Heights University Hospital

All Charges

Charge

Type

Setting

Price

NM RED CELL SURVIVAL STUDY

Facility

$1,222.15

Service Code	HCPCS 78130
Hospital Charge Code	4500991
Hospital Revenue Code	341
Min. Negotiated Rate	$56.57
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	$56.57
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 RED CELL SURVIVAL STUDY

Facility

$1,222.15

Service Code	HCPCS 78130
Hospital Charge Code	4500991
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM RED CELL SURVIVL DFRNTL ORG

Facility

$1,222.15

Service Code	HCPCS 78135
Hospital Charge Code	4500990
Hospital Revenue Code	341
Min. Negotiated Rate	$158.88
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) PPO	$311.65
Rate for Payer: Cigna Commercial	$611.08
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 RED CELL SURVIVL DFRNTL ORG

Facility

$1,222.15

Service Code	HCPCS 78135
Hospital Charge Code	4500990
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM RENAL SCAN STATIC

Facility

$1,355.00

Service Code	HCPCS 78700
Hospital Charge Code	4500245
Hospital Revenue Code	341
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

NM RENAL SCAN STATIC

Facility

$1,355.00

Service Code	HCPCS 78700
Hospital Charge Code	4500245
Hospital Revenue Code	341
Min. Negotiated Rate	$74.80
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM RENOGRAM STATIC

Facility

$1,355.00

Service Code	HCPCS 78700
Hospital Charge Code	4500443
Hospital Revenue Code	341
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

NM RENOGRAM STATIC

Facility

$1,355.00

Service Code	HCPCS 78700
Hospital Charge Code	4500443
Hospital Revenue Code	341
Min. Negotiated Rate	$74.80
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM RESPIRATORY OTHER

Facility

$1,175.35

Service Code	HCPCS 78599
Hospital Charge Code	4500992
Hospital Revenue Code	341
Min. Negotiated Rate	$176.30
Max. Negotiated Rate	$176.30
Rate for Payer: Qualcare PPO/HMO/WC	$176.30

NM RESPIRATORY OTHER

Facility

$1,175.35

Service Code	HCPCS 78599
Hospital Charge Code	4500992
Hospital Revenue Code	341
Min. Negotiated Rate	$152.80
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$352.61
Rate for Payer: Aetna Medicare Advantage	$352.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.71
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.80
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.30
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM RETICULOENDOTHEL UNLST PROC

Facility

$1,388.55

Service Code	HCPCS 78199
Hospital Charge Code	4500993
Hospital Revenue Code	341
Min. Negotiated Rate	$208.28
Max. Negotiated Rate	$208.28
Rate for Payer: Qualcare PPO/HMO/WC	$208.28

NM RETICULOENDOTHEL UNLST PROC

Facility

$1,388.55

Service Code	HCPCS 78199
Hospital Charge Code	4500993
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 RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74116071
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 RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74115071
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 RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74117071
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74117071
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 RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74115071
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NM RUBIDIUM ISOTOPE

Facility

$1,425.00

Hospital Charge Code	74116071
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NMRUBIDIUMISOTOPE UP TO 25 MCI

Facility

$1,425.00

Hospital Charge Code	4501051
Hospital Revenue Code	343
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

NMRUBIDIUMISOTOPE UP TO 25 MCI

Facility

$1,425.00

Hospital Charge Code	4501051
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 SALIVARY GLAND FNCTION STDY

Facility

$1,336.60

Service Code	HCPCS 78232
Hospital Charge Code	4500994
Hospital Revenue Code	341
Min. Negotiated Rate	$200.49
Max. Negotiated Rate	$200.49
Rate for Payer: Qualcare PPO/HMO/WC	$200.49

NM SALIVARY GLAND FNCTION STDY

Facility

$1,336.60

Service Code	HCPCS 78232
Hospital Charge Code	4500994
Hospital Revenue Code	341
Min. Negotiated Rate	$91.63
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$400.98
Rate for Payer: Aetna Medicare Advantage	$400.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.83
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.76
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.49
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM SALIVARY GLAND IMAGING

Facility

$1,336.60

Service Code	HCPCS 78230
Hospital Charge Code	4500995
Hospital Revenue Code	341
Min. Negotiated Rate	$200.49
Max. Negotiated Rate	$200.49
Rate for Payer: Qualcare PPO/HMO/WC	$200.49

NM SALIVARY GLAND IMAGING

Facility

$1,336.60

Service Code	HCPCS 78230
Hospital Charge Code	4500995
Hospital Revenue Code	341
Min. Negotiated Rate	$79.19
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$400.98
Rate for Payer: Aetna Medicare Advantage	$400.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.83
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.76
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.49
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

NM SALIVARY GLND/IMAG.W SERIAL

Facility

$1,448.92

Service Code	HCPCS 78231
Hospital Charge Code	4508010
Hospital Revenue Code	341
Min. Negotiated Rate	$91.63
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Better Health Medicaid	$115.56
Rate for Payer: Aetna Commercial	$434.68
Rate for Payer: Aetna Medicare Advantage	$434.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.47
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.36
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.34
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$117.87

Know your out-of-pocket cost for care.

All Charges