Heights University Hospital

All Charges

Charge

Type

Setting

Price

NL SCREW 2.7 X 16

Facility

$485.00

Service Code	HCPCS C1713
Hospital Charge Code	270684674
Hospital Revenue Code	278
Min. Negotiated Rate	$72.75
Max. Negotiated Rate	$117.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.37
Rate for Payer: Qualcare PPO/HMO/WC	$72.75

NM ABSCESS LOCALIZ WB

Facility

$12,000.00

Service Code	HCPCS 78806
Hospital Charge Code	4500617
Hospital Revenue Code	341
Min. Negotiated Rate	$1,560.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM ABSCESS LOCALIZ WB

Facility

$12,000.00

Service Code	HCPCS 78806
Hospital Charge Code	4500617
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM ACUTE VENOUS THROMB IMAGING

Facility

$738.60

Service Code	HCPCS 78456
Hospital Charge Code	4500937
Hospital Revenue Code	341
Min. Negotiated Rate	$96.02
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$221.58
Rate for Payer: Aetna Medicare Advantage	$221.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.34
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.02
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.79
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM ACUTE VENOUS THROMB IMAGING

Facility

$738.60

Service Code	HCPCS 78456
Hospital Charge Code	4500937
Hospital Revenue Code	341
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$110.79
Rate for Payer: Qualcare PPO/HMO/WC	$110.79

NM ADRENAL IMA CORTEX &/OR MED

Facility

$2,616.85

Service Code	HCPCS 78075
Hospital Charge Code	4500906
Hospital Revenue Code	341
Min. Negotiated Rate	$102.85
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$785.05
Rate for Payer: Aetna Medicare Advantage	$785.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$667.30
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.19
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$392.53
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM ADRENAL IMA CORTEX &/OR MED

Facility

$2,616.85

Service Code	HCPCS 78075
Hospital Charge Code	4500906
Hospital Revenue Code	341
Min. Negotiated Rate	$392.53
Max. Negotiated Rate	$392.53
Rate for Payer: Qualcare PPO/HMO/WC	$392.53

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74115070
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74117070
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74115070
Hospital Revenue Code	343
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74116070
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	4500295
Hospital Revenue Code	343
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	4500295
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74117070
Hospital Revenue Code	343
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM AMMONIA ISOTOPE N13

Facility

$1,425.00

Hospital Charge Code	74116070
Hospital Revenue Code	343
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM BLOOD OTHER

Facility

$1,388.55

Service Code	HCPCS 78199
Hospital Charge Code	4500938
Hospital Revenue Code	341
Min. Negotiated Rate	$180.51
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$416.56
Rate for Payer: Aetna Medicare Advantage	$416.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.08
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.51
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.28
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BLOOD OTHER

Facility

$1,388.55

Service Code	HCPCS 78199
Hospital Charge Code	4500938
Hospital Revenue Code	341
Min. Negotiated Rate	$208.28
Max. Negotiated Rate	$208.28
Rate for Payer: Qualcare PPO/HMO/WC	$208.28

NM BONE DENSITY SINGLE PHOTON

Facility

$258.55

Service Code	HCPCS 78350
Hospital Charge Code	4500940
Hospital Revenue Code	341
Min. Negotiated Rate	$38.78
Max. Negotiated Rate	$38.78
Rate for Payer: Qualcare PPO/HMO/WC	$38.78

NM BONE DENSITY SINGLE PHOTON

Facility

$258.55

Service Code	HCPCS 78350
Hospital Charge Code	4500940
Hospital Revenue Code	341
Min. Negotiated Rate	$33.61
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$77.56
Rate for Payer: Aetna Medicare Advantage	$77.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.93
Rate for Payer: Cigna Commercial	$129.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.61
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.78
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BONE IMAGING LIMITED

Facility

$1,415.50

Service Code	HCPCS 78300
Hospital Charge Code	4500941
Hospital Revenue Code	341
Min. Negotiated Rate	$212.32
Max. Negotiated Rate	$212.32
Rate for Payer: Qualcare PPO/HMO/WC	$212.32

NM BONE IMAGING LIMITED

Facility

$1,415.50

Service Code	HCPCS 78300
Hospital Charge Code	4500941
Hospital Revenue Code	341
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Better Health Medicaid	$181.50
Rate for Payer: Aetna Commercial	$424.65
Rate for Payer: Aetna Medicare Advantage	$424.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.95
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.01
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$185.13

NM BONE IMAG LIMIT MULTI AREAS

Facility

$1,415.50

Service Code	HCPCS 78103
Hospital Charge Code	4500942
Hospital Revenue Code	341
Min. Negotiated Rate	$154.28
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$424.65
Rate for Payer: Aetna Medicare Advantage	$424.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.95
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.01
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BONE IMAG LIMIT MULTI AREAS

Facility

$1,415.50

Service Code	HCPCS 78103
Hospital Charge Code	4500942
Hospital Revenue Code	341
Min. Negotiated Rate	$212.32
Max. Negotiated Rate	$212.32
Rate for Payer: Qualcare PPO/HMO/WC	$212.32

NM BONE MARROW LIMITED

Facility

$12,000.00

Service Code	HCPCS 78102
Hospital Charge Code	4500559
Hospital Revenue Code	341
Min. Negotiated Rate	$123.42
Max. Negotiated Rate	$3,600.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BONE MARROW LIMITED

Facility

$12,000.00

Service Code	HCPCS 78102
Hospital Charge Code	4500559
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

Know your out-of-pocket cost for care.

All Charges