Heights University Hospital

All Charges

Charge

Type

Setting

Price

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$228.75

Service Code	HCPCS 83661
Hospital Charge Code	3002310A
Hospital Revenue Code	301
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$34.31
Rate for Payer: Qualcare PPO/HMO/WC	$34.31

LECT STIM-UNATTENDED NOT WC

Facility

$206.00

Service Code	HCPCS 97014GO
Hospital Charge Code	74203027
Hospital Revenue Code	430
Min. Negotiated Rate	$26.78
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$61.80
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.78
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

LECT STIM-UNATTENDED NOT WC

Facility

$206.00

Service Code	HCPCS 97014GO
Hospital Charge Code	74203027
Hospital Revenue Code	430
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

LED BULD LARYNGOSCOPE LAMP

Facility

$62.50

Hospital Charge Code	270664904
Hospital Revenue Code	270
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$31.25
Rate for Payer: Aetna Commercial	$18.75
Rate for Payer: Aetna Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.94
Rate for Payer: Cigna Commercial	$31.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.12
Rate for Payer: Oxford Commercial	$31.25
Rate for Payer: Qualcare PPO/HMO/WC	$9.38
Rate for Payer: UnitedHealthcare Commercial	$31.25

LED BULD LARYNGOSCOPE LAMP

Facility

$62.50

Hospital Charge Code	270664904
Hospital Revenue Code	270
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$9.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.38

LEDERCILLIN VK/250MG/TAB

Facility

$4.00

Hospital Charge Code	60633273
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

LEDERCILLIN VK/250MG/TAB

Facility

$4.00

Hospital Charge Code	60633273
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LEDERCILLIN VK/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633274
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

LEDERCILLIN VK/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633274
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LEFT FIBULA PLATE

Facility

$17,952.90

Service Code	HCPCS C1713
Hospital Charge Code	270704756
Hospital Revenue Code	278
Min. Negotiated Rate	$2,692.93
Max. Negotiated Rate	$8,976.45
Rate for Payer: Aetna Commercial	$5,385.87
Rate for Payer: Aetna Medicare Advantage	$5,385.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,577.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,577.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,590.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,577.99
Rate for Payer: Cigna Commercial	$8,976.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,344.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.93

LEFT FIBULA PLATE

Facility

$17,952.90

Service Code	HCPCS C1713
Hospital Charge Code	270704756
Hospital Revenue Code	278
Min. Negotiated Rate	$2,692.93
Max. Negotiated Rate	$4,344.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,590.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,344.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.93

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411235
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	366893458
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411235
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	366893458
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: UnitedHealthcare Commercial	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH ABORT

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411237
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH ABORT

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411237
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	366893452
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	74110021
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	5100193
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	5100193
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	366893452
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
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	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	74110021
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT LPS-FLEX SIZE D

Facility

$12,166.15

Hospital Charge Code	270657031
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$3,649.84
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

LEFT LPS-FLEX SIZE D

Facility

$12,166.15

Hospital Charge Code	270657031
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

Know your out-of-pocket cost for care.

All Charges