Heights University Hospital

All Charges

Charge

Type

Setting

Price

NM MYOCARDI PERF W WALL MOTI**

Facility

$160.00

Service Code	HCPCS 78478
Hospital Charge Code	4500898
Hospital Revenue Code	341
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

NM MYOCARDI PERF W WALL MOTI**

Facility

$160.00

Service Code	HCPCS 78478
Hospital Charge Code	4500898
Hospital Revenue Code	341
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM MYOCARD PLANAR SINGLE STUDY

Facility

$6,289.55

Service Code	HCPCS 78453
Hospital Charge Code	5600194
Hospital Revenue Code	341
Min. Negotiated Rate	$134.64
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,886.87
Rate for Payer: Aetna Medicare Advantage	$1,886.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,603.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,603.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,603.84
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$817.64
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$943.43
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM MYOCARD PLANAR SINGLE STUDY

Facility

$6,289.55

Service Code	HCPCS 78453
Hospital Charge Code	5600194
Hospital Revenue Code	341
Min. Negotiated Rate	$943.43
Max. Negotiated Rate	$943.43
Rate for Payer: Qualcare PPO/HMO/WC	$943.43

NM NERVOUS SYSTEM OTHER

Facility

$1,833.50

Service Code	HCPCS 78699
Hospital Charge Code	4500972
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM NERVOUS SYSTEM OTHER

Facility

$1,833.50

Service Code	HCPCS 78699
Hospital Charge Code	4500972
Hospital Revenue Code	341
Min. Negotiated Rate	$238.35
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) 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 ONCOSCINT PER DOSE

Facility

$8,657.00

Service Code	HCPCS A4642
Hospital Charge Code	4509015
Hospital Revenue Code	343
Min. Negotiated Rate	$1,125.41
Max. Negotiated Rate	$4,328.50
Rate for Payer: Aetna Commercial	$2,597.10
Rate for Payer: Aetna Medicare Advantage	$2,597.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,207.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,207.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,207.53
Rate for Payer: Cigna Commercial	$4,328.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,298.55

NM ONCOSCINT PER DOSE

Facility

$8,657.00

Service Code	HCPCS A4642
Hospital Charge Code	4509015
Hospital Revenue Code	343
Min. Negotiated Rate	$1,298.55
Max. Negotiated Rate	$1,298.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,298.55

NM PARATHYROID IMAGING

Facility

$12,000.00

Service Code	HCPCS 78070
Hospital Charge Code	4500591
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 PARATHYROID IMAGING

Facility

$12,000.00

Service Code	HCPCS 78070
Hospital Charge Code	4500591
Hospital Revenue Code	341
Min. Negotiated Rate	$69.19
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	$69.19
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 PERITONEAL VENOUS SHUNT PAT

Facility

$12,000.00

Service Code	HCPCS 78291
Hospital Charge Code	4500894
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 PERITONEAL VENOUS SHUNT PAT

Facility

$12,000.00

Service Code	HCPCS 78291
Hospital Charge Code	4500894
Hospital Revenue Code	341
Min. Negotiated Rate	$60.21
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	$60.21
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

NMP FIBERS (LONG)-SMALL.

Facility

$14,450.00

Service Code	HCPCS C1765
Hospital Charge Code	270703660
Hospital Revenue Code	278
Min. Negotiated Rate	$2,167.50
Max. Negotiated Rate	$3,496.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,496.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,167.50

NMP FIBERS (LONG)-SMALL.

Facility

$14,450.00

Service Code	HCPCS C1765
Hospital Charge Code	270703660
Hospital Revenue Code	278
Min. Negotiated Rate	$2,167.50
Max. Negotiated Rate	$7,225.00
Rate for Payer: Aetna Commercial	$4,335.00
Rate for Payer: Aetna Medicare Advantage	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,684.75
Rate for Payer: Cigna Commercial	$7,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,496.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,167.50

NMP FIBERS (LONG)- XSMALL

Facility

$7,225.00

Hospital Charge Code	270702965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$3,612.50
Rate for Payer: Aetna Commercial	$2,167.50
Rate for Payer: Aetna Medicare Advantage	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,842.38
Rate for Payer: Cigna Commercial	$3,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

NMP FIBERS (LONG)- XSMALL

Facility

$7,225.00

Hospital Charge Code	270702965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$1,748.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

NMP FIBERS (LONH) MEDIUM

Facility

$20,400.00

Service Code	HCPCS C1762
Hospital Charge Code	270704153
Hospital Revenue Code	278
Min. Negotiated Rate	$3,060.00
Max. Negotiated Rate	$4,936.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,936.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,060.00

NMP FIBERS (LONH) MEDIUM

Facility

$20,400.00

Service Code	HCPCS C1762
Hospital Charge Code	270704153
Hospital Revenue Code	278
Min. Negotiated Rate	$3,060.00
Max. Negotiated Rate	$10,200.00
Rate for Payer: Aetna Commercial	$6,120.00
Rate for Payer: Aetna Medicare Advantage	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,202.00
Rate for Payer: Cigna Commercial	$10,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,936.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,060.00

NM PLASMA VOLUME

Facility

$1,222.15

Service Code	HCPCS 78110
Hospital Charge Code	4500974
Hospital Revenue Code	341
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$366.64
Rate for Payer: Aetna Medicare Advantage	$366.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.65
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.88
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PLASMA VOLUME

Facility

$1,222.15

Service Code	HCPCS 78110
Hospital Charge Code	4500974
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM PLASMA VOLUMES MULTI SMPLES

Facility

$1,222.15

Service Code	HCPCS 78111
Hospital Charge Code	4500975
Hospital Revenue Code	341
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$366.64
Rate for Payer: Aetna Medicare Advantage	$366.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.65
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.88
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.32
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PLASMA VOLUMES MULTI SMPLES

Facility

$1,222.15

Service Code	HCPCS 78111
Hospital Charge Code	4500975
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM PLATELET KINETICS

Facility

$1,249.20

Service Code	HCPCS 78190
Hospital Charge Code	4500976
Hospital Revenue Code	341
Min. Negotiated Rate	$162.40
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$374.76
Rate for Payer: Aetna Medicare Advantage	$374.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.55
Rate for Payer: Cigna Commercial	$624.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.40
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.38
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PLATELET KINETICS

Facility

$1,249.20

Service Code	HCPCS 78190
Hospital Charge Code	4500976
Hospital Revenue Code	341
Min. Negotiated Rate	$187.38
Max. Negotiated Rate	$187.38
Rate for Payer: Qualcare PPO/HMO/WC	$187.38

NM PLMNRY VNT GAS W/RBRTH MLTI

Facility

$1,175.95

Hospital Charge Code	4500980
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

Know your out-of-pocket cost for care.

All Charges