Heights University Hospital

All Charges

Charge

Type

Setting

Price

MRA/MRV CHEST WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS C8910
Hospital Charge Code	2400121
Hospital Revenue Code	618
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA/MRV CHEST W/WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS C8911
Hospital Charge Code	2400122
Hospital Revenue Code	618
Min. Negotiated Rate	$830.80
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) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$830.80
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/MRV CHEST W/WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS C8911
Hospital Charge Code	2400122
Hospital Revenue Code	618
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA/MRV HEAD W CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70545
Hospital Charge Code	2400390
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/MRV HEAD W CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70545
Hospital Charge Code	2400390
Hospital Revenue Code	615
Min. Negotiated Rate	$637.67
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	$637.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$830.80
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/MRV HEAD WO CONSTRAST

Facility

$13,500.00

Service Code	HCPCS 70544
Hospital Charge Code	2400385
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/MRV HEAD WO CONSTRAST

Facility

$13,500.00

Service Code	HCPCS 70544
Hospital Charge Code	2400385
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/MRV HEAD W/ & W/O CONTRST

Facility

$13,500.00

Service Code	HCPCS 70546
Hospital Charge Code	2400395
Hospital Revenue Code	615
Min. Negotiated Rate	$820.26
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	$820.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$830.80
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/MRV HEAD W/ & W/O CONTRST

Facility

$13,500.00

Service Code	HCPCS 70546
Hospital Charge Code	2400395
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/MRV LOWR EXT WO CONT BILAT

Facility

$13,500.00

Service Code	HCPCS 7372550
Hospital Charge Code	2400096
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/MRV LOWR EXT WO CONT BILAT

Facility

$13,500.00

Service Code	HCPCS 7372550
Hospital Charge Code	2400096
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/MRV NECK W CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70548
Hospital Charge Code	2400405
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/MRV NECK W CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70548
Hospital Charge Code	2400405
Hospital Revenue Code	615
Min. Negotiated Rate	$637.67
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	$637.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$830.80
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/MRV NECK WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70547
Hospital Charge Code	2400400
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/MRV NECK WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70547
Hospital Charge Code	2400400
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/MRV NECK W/WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70549
Hospital Charge Code	2400410
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/MRV NECK W/WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70549
Hospital Charge Code	2400410
Hospital Revenue Code	615
Min. Negotiated Rate	$820.26
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	$820.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$830.80
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/MRV PELVIS WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 72198
Hospital Charge Code	2400231
Hospital Revenue Code	618
Min. Negotiated Rate	$383.67
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	$474.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$383.67
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/MRV PELVIS WO CONTRAST

Facility

$13,500.00

Service Code	HCPCS 72198
Hospital Charge Code	2400231
Hospital Revenue Code	618
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA/MRV UPPER EXT W/WO CONT LT

Facility

$13,500.00

Service Code	HCPCS 73225LT
Hospital Charge Code	2400265
Hospital Revenue Code	618
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRA/MRV UPPER EXT W/WO CONT LT

Facility

$13,500.00

Service Code	HCPCS 73225LT
Hospital Charge Code	2400265
Hospital Revenue Code	618
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 NECK W/O CONT

Facility

$13,500.00

Service Code	HCPCS 70547
Hospital Charge Code	94061029
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 NECK W/O CONT

Facility

$13,500.00

Service Code	HCPCS 70547
Hospital Charge Code	94061029
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

MR ANGIOGRAPHY ABDOMEN

Facility

$2,354.00

Service Code	HCPCS 74185
Hospital Charge Code	94061133
Hospital Revenue Code	618
Min. Negotiated Rate	$353.10
Max. Negotiated Rate	$353.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.10

MR ANGIOGRAPHY ABDOMEN

Facility

$2,354.00

Service Code	HCPCS 74185
Hospital Charge Code	94061133
Hospital Revenue Code	618
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$706.20
Rate for Payer: Aetna Medicare Advantage	$706.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.27
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	$600.27
Rate for Payer: Cigna Commercial	$383.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.02
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$353.10
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

Know your out-of-pocket cost for care.

All Charges