Heights University Hospital

All Charges

Charge

Type

Setting

Price

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$10,499.25
Max. Negotiated Rate	$16,938.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$10,499.25
Max. Negotiated Rate	$34,997.50
Rate for Payer: Aetna Commercial	$20,998.50
Rate for Payer: Aetna Medicare Advantage	$20,998.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,848.72
Rate for Payer: Cigna Commercial	$34,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25

AORTIC-THORACIC FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411165
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

AORTIC-THORACIC FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411165
Hospital Revenue Code	320
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$909.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$773.26
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
Hospital Revenue Code	323
Min. Negotiated Rate	$282.74
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
Hospital Revenue Code	323
Min. Negotiated Rate	$282.74
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	5100490
Hospital Revenue Code	323
Min. Negotiated Rate	$282.74
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	5100490
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	5100052
Hospital Revenue Code	481
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	74110011
Hospital Revenue Code	481
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$34.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	5100052
Hospital Revenue Code	481
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$34.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	74110011
Hospital Revenue Code	481
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	5100300
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,172.01
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$941.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	74110035
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	5100300
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	74110035
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,172.01
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$941.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$5.36
Rate for Payer: Aetna Commercial	$3.22
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.73
Rate for Payer: Cigna Commercial	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$5.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.61
Rate for Payer: UnitedHealthcare Commercial	$5.36

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$7.66
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.64
Rate for Payer: Aetna Medicare Advantage	$15.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.13
Rate for Payer: Cigna Commercial	$15.32
Rate for Payer: Cigna Medicare Advantage	$7.66
Rate for Payer: Clover Medicare Advantage	$14.55
Rate for Payer: EmblemHealth Commercial	$45.96
Rate for Payer: Humana Medicare Advantage	$15.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.24
Rate for Payer: Wellcare Medicare Advantage	$15.32

APEX DBM FIBER PUTTY

Facility

$7,250.00

Hospital Charge Code	270702104
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$3,625.00
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: Aetna Commercial	$2,175.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

Know your out-of-pocket cost for care.

All Charges