Heights University Hospital

All Charges

Charge

Type

Setting

Price

MRI CARBON ROD, 200MM

Facility

$1,183.00

Hospital Charge Code	270656539
Hospital Revenue Code	271
Min. Negotiated Rate	$177.45
Max. Negotiated Rate	$177.45
Rate for Payer: Qualcare PPO/HMO/WC	$177.45

MRI CARD CARD MORPH WO/WITH FL

Facility

$1,762.00

Service Code	HCPCS 75565
Hospital Charge Code	2408025
Hospital Revenue Code	614
Min. Negotiated Rate	$264.30
Max. Negotiated Rate	$264.30
Rate for Payer: Qualcare PPO/HMO/WC	$264.30

MRI CARD CARD MORPH WO/WITH FL

Facility

$1,762.00

Service Code	HCPCS 75565
Hospital Charge Code	2408025
Hospital Revenue Code	614
Min. Negotiated Rate	$51.88
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$528.60
Rate for Payer: Aetna Medicare Advantage	$528.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$449.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$449.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$449.31
Rate for Payer: Cigna Commercial	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.06
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.30
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI-CARDC MORPH WO-FOLLWD WITH

Facility

$3,173.52

Service Code	HCPCS 75561
Hospital Charge Code	2408020
Hospital Revenue Code	614
Min. Negotiated Rate	$412.56
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$952.06
Rate for Payer: Aetna Medicare Advantage	$952.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.25
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.56
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.03
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI-CARDC MORPH WO-FOLLWD WITH

Facility

$3,173.52

Service Code	HCPCS 75561
Hospital Charge Code	2408020
Hospital Revenue Code	614
Min. Negotiated Rate	$476.03
Max. Negotiated Rate	$476.03
Rate for Payer: Qualcare PPO/HMO/WC	$476.03

MRI CARDC W/OR W/O MORPH COMPL

Facility

$1,656.85

Service Code	HCPCS 75554
Hospital Charge Code	2400349
Hospital Revenue Code	610
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$248.53
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

MRI CARDC W/OR W/O MORPH COMPL

Facility

$1,656.85

Service Code	HCPCS 75554
Hospital Charge Code	2400349
Hospital Revenue Code	610
Min. Negotiated Rate	$215.39
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$497.06
Rate for Payer: Aetna Medicare Advantage	$497.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.50
Rate for Payer: Cigna Commercial	$828.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.39
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$248.53
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI CARDIAC/MORPHLGY W/CONTRAS

Facility

$2,000.85

Service Code	HCPCS 75553
Hospital Charge Code	2400331
Hospital Revenue Code	610
Min. Negotiated Rate	$260.11
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$600.25
Rate for Payer: Aetna Medicare Advantage	$600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.22
Rate for Payer: Cigna Commercial	$1,000.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.11
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.13
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI CARDIAC/MORPHLGY W/CONTRAS

Facility

$2,000.85

Service Code	HCPCS 75553
Hospital Charge Code	2400331
Hospital Revenue Code	610
Min. Negotiated Rate	$300.13
Max. Negotiated Rate	$300.13
Rate for Payer: Qualcare PPO/HMO/WC	$300.13

MRI CARDIAC/MORPHLGY W/O CONTR

Facility

$2,000.85

Service Code	HCPCS 75552
Hospital Charge Code	2400323
Hospital Revenue Code	610
Min. Negotiated Rate	$260.11
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$600.25
Rate for Payer: Aetna Medicare Advantage	$600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.22
Rate for Payer: Cigna Commercial	$1,000.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.11
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.13
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI CARDIAC/MORPHLGY W/O CONTR

Facility

$2,000.85

Service Code	HCPCS 75552
Hospital Charge Code	2400323
Hospital Revenue Code	610
Min. Negotiated Rate	$300.13
Max. Negotiated Rate	$300.13
Rate for Payer: Qualcare PPO/HMO/WC	$300.13

MRI-CARDIAC MORPH W/O CONTRAST

Facility

$2,036.00

Service Code	HCPCS 75557
Hospital Charge Code	2408015
Hospital Revenue Code	614
Min. Negotiated Rate	$264.68
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$610.80
Rate for Payer: Aetna Medicare Advantage	$610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$519.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$519.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$519.18
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.68
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$305.40
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI-CARDIAC MORPH W/O CONTRAST

Facility

$2,036.00

Service Code	HCPCS 75557
Hospital Charge Code	2408015
Hospital Revenue Code	614
Min. Negotiated Rate	$305.40
Max. Negotiated Rate	$305.40
Rate for Payer: Qualcare PPO/HMO/WC	$305.40

MRI CARDIAC W/OR W/O MORPH LTD

Facility

$1,656.85

Service Code	HCPCS 75555
Hospital Charge Code	2400356
Hospital Revenue Code	610
Min. Negotiated Rate	$215.39
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$497.06
Rate for Payer: Aetna Medicare Advantage	$497.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.50
Rate for Payer: Cigna Commercial	$828.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.39
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$248.53
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI CARDIAC W/OR W/O MORPH LTD

Facility

$1,656.85

Service Code	HCPCS 75555
Hospital Charge Code	2400356
Hospital Revenue Code	610
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$248.53
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

MRI CERVICAL SPINE

Facility

$13,500.00

Service Code	HCPCS 72141
Hospital Charge Code	94061071
Hospital Revenue Code	612
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRI CERVICAL SPINE

Facility

$13,500.00

Service Code	HCPCS 72141
Hospital Charge Code	94061071
Hospital Revenue Code	612
Min. Negotiated Rate	$568.20
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	$617.10
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

MRI CERVICAL SP W/GAD INJ

Facility

$13,500.00

Service Code	HCPCS 72142
Hospital Charge Code	94061073
Hospital Revenue Code	612
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRI CERVICAL SP W/GAD INJ

Facility

$13,500.00

Service Code	HCPCS 72142
Hospital Charge Code	94061073
Hospital Revenue Code	612
Min. Negotiated Rate	$660.11
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	$660.11
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

MRI CERVICAL SP W/WO CONT

Facility

$13,500.00

Service Code	HCPCS 72156
Hospital Charge Code	94061083
Hospital Revenue Code	612
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRI CERVICAL SP W/WO CONT

Facility

$13,500.00

Service Code	HCPCS 72156
Hospital Charge Code	94061083
Hospital Revenue Code	612
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) NJ Health	$896.29
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

MRI CHEST

Facility

$13,500.00

Service Code	HCPCS 71550
Hospital Charge Code	94061047
Hospital Revenue Code	614
Min. Negotiated Rate	$561.00
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	$561.00
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

MRI CHEST

Facility

$13,500.00

Service Code	HCPCS 71550
Hospital Charge Code	94061047
Hospital Revenue Code	614
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRI CHEST LYMPHADEN H/M W CNTR

Facility

$2,210.50

Service Code	HCPCS 71551
Hospital Charge Code	2400595
Hospital Revenue Code	614
Min. Negotiated Rate	$287.37
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$663.15
Rate for Payer: Aetna Medicare Advantage	$663.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$557.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.68
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.37
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$331.57
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

MRI CHEST LYMPHADEN H/M W CNTR

Facility

$2,210.50

Service Code	HCPCS 71551
Hospital Charge Code	2400595
Hospital Revenue Code	614
Min. Negotiated Rate	$331.57
Max. Negotiated Rate	$331.57
Rate for Payer: Qualcare PPO/HMO/WC	$331.57

Know your out-of-pocket cost for care.

All Charges