Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	2690665
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	2690665
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,456.42
Rate for Payer: Aetna Commercial	$8,073.85
Rate for Payer: Aetna Medicare Advantage	$8,073.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,862.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,862.78
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	$6,862.78
Rate for Payer: Cigna Commercial	$13,456.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,498.67
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	321050592B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,456.42
Rate for Payer: Aetna Commercial	$8,073.85
Rate for Payer: Aetna Medicare Advantage	$8,073.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,862.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,862.78
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	$6,862.78
Rate for Payer: Cigna Commercial	$13,456.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,498.67
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	321050592B
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$15,231.00

Service Code	HCPCS 5059250
Hospital Charge Code	7411826
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-LT

Facility

$15,231.00

Service Code	HCPCS 50592LT
Hospital Charge Code	7411972
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-LT

Facility

$15,231.00

Service Code	HCPCS 50592LT
Hospital Charge Code	2691660
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-LT

Facility

$15,231.00

Service Code	HCPCS 50592LT
Hospital Charge Code	2691660
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-LT

Facility

$15,231.00

Service Code	HCPCS 50592LT
Hospital Charge Code	7411972
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-RT

Facility

$15,231.00

Service Code	HCPCS 50592RT
Hospital Charge Code	7411973
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-RT

Facility

$15,231.00

Service Code	HCPCS 50592RT
Hospital Charge Code	2691665
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-RT

Facility

$15,231.00

Service Code	HCPCS 50592RT
Hospital Charge Code	2691665
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA KIDNEY-RT

Facility

$15,231.00

Service Code	HCPCS 50592RT
Hospital Charge Code	7411973
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-BIL

Facility

$15,231.00

Service Code	HCPCS 3299850
Hospital Charge Code	7411785
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-BIL

Facility

$15,231.00

Service Code	HCPCS 3299850
Hospital Charge Code	2690400
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-BIL

Facility

$15,231.00

Service Code	HCPCS 3299850
Hospital Charge Code	2690400
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-BIL

Facility

$15,231.00

Service Code	HCPCS 3299850
Hospital Charge Code	7411785
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	7411890
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	7411890
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	2691100
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	2691100
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$4,569.30
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IRRIG 0.9% NACL 1000ML *****

Facility

$10.00

Hospital Charge Code	7000128
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

IRRIG 0.9% NACL 1000ML *****

Facility

$10.00

Hospital Charge Code	7000128
Hospital Revenue Code	258
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$6.75
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$11.25

Know your out-of-pocket cost for care.

All Charges