Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARTERY X-RAYS CHEST

Facility

$14,613.44

Service Code	HCPCS 75756
Hospital Charge Code	366875756
Hospital Revenue Code	323
Min. Negotiated Rate	$2,192.02
Max. Negotiated Rate	$2,192.02
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.02

ARTERY X-RAYS CHEST

Facility

$14,613.44

Service Code	HCPCS 75756
Hospital Charge Code	366875756
Hospital Revenue Code	323
Min. Negotiated Rate	$130.06
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,384.03
Rate for Payer: Aetna Medicare Advantage	$4,384.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,726.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,726.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,726.43
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.75
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.02
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS LUNG

Facility

$34,050.00

Service Code	HCPCS 75741
Hospital Charge Code	366875741
Hospital Revenue Code	320
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$10,215.00
Rate for Payer: Aetna Commercial	$10,215.00
Rate for Payer: Aetna Medicare Advantage	$10,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,682.75
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,426.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS LUNG

Facility

$34,050.00

Service Code	HCPCS 75741
Hospital Charge Code	366875741
Hospital Revenue Code	320
Min. Negotiated Rate	$5,107.50
Max. Negotiated Rate	$5,107.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50

ARTERY X-RAYS LUNG

Facility

$34,050.00

Service Code	HCPCS 75741
Hospital Charge Code	411075741
Hospital Revenue Code	320
Min. Negotiated Rate	$5,107.50
Max. Negotiated Rate	$5,107.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50

ARTERY X-RAYS LUNG

Facility

$34,050.00

Service Code	HCPCS 75741
Hospital Charge Code	411075741
Hospital Revenue Code	320
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$10,215.00
Rate for Payer: Aetna Commercial	$10,215.00
Rate for Payer: Aetna Medicare Advantage	$10,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,682.75
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,426.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS LUNGS

Facility

$12,461.85

Service Code	HCPCS 75743
Hospital Charge Code	366875743
Hospital Revenue Code	323
Min. Negotiated Rate	$1,869.28
Max. Negotiated Rate	$1,869.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.28

ARTERY X-RAYS LUNGS

Facility

$12,461.85

Service Code	HCPCS 75743
Hospital Charge Code	411075743
Hospital Revenue Code	323
Min. Negotiated Rate	$327.23
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.55
Rate for Payer: Aetna Medicare Advantage	$3,738.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,177.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,177.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,177.77
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS LUNGS

Facility

$12,461.85

Service Code	HCPCS 75743
Hospital Charge Code	366875743
Hospital Revenue Code	323
Min. Negotiated Rate	$327.23
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.55
Rate for Payer: Aetna Medicare Advantage	$3,738.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,177.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,177.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,177.77
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS LUNGS

Facility

$12,461.85

Service Code	HCPCS 75743
Hospital Charge Code	411075743
Hospital Revenue Code	323
Min. Negotiated Rate	$1,869.28
Max. Negotiated Rate	$1,869.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.28

ARTERY X-RAYS PELVIS

Facility

$25,004.60

Service Code	HCPCS 75736
Hospital Charge Code	411075736
Hospital Revenue Code	320
Min. Negotiated Rate	$3,750.69
Max. Negotiated Rate	$3,750.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69

ARTERY X-RAYS PELVIS

Facility

$25,004.60

Service Code	HCPCS 75736
Hospital Charge Code	411075736
Hospital Revenue Code	320
Min. Negotiated Rate	$282.74
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,501.38
Rate for Payer: Aetna Medicare Advantage	$7,501.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,376.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,376.17
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	$6,376.17
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS SPINE

Facility

$25,004.60

Service Code	HCPCS 75705
Hospital Charge Code	366875705
Hospital Revenue Code	320
Min. Negotiated Rate	$333.05
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,501.38
Rate for Payer: Aetna Medicare Advantage	$7,501.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,376.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,376.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,376.17
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS SPINE

Facility

$25,004.60

Service Code	HCPCS 75705
Hospital Charge Code	411075705
Hospital Revenue Code	320
Min. Negotiated Rate	$333.05
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,501.38
Rate for Payer: Aetna Medicare Advantage	$7,501.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,376.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,376.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,376.17
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS SPINE

Facility

$25,004.60

Service Code	HCPCS 75705
Hospital Charge Code	411075705
Hospital Revenue Code	320
Min. Negotiated Rate	$3,750.69
Max. Negotiated Rate	$3,750.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69

ARTERY X-RAYS SPINE

Facility

$25,004.60

Service Code	HCPCS 75705
Hospital Charge Code	366875705
Hospital Revenue Code	320
Min. Negotiated Rate	$3,750.69
Max. Negotiated Rate	$3,750.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.69

ARTHD CMBN 1INTRSPC LUMBAR

Facility

$108,286.15

Service Code	HCPCS 22633
Hospital Charge Code	1600000292
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$64,616.81
Rate for Payer: Aetna Commercial	$32,485.85
Rate for Payer: Aetna Medicare Advantage	$32,485.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,612.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,612.97
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	$27,612.97
Rate for Payer: Cigna Commercial	$64,616.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,077.20
Rate for Payer: Oxford Commercial	$10,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,242.92
Rate for Payer: UnitedHealthcare Commercial	$11,456.00

ARTHD CMBN 1INTRSPC LUMBAR

Facility

$108,286.15

Service Code	HCPCS 22633
Hospital Charge Code	1600000292
Hospital Revenue Code	360
Min. Negotiated Rate	$16,242.92
Max. Negotiated Rate	$16,242.92
Rate for Payer: Qualcare PPO/HMO/WC	$16,242.92

ARTHOFLEX 40x70 mm

Facility

$10,200.00

Service Code	HCPCS Q4125
Hospital Charge Code	270657242
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$3,060.00
Rate for Payer: Aetna Commercial	$3,060.00
Rate for Payer: Aetna Medicare Advantage	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,601.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,601.00
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,468.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,530.00

ARTHOFLEX 40x70 mm

Facility

$10,200.00

Service Code	HCPCS Q4125
Hospital Charge Code	270657242
Hospital Revenue Code	278
Min. Negotiated Rate	$1,530.00
Max. Negotiated Rate	$2,468.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,468.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,530.00

ARTHOFLEX DECELLULARIZED DERMS

Facility

$19,445.00

Service Code	HCPCS Q4125
Hospital Charge Code	270679770
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$5,833.50
Rate for Payer: Aetna Commercial	$5,833.50
Rate for Payer: Aetna Medicare Advantage	$5,833.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,958.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,958.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,889.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,958.48
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,705.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,916.75

ARTHOFLEX DECELLULARIZED DERMS

Facility

$19,445.00

Service Code	HCPCS Q4125
Hospital Charge Code	270679770
Hospital Revenue Code	278
Min. Negotiated Rate	$2,916.75
Max. Negotiated Rate	$4,705.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,889.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,705.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,916.75

ARTHRD PST DFRM 7-12 VRT SGM

Facility

$14,810.75

Service Code	HCPCS 22802
Hospital Charge Code	16000805
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$4,443.23
Rate for Payer: Aetna Medicare Advantage	$4,443.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,776.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,776.74
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	$3,776.74
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,925.40
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,221.61
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

ARTHRD PST DFRM 7-12 VRT SGM

Facility

$14,810.75

Service Code	HCPCS 22802
Hospital Charge Code	16000805
Hospital Revenue Code	360
Min. Negotiated Rate	$2,221.61
Max. Negotiated Rate	$2,221.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,221.61

ARTHRD SI JT PRQ WO TFXJ DEV

Facility

$84,204.60

Service Code	HCPCS 27278
Hospital Charge Code	16001048
Hospital Revenue Code	360
Min. Negotiated Rate	$12,630.69
Max. Negotiated Rate	$12,630.69
Rate for Payer: Qualcare PPO/HMO/WC	$12,630.69

Know your out-of-pocket cost for care.

All Charges