Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR SUTURE DRESSING TRAY/SUPPLI

Facility

$15.00

Hospital Charge Code	4800970
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411744
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411744
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600119
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600119
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	2680245
Hospital Revenue Code	320
Min. Negotiated Rate	$159.53
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	7411660
Hospital Revenue Code	320
Min. Negotiated Rate	$159.53
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	2680245
Hospital Revenue Code	320
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	7411660
Hospital Revenue Code	320
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	321032555B
Hospital Revenue Code	361
Min. Negotiated Rate	$819.91
Max. Negotiated Rate	$819.91
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	2690375
Hospital Revenue Code	361
Min. Negotiated Rate	$710.59
Max. Negotiated Rate	$2,733.03
Rate for Payer: Aetna Commercial	$1,639.82
Rate for Payer: Aetna Medicare Advantage	$1,639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.84
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	$1,393.84
Rate for Payer: Cigna Commercial	$2,733.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.59
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	321032555B
Hospital Revenue Code	361
Min. Negotiated Rate	$710.59
Max. Negotiated Rate	$2,733.03
Rate for Payer: Aetna Commercial	$1,639.82
Rate for Payer: Aetna Medicare Advantage	$1,639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.84
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	$1,393.84
Rate for Payer: Cigna Commercial	$2,733.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.59
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	2690375
Hospital Revenue Code	361
Min. Negotiated Rate	$819.91
Max. Negotiated Rate	$819.91
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-LT

Facility

$605.45

Service Code	HCPCS 32555
Hospital Charge Code	7411383
Hospital Revenue Code	361
Min. Negotiated Rate	$78.71
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$181.63
Rate for Payer: Aetna Medicare Advantage	$181.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.39
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	$154.39
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.71
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.82
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	2691040
Hospital Revenue Code	361
Min. Negotiated Rate	$471.99
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	321032555L
Hospital Revenue Code	361
Min. Negotiated Rate	$471.99
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-THORACENTESIS-LT

Facility

$605.45

Service Code	HCPCS 32555
Hospital Charge Code	7411383
Hospital Revenue Code	361
Min. Negotiated Rate	$90.82
Max. Negotiated Rate	$90.82
Rate for Payer: Qualcare PPO/HMO/WC	$90.82

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	2691040
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	321032555L
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	2680130
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	321032555
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$2,289.68

Service Code	HCPCS 32555
Hospital Charge Code	7411382
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	2680130
Hospital Revenue Code	361
Min. Negotiated Rate	$471.99
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	321032555
Hospital Revenue Code	361
Min. Negotiated Rate	$471.99
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-THORACENTESIS/PUNT/PLEURAL

Facility

$2,289.68

Service Code	HCPCS 32555
Hospital Charge Code	7411382
Hospital Revenue Code	361
Min. Negotiated Rate	$297.66
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$686.90
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
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	$583.87
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.66
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

Know your out-of-pocket cost for care.

All Charges