Heights University Hospital

All Charges

Charge

Type

Setting

Price

NM BONE MARROW MULTIPLE

Facility

$1,415.50

Service Code	HCPCS 78103
Hospital Charge Code	4500567
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 MARROW MULTIPLE

Facility

$1,415.50

Service Code	HCPCS 78103
Hospital Charge Code	4500567
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 WHOLE BODY

Facility

$1,376.00

Service Code	HCPCS 78104
Hospital Charge Code	4500575
Hospital Revenue Code	341
Min. Negotiated Rate	$174.92
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$412.80
Rate for Payer: Aetna Medicare Advantage	$412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.88
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.88
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.40
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BONE MARROW WHOLE BODY

Facility

$1,376.00

Service Code	HCPCS 78104
Hospital Charge Code	4500575
Hospital Revenue Code	341
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$206.40
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

NM-BONE SCAN MULTIPLE AREAS

Facility

$1,802.00

Service Code	HCPCS 78305
Hospital Charge Code	4508015
Hospital Revenue Code	341
Min. Negotiated Rate	$270.30
Max. Negotiated Rate	$270.30
Rate for Payer: Qualcare PPO/HMO/WC	$270.30

NM-BONE SCAN MULTIPLE AREAS

Facility

$1,802.00

Service Code	HCPCS 78305
Hospital Charge Code	4508015
Hospital Revenue Code	341
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$3,540.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Aetna Better Health Medicaid	$1,181.50
Rate for Payer: Aetna Commercial	$540.60
Rate for Payer: Aetna Medicare Advantage	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.51
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.26
Rate for Payer: Qualcare PPO/HMO/WC	$270.30
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,205.13

NM BONE SCAN WHOLE BODY

Facility

$12,000.00

Service Code	HCPCS 78306
Hospital Charge Code	4500088
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 BONE SCAN WHOLE BODY

Facility

$12,000.00

Service Code	HCPCS 78306
Hospital Charge Code	4500088
Hospital Revenue Code	341
Min. Negotiated Rate	$140.25
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	$140.25
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 SPECT

Facility

$12,000.00

Service Code	HCPCS 78320
Hospital Charge Code	4500468
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 BONE SPECT

Facility

$12,000.00

Service Code	HCPCS 78320
Hospital Charge Code	4500468
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 BRAIN & FLOW

Facility

$12,000.00

Service Code	HCPCS 78606
Hospital Charge Code	4500138
Hospital Revenue Code	341
Min. Negotiated Rate	$174.84
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	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$1,293.03
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 BRAIN & FLOW

Facility

$12,000.00

Service Code	HCPCS 78606
Hospital Charge Code	4500138
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 BRAIN IMAG COMP STDY STATIC

Facility

$1,833.50

Service Code	HCPCS 78605
Hospital Charge Code	4500943
Hospital Revenue Code	341
Min. Negotiated Rate	$139.35
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$550.05
Rate for Payer: Aetna Medicare Advantage	$550.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.54
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.35
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.02
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN IMAG COMP STDY STATIC

Facility

$1,833.50

Service Code	HCPCS 78605
Hospital Charge Code	4500943
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM BRAIN IMAGING LIMITD STATIC

Facility

$1,833.50

Service Code	HCPCS 78600
Hospital Charge Code	4500944
Hospital Revenue Code	341
Min. Negotiated Rate	$123.42
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$550.05
Rate for Payer: Aetna Medicare Advantage	$550.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.54
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	$467.54
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.35
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.02
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN IMAGING LIMITD STATIC

Facility

$1,833.50

Service Code	HCPCS 78600
Hospital Charge Code	4500944
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM BRAIN IMAG LTD STATIC W/VAS

Facility

$1,833.50

Service Code	HCPCS 78601
Hospital Charge Code	4500945
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM BRAIN IMAG LTD STATIC W/VAS

Facility

$1,833.50

Service Code	HCPCS 78601
Hospital Charge Code	4500945
Hospital Revenue Code	341
Min. Negotiated Rate	$158.95
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$550.05
Rate for Payer: Aetna Medicare Advantage	$550.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.54
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.35
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.02
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN IMAG VASCLAR FLW ONLY

Facility

$1,833.50

Service Code	HCPCS 78610
Hospital Charge Code	4500946
Hospital Revenue Code	341
Min. Negotiated Rate	$31.66
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$550.05
Rate for Payer: Aetna Medicare Advantage	$550.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.54
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.35
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.02
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN IMAG VASCLAR FLW ONLY

Facility

$1,833.50

Service Code	HCPCS 78610
Hospital Charge Code	4500946
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM BRAIN SCAN*****

Facility

$447.00

Service Code	HCPCS 78605
Hospital Charge Code	4500096
Hospital Revenue Code	341
Min. Negotiated Rate	$58.11
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$134.10
Rate for Payer: Aetna Medicare Advantage	$134.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.98
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.05
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN SCAN*****

Facility

$447.00

Service Code	HCPCS 78605
Hospital Charge Code	4500096
Hospital Revenue Code	341
Min. Negotiated Rate	$67.05
Max. Negotiated Rate	$67.05
Rate for Payer: Qualcare PPO/HMO/WC	$67.05

NM BRAIN SPECT

Facility

$1,799.25

Service Code	HCPCS 78607
Hospital Charge Code	4500492
Hospital Revenue Code	341
Min. Negotiated Rate	$233.90
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$539.77
Rate for Payer: Aetna Medicare Advantage	$539.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$458.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$458.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$458.81
Rate for Payer: Cigna Commercial	$899.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.90
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$269.89
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM BRAIN SPECT

Facility

$1,799.25

Service Code	HCPCS 78607
Hospital Charge Code	4500492
Hospital Revenue Code	341
Min. Negotiated Rate	$269.89
Max. Negotiated Rate	$269.89
Rate for Payer: Qualcare PPO/HMO/WC	$269.89

NM CARDIAC BLOOD POOL SINGLE

Facility

$1,489.30

Service Code	HCPCS 78481
Hospital Charge Code	4500948
Hospital Revenue Code	341
Min. Negotiated Rate	$223.40
Max. Negotiated Rate	$223.40
Rate for Payer: Qualcare PPO/HMO/WC	$223.40

Know your out-of-pocket cost for care.

All Charges