Code	320
Min. Negotiated Rate	$288.29
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$665.29
Rate for Payer: Aetna Medicare Advantage	$665.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$565.50
Rate for Payer: Cigna Commercial	$1,108.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.29
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$332.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR RENAL CTHTER PERC PLCMT RGH

Facility

$2,217.65

Service Code	HCPCS 74475
Hospital Charge Code	2600109
Hospital Revenue Code	320
Min. Negotiated Rate	$332.65
Max. Negotiated Rate	$332.65
Rate for Payer: Qualcare PPO/HMO/WC	$332.65

IR RENAL CTHTER PERC PLCMT RGH

Facility

$2,217.65

Service Code	HCPCS 74475
Hospital Charge Code	2600109
Hospital Revenue Code	320
Min. Negotiated Rate	$288.29
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$665.29
Rate for Payer: Aetna Medicare Advantage	$665.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$565.50
Rate for Payer: Cigna Commercial	$1,108.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.29
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$332.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR RENAL CYST ASPIRATION PERC

Facility

$3,392.55

Service Code	HCPCS 50390
Hospital Charge Code	321050390
Hospital Revenue Code	361
Min. Negotiated Rate	$441.03
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,017.76
Rate for Payer: Aetna Medicare Advantage	$1,017.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$865.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$865.10
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	$865.10
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.03
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR RENAL CYST ASPIRATION PERC

Facility

$3,392.55

Service Code	HCPCS 50390
Hospital Charge Code	321050390
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

Service Code	HCPCS 50390
Hospital Charge Code	7411604
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

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

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

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

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

Service Code	HCPCS 50390
Hospital Charge Code	7411604
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,575.00
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	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

Service Code	HCPCS 50390
Hospital Charge Code	366850390
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,575.00
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	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR RENAL CYST ASPIRATION PERC

Facility

$4,709.90

Service Code	HCPCS 50390
Hospital Charge Code	411050390
Hospital Revenue Code	361
Min. Negotiated Rate	$612.29
Max. Negotiated Rate	$2,575.00
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	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR RENAL CYST ASPIRATION PERC

Facility

$3,392.55

Service Code	HCPCS 50390
Hospital Charge Code	2004091
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

IR RENAL CYST ASPIRATION PERC

Facility

$3,392.55

Service Code	HCPCS 50390
Hospital Charge Code	2004091
Hospital Revenue Code	361
Min. Negotiated Rate	$441.03
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,017.76
Rate for Payer: Aetna Medicare Advantage	$1,017.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$865.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$865.10
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	$865.10
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.03
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR RENAL CYST ASP PERC BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	7412053
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 RENAL CYST ASP PERC BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	7412053
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 RENAL CYST ASP PERC LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	7412054
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR RENAL CYST ASP PERC LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	7412054
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 RENAL CYST ASP PERC RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	7412055
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 RENAL CYST ASP PERC RT

Facility

$4,709.90

Service Code	HCPCS 50390RT
Hospital Charge Code	7412055
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR RENAL CYST PUNCTURE

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2001600
Hospital Revenue Code	320
Min. Negotiated Rate	$99.73
Max. Negotiated Rate	$99.73
Rate for Payer: Qualcare PPO/HMO/WC	$99.73

IR RENAL CYST PUNCTURE

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2001600
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$199.46
Rate for Payer: Aetna Medicare Advantage	$199.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.54
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.43
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR RENAL CYST STUDY TRANSLUM W

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2004760
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$199.46
Rate for Payer: Aetna Medicare Advantage	$199.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.54
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.43
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges