Heights University Hospital

All Charges

Charge

Type

Setting

Price

NM PLMNRY VNT GAS W/RBRTH MLTI

Facility

$1,175.95

Hospital Charge Code	4500980
Hospital Revenue Code	341
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$352.79
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.87
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PLMNRY VNT GAS W/RBRTH SNGL

Facility

$1,175.95

Hospital Charge Code	4500981
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PLMNRY VNT GAS W/RBRTH SNGL

Facility

$1,175.95

Hospital Charge Code	4500981
Hospital Revenue Code	341
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$352.79
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.87
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NMP MICRO PARTICULATES-MEDIUM

Facility

$13,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270706059
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NMP MICRO PARTICULATES-MEDIUM

Facility

$13,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270706059
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
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	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NMPMPLG (FIBERS).

Facility

$26,475.00

Service Code	HCPCS C1765
Hospital Charge Code	270703695
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$13,237.50
Rate for Payer: Aetna Commercial	$7,942.50
Rate for Payer: Aetna Medicare Advantage	$7,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,751.12
Rate for Payer: Cigna Commercial	$13,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

NMPMPLG (FIBERS).

Facility

$26,475.00

Service Code	HCPCS C1765
Hospital Charge Code	270703695
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$6,406.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

NM PULMNRY VENTILATION/PERFSON

Facility

$1,917.00

Hospital Charge Code	4500984
Hospital Revenue Code	341
Min. Negotiated Rate	$249.21
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$575.10
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.21
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PULMNRY VENTILATION/PERFSON

Facility

$1,917.00

Hospital Charge Code	4500984
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMNRY VENTLTN AEROSOL SNG

Facility

$1,175.95

Hospital Charge Code	4500982
Hospital Revenue Code	341
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$352.79
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.87
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PULMNRY VENTLTN AEROSOL SNG

Facility

$1,175.95

Hospital Charge Code	4500982
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PULMNRY VENTLTN GASEOUS SNG

Facility

$1,175.95

Hospital Charge Code	4500983
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PULMNRY VENTLTN GASEOUS SNG

Facility

$1,175.95

Hospital Charge Code	4500983
Hospital Revenue Code	341
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$352.79
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.87
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM-PULMONARY DIFF LUNG

Facility

$1,759.00

Hospital Charge Code	4509010
Hospital Revenue Code	341
Min. Negotiated Rate	$263.85
Max. Negotiated Rate	$263.85
Rate for Payer: Qualcare PPO/HMO/WC	$263.85

NM-PULMONARY DIFF LUNG

Facility

$1,759.00

Hospital Charge Code	4509010
Hospital Revenue Code	341
Min. Negotiated Rate	$228.67
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$527.70
Rate for Payer: Aetna Medicare Advantage	$527.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.55
Rate for Payer: Cigna Commercial	$879.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.67
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$263.85
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PULMONARY PERFUSION W/VENT

Facility

$1,917.00

Hospital Charge Code	4500978
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMONARY PERFUSION W/VENT

Facility

$1,917.00

Hospital Charge Code	4500978
Hospital Revenue Code	341
Min. Negotiated Rate	$249.21
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$575.10
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.21
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM PULMON PERFUSN W/VENT RBRTH

Facility

$1,917.00

Hospital Charge Code	4500979
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMON PERFUSN W/VENT RBRTH

Facility

$1,917.00

Hospital Charge Code	4500979
Hospital Revenue Code	341
Min. Negotiated Rate	$249.21
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$575.10
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.21
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM QUANTATIVE PULMONARY SCAN

Facility

$339.25

Service Code	HCPCS 94010
Hospital Charge Code	4501020
Hospital Revenue Code	460
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$101.78
Rate for Payer: Aetna Medicare Advantage	$101.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

NM QUANTATIVE PULMONARY SCAN

Facility

$339.25

Service Code	HCPCS 94010
Hospital Charge Code	4501020
Hospital Revenue Code	460
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

NM RBC VOLUME

Facility

$1,222.15

Service Code	HCPCS 78120
Hospital Charge Code	4500988
Hospital Revenue Code	341
Min. Negotiated Rate	$61.71
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	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.65
Rate for Payer: Cigna Commercial	$952.02
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 RBC VOLUME

Facility

$1,222.15

Service Code	HCPCS 78120
Hospital Charge Code	4500988
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM RBC VOLUME SAMPLES

Facility

$1,222.15

Service Code	HCPCS 78121
Hospital Charge Code	4500989
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM RBC VOLUME SAMPLES

Facility

$1,222.15

Service Code	HCPCS 78121
Hospital Charge Code	4500989
Hospital Revenue Code	341
Min. Negotiated Rate	$82.28
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	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.65
Rate for Payer: Cigna Commercial	$1,293.03
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

Know your out-of-pocket cost for care.

All Charges