Heights University Hospital

All Charges

Charge

Type

Setting

Price

Other SLP D/C Status CJ

Facility

$0.01

Service Code	HCPCS G9176GNCJ
Hospital Charge Code	74204093CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP D/C Status CJ

Facility

$0.01

Service Code	HCPCS G9176GNCJ
Hospital Charge Code	74204093CJ
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP D/C STATUS CK

Facility

$0.01

Service Code	HCPCS G9176GNCK
Hospital Charge Code	74204093CK
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP D/C STATUS CK

Facility

$0.01

Service Code	HCPCS G9176GNCK
Hospital Charge Code	74204093CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER SLP D/C STATUS CL

Facility

$0.01

Service Code	HCPCS G9176GNCL
Hospital Charge Code	74204093CL
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP D/C STATUS CL

Facility

$0.01

Service Code	HCPCS G9176GNCL
Hospital Charge Code	74204093CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP D/C Status CM

Facility

$0.01

Service Code	HCPCS G9176GNCM
Hospital Charge Code	74204093CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP D/C Status CM

Facility

$0.01

Service Code	HCPCS G9176GNCM
Hospital Charge Code	74204093CM
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP D/C STATUS CN

Facility

$0.01

Service Code	HCPCS G9176GNCN
Hospital Charge Code	74204093CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER SLP D/C STATUS CN

Facility

$0.01

Service Code	HCPCS G9176GNCN
Hospital Charge Code	74204093CN
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CH

Facility

$0.01

Service Code	HCPCS G9175GNCH
Hospital Charge Code	74204091CH
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CH

Facility

$0.01

Service Code	HCPCS G9175GNCH
Hospital Charge Code	74204091CH
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CI

Facility

$0.01

Service Code	HCPCS G9175GNCI
Hospital Charge Code	74204091CI
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CI

Facility

$0.01

Service Code	HCPCS G9175GNCI
Hospital Charge Code	74204091CI
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9175GNCJ
Hospital Charge Code	74204091CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9175GNCJ
Hospital Charge Code	74204091CJ
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CK

Facility

$0.01

Service Code	HCPCS G9175GNCK
Hospital Charge Code	74204091CK
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CK

Facility

$0.01

Service Code	HCPCS G9175GNCK
Hospital Charge Code	74204091CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CL

Facility

$0.01

Service Code	HCPCS G9175GNCL
Hospital Charge Code	74204091CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CL

Facility

$0.01

Service Code	HCPCS G9175GNCL
Hospital Charge Code	74204091CL
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Other SLP Goal Status CM

Facility

$0.01

Service Code	HCPCS G9175GNCM
Hospital Charge Code	74204091CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Goal Status CM

Facility

$0.01

Service Code	HCPCS G9175GNCM
Hospital Charge Code	74204091CM
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9175GNCN
Hospital Charge Code	74204091CN
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER SLP GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9175GNCN
Hospital Charge Code	74204091CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER SMALL AND LARGE BOWEL PROCEDURES

Facility

$20,291.90

Service Code	APR-DRG 2232
Min. Negotiated Rate	$13,730.19
Max. Negotiated Rate	$20,291.90
Rate for Payer: Aetna Better Health Medicaid	$19,894.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,291.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13,730.19

Know your out-of-pocket cost for care.

All Charges