Heights University Hospital

All Charges

Charge

Type

Setting

Price

M.PNEUMONIAE CULTURE

Facility

$105.75

Service Code	HCPCS 87109
Hospital Charge Code	39900489
Hospital Revenue Code	309
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.86
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.39
Rate for Payer: Cigna Commercial	$15.39
Rate for Payer: Cigna Medicare Advantage	$7.70
Rate for Payer: Clover Medicare Advantage	$14.62
Rate for Payer: EmblemHealth Commercial	$46.17
Rate for Payer: Humana Medicare Advantage	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.86
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.31
Rate for Payer: Wellcare Medicare Advantage	$15.39

M.PNEUMONIAE CULTURE

Facility

$105.75

Service Code	HCPCS 87109
Hospital Charge Code	39900269
Hospital Revenue Code	309
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.86
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.39
Rate for Payer: Cigna Commercial	$15.39
Rate for Payer: Cigna Medicare Advantage	$7.70
Rate for Payer: Clover Medicare Advantage	$14.62
Rate for Payer: EmblemHealth Commercial	$46.17
Rate for Payer: Humana Medicare Advantage	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.86
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.31
Rate for Payer: Wellcare Medicare Advantage	$15.39

M.PNEUMONIAE CULTURE

Facility

$105.75

Service Code	HCPCS 87109
Hospital Charge Code	39900489
Hospital Revenue Code	309
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$15.86
Rate for Payer: Qualcare PPO/HMO/WC	$15.86

MPO-AB****

Facility

$99.00

Service Code	HCPCS 83520
Hospital Charge Code	3002059
Hospital Revenue Code	301
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

MPO-AB****

Facility

$99.00

Service Code	HCPCS 83520
Hospital Charge Code	3002059
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

MPOX VIR DNA QUAL RT PCR

Facility

$100.00

Service Code	HCPCS 87593
Hospital Charge Code	401312084
Hospital Revenue Code	306
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$166.24
Rate for Payer: Aetna Medicare Advantage	$51.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.00
Rate for Payer: Cigna Commercial	$51.31
Rate for Payer: Cigna Medicare Advantage	$25.66
Rate for Payer: Clover Medicare Advantage	$48.74
Rate for Payer: EmblemHealth Commercial	$153.93
Rate for Payer: Humana Medicare Advantage	$52.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$54.39
Rate for Payer: Wellcare Medicare Advantage	$51.31

MPOX VIR DNA QUAL RT PCR

Facility

$100.00

Service Code	HCPCS 87593
Hospital Charge Code	401312084
Hospital Revenue Code	306
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

MRA ABDOMEN W/WO C

Facility

$2,320.85

Service Code	HCPCS 74185
Hospital Charge Code	2400318
Hospital Revenue Code	618
Min. Negotiated Rate	$348.13
Max. Negotiated Rate	$348.13
Rate for Payer: Qualcare PPO/HMO/WC	$348.13

MRA ABDOMEN W/WO C

Facility

$2,320.85

Service Code	HCPCS 74185
Hospital Charge Code	2400318
Hospital Revenue Code	618
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$696.25
Rate for Payer: Aetna Medicare Advantage	$696.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.82
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	$591.82
Rate for Payer: Cigna Commercial	$383.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.71
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$348.13
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA CHEST W/ C

Facility

$1,937.65

Hospital Charge Code	2400120
Hospital Revenue Code	618
Min. Negotiated Rate	$251.89
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$581.29
Rate for Payer: Aetna Medicare Advantage	$581.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.10
Rate for Payer: Cigna Commercial	$968.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.89
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$290.65
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA CHEST W/ C

Facility

$1,937.65

Hospital Charge Code	2400120
Hospital Revenue Code	618
Min. Negotiated Rate	$290.65
Max. Negotiated Rate	$290.65
Rate for Payer: Qualcare PPO/HMO/WC	$290.65

MRA-CHEST WO/W CONTRAST

Facility

$3,538.00

Service Code	HCPCS 71555
Hospital Charge Code	2408001
Hospital Revenue Code	618
Min. Negotiated Rate	$530.70
Max. Negotiated Rate	$530.70
Rate for Payer: Qualcare PPO/HMO/WC	$530.70

MRA-CHEST WO/W CONTRAST

Facility

$3,538.00

Service Code	HCPCS 71555
Hospital Charge Code	2408001
Hospital Revenue Code	618
Min. Negotiated Rate	$381.74
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$1,061.40
Rate for Payer: Aetna Medicare Advantage	$1,061.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.19
Rate for Payer: Cigna Commercial	$381.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.94
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$530.70
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA HEAD &/OR NECK W/O CONTRST

Facility

$5,866.80

Service Code	HCPCS 70541
Hospital Charge Code	2400067
Hospital Revenue Code	611
Min. Negotiated Rate	$880.02
Max. Negotiated Rate	$880.02
Rate for Payer: Qualcare PPO/HMO/WC	$880.02

MRA HEAD &/OR NECK W/O CONTRST

Facility

$5,866.80

Service Code	HCPCS 70541
Hospital Charge Code	2400067
Hospital Revenue Code	611
Min. Negotiated Rate	$762.68
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$1,760.04
Rate for Payer: Aetna Medicare Advantage	$1,760.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.03
Rate for Payer: Cigna Commercial	$2,933.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.68
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$880.02
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA HEAD W/O CONT

Facility

$13,500.00

Service Code	HCPCS 70544
Hospital Charge Code	94061027
Hospital Revenue Code	615
Min. Negotiated Rate	$566.61
Max. Negotiated Rate	$4,050.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.00
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA HEAD W/O CONT

Facility

$13,500.00

Service Code	HCPCS 70544
Hospital Charge Code	94061027
Hospital Revenue Code	615
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA-LOWER EXTREM WO/W CONT-RT

Facility

$2,895.00

Service Code	HCPCS 73725RT
Hospital Charge Code	2407001
Hospital Revenue Code	616
Min. Negotiated Rate	$376.35
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$868.50
Rate for Payer: Aetna Medicare Advantage	$868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$738.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$738.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$738.23
Rate for Payer: Cigna Commercial	$1,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.35
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$434.25
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA-LOWER EXTREM WO/W CONT-RT

Facility

$2,895.00

Service Code	HCPCS 73725RT
Hospital Charge Code	2407001
Hospital Revenue Code	616
Min. Negotiated Rate	$434.25
Max. Negotiated Rate	$434.25
Rate for Payer: Qualcare PPO/HMO/WC	$434.25

MRA LOW EXTR W/ OR W/O CONT RT

Facility

$13,500.00

Service Code	HCPCS 73725RT
Hospital Charge Code	2400300
Hospital Revenue Code	616
Min. Negotiated Rate	$1,755.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.00
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA LOW EXTR W/ OR W/O CONT RT

Facility

$13,500.00

Service Code	HCPCS 73725RT
Hospital Charge Code	2400300
Hospital Revenue Code	616
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA LOWR EXTR W/ CON BIL

Facility

$3,889.70

Service Code	HCPCS 7372550
Hospital Charge Code	2400095
Hospital Revenue Code	616
Min. Negotiated Rate	$505.66
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$1,166.91
Rate for Payer: Aetna Medicare Advantage	$1,166.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$991.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$991.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$991.87
Rate for Payer: Cigna Commercial	$1,944.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.66
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$583.46
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRA LOWR EXTR W/ CON BIL

Facility

$3,889.70

Service Code	HCPCS 7372550
Hospital Charge Code	2400095
Hospital Revenue Code	616
Min. Negotiated Rate	$583.46
Max. Negotiated Rate	$583.46
Rate for Payer: Qualcare PPO/HMO/WC	$583.46

MRA LOWR EXTR W/ CON BIL

Facility

$1,944.85

Service Code	HCPCS 7372550
Hospital Charge Code	2400295
Hospital Revenue Code	610
Min. Negotiated Rate	$291.73
Max. Negotiated Rate	$291.73
Rate for Payer: Qualcare PPO/HMO/WC	$291.73

MRA LOWR EXTR W/ CON BIL

Facility

$1,944.85

Service Code	HCPCS 7372550
Hospital Charge Code	24000295
Hospital Revenue Code	610
Min. Negotiated Rate	$291.73
Max. Negotiated Rate	$291.73
Rate for Payer: Qualcare PPO/HMO/WC	$291.73

Know your out-of-pocket cost for care.

All Charges