Heights University Hospital

All Charges

Charge

Type

Setting

Price

NJX AA&/STRD GR OCPL NRV

Facility

$1,630.99

Service Code	HCPCS 64405
Hospital Charge Code	321564405
Hospital Revenue Code	361
Min. Negotiated Rate	$244.65
Max. Negotiated Rate	$244.65
Rate for Payer: Qualcare PPO/HMO/WC	$244.65

NJX AA&/STRD NRV NRVTG SI JT

Facility

$2,930.12

Service Code	HCPCS 64451
Hospital Charge Code	16000653
Hospital Revenue Code	360
Min. Negotiated Rate	$380.92
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$879.04
Rate for Payer: Aetna Medicare Advantage	$879.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.18
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	$747.18
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.92
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.52
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX AA&/STRD NRV NRVTG SI JT

Facility

$2,930.12

Service Code	HCPCS 64451
Hospital Charge Code	16000653
Hospital Revenue Code	360
Min. Negotiated Rate	$439.52
Max. Negotiated Rate	$439.52
Rate for Payer: Qualcare PPO/HMO/WC	$439.52

NJX AA&/STRD SCIATIC NRV IMG

Facility

$3,865.20

Service Code	HCPCS 64445
Hospital Charge Code	321564445
Hospital Revenue Code	361
Min. Negotiated Rate	$502.48
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,159.56
Rate for Payer: Aetna Medicare Advantage	$1,159.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.63
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	$985.63
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.48
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.78
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX AA&/STRD SCIATIC NRV IMG

Facility

$3,865.20

Service Code	HCPCS 64445
Hospital Charge Code	321564445
Hospital Revenue Code	361
Min. Negotiated Rate	$579.78
Max. Negotiated Rate	$579.78
Rate for Payer: Qualcare PPO/HMO/WC	$579.78

NJX AA& STRD TFRM EPI C/T EA

Facility

$5,068.00

Service Code	HCPCS 64480
Hospital Charge Code	411064480
Hospital Revenue Code	361
Min. Negotiated Rate	$760.20
Max. Negotiated Rate	$760.20
Rate for Payer: Qualcare PPO/HMO/WC	$760.20

NJX AA& STRD TFRM EPI C/T EA

Facility

$5,068.00

Service Code	HCPCS 64480
Hospital Charge Code	411064480
Hospital Revenue Code	361
Min. Negotiated Rate	$57.48
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,520.40
Rate for Payer: Aetna Medicare Advantage	$1,520.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,292.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,292.34
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	$1,292.34
Rate for Payer: Cigna Commercial	$57.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.84
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.20
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

NJX AA&/STRD TFRM EPI L/S 1

Facility

$5,111.97

Service Code	HCPCS 64483
Hospital Charge Code	321564483
Hospital Revenue Code	361
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$766.80
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

NJX AA&/STRD TFRM EPI L/S 1

Facility

$5,111.97

Service Code	HCPCS 64483
Hospital Charge Code	321564483
Hospital Revenue Code	361
Min. Negotiated Rate	$664.56
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Better Health Medicaid	$2,266.41
Rate for Payer: Aetna Commercial	$1,533.59
Rate for Payer: Aetna Medicare Advantage	$1,533.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.55
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	$1,303.55
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.56
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$766.80
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

NJX AA&STRD TFRM EPI L/S 1

Facility

$5,068.00

Service Code	HCPCS 64483
Hospital Charge Code	411064483
Hospital Revenue Code	361
Min. Negotiated Rate	$658.84
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Better Health Medicaid	$2,266.41
Rate for Payer: Aetna Commercial	$1,520.40
Rate for Payer: Aetna Medicare Advantage	$1,520.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,292.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,292.34
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	$1,292.34
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.84
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.20
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

NJX AA&STRD TFRM EPI L/S 1

Facility

$5,068.00

Service Code	HCPCS 64483
Hospital Charge Code	411064483
Hospital Revenue Code	361
Min. Negotiated Rate	$760.20
Max. Negotiated Rate	$760.20
Rate for Payer: Qualcare PPO/HMO/WC	$760.20

NJX AA&/STRD TFRM EPI L/S 1 BI

Facility

$10,223.94

Service Code	HCPCS 6448350
Hospital Charge Code	3215644832
Hospital Revenue Code	361
Min. Negotiated Rate	$1,533.59
Max. Negotiated Rate	$1,533.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.59

NJX AA&/STRD TFRM EPI L/S 1 BI

Facility

$10,223.94

Service Code	HCPCS 6448350
Hospital Charge Code	3215644832
Hospital Revenue Code	361
Min. Negotiated Rate	$1,329.11
Max. Negotiated Rate	$5,111.97
Rate for Payer: Aetna Commercial	$3,067.18
Rate for Payer: Aetna Medicare Advantage	$3,067.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,607.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,607.10
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	$2,607.10
Rate for Payer: Cigna Commercial	$5,111.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.59

NJX AA&/STRDTFRMEPILSADDLBIL

Facility

$10,223.94

Service Code	HCPCS 6448450
Hospital Charge Code	3215644842
Hospital Revenue Code	361
Min. Negotiated Rate	$1,329.11
Max. Negotiated Rate	$5,111.97
Rate for Payer: Aetna Commercial	$3,067.18
Rate for Payer: Aetna Medicare Advantage	$3,067.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,607.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,607.10
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	$2,607.10
Rate for Payer: Cigna Commercial	$5,111.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.59

NJX AA&/STRDTFRMEPILSADDLBIL

Facility

$10,223.94

Service Code	HCPCS 6448450
Hospital Charge Code	3215644842
Hospital Revenue Code	361
Min. Negotiated Rate	$1,533.59
Max. Negotiated Rate	$1,533.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.59

NJX AA&/STRD TFRM EPI L/S EA

Facility

$5,111.97

Service Code	HCPCS 64484
Hospital Charge Code	321564484
Hospital Revenue Code	361
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$766.80
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

NJX AA&/STRD TFRM EPI L/S EA

Facility

$5,111.97

Service Code	HCPCS 64484
Hospital Charge Code	321564484
Hospital Revenue Code	361
Min. Negotiated Rate	$47.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,533.59
Rate for Payer: Aetna Medicare Advantage	$1,533.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.55
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	$1,303.55
Rate for Payer: Cigna Commercial	$47.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$766.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

NJX AA&STRD TFRM EPI L/S EA

Facility

$5,068.00

Service Code	HCPCS 64484
Hospital Charge Code	411064484
Hospital Revenue Code	361
Min. Negotiated Rate	$47.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,520.40
Rate for Payer: Aetna Medicare Advantage	$1,520.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,292.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,292.34
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	$1,292.34
Rate for Payer: Cigna Commercial	$47.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.84
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.20
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

NJX AA&STRD TFRM EPI L/S EA

Facility

$5,068.00

Service Code	HCPCS 64484
Hospital Charge Code	411064484
Hospital Revenue Code	361
Min. Negotiated Rate	$760.20
Max. Negotiated Rate	$760.20
Rate for Payer: Qualcare PPO/HMO/WC	$760.20

NJX B1 SUB MTRL SBCHDRL DFCT

Facility

$14,284.88

Service Code	HCPCS 0707T
Hospital Charge Code	1600000696
Hospital Revenue Code	360
Min. Negotiated Rate	$1,857.03
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,285.46
Rate for Payer: Aetna Medicare Advantage	$4,285.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,642.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,642.64
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	$3,642.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,857.03
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,142.73
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

NJX B1 SUB MTRL SBCHDRL DFCT

Facility

$14,284.88

Service Code	HCPCS 0707T
Hospital Charge Code	1600000696
Hospital Revenue Code	360
Min. Negotiated Rate	$2,142.73
Max. Negotiated Rate	$2,142.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,142.73

NJX INTERLAMINAR CRV/THRC

Facility

$5,965.40

Service Code	HCPCS 62321
Hospital Charge Code	16001017
Hospital Revenue Code	360
Min. Negotiated Rate	$894.81
Max. Negotiated Rate	$894.81
Rate for Payer: Qualcare PPO/HMO/WC	$894.81

NJX INTERLAMINAR CRV/THRC

Facility

$3,865.20

Service Code	HCPCS 62321
Hospital Charge Code	321562321
Hospital Revenue Code	361
Min. Negotiated Rate	$502.48
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,159.56
Rate for Payer: Aetna Medicare Advantage	$1,159.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.63
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	$985.63
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.48
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.78
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX INTERLAMINAR CRV/THRC

Facility

$5,965.40

Service Code	HCPCS 62321
Hospital Charge Code	16001017
Hospital Revenue Code	360
Min. Negotiated Rate	$775.50
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,789.62
Rate for Payer: Aetna Medicare Advantage	$1,789.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,521.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,521.18
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	$1,521.18
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.50
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$894.81
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX INTERLAMINAR CRV/THRC

Facility

$3,865.20

Service Code	HCPCS 62321
Hospital Charge Code	321562321
Hospital Revenue Code	361
Min. Negotiated Rate	$579.78
Max. Negotiated Rate	$579.78
Rate for Payer: Qualcare PPO/HMO/WC	$579.78

Know your out-of-pocket cost for care.

All Charges