Heights University Hospital

All Charges

Charge

Type

Setting

Price

PACK CYSTO 3 K/C

Facility

$100.00

Hospital Charge Code	270654020
Hospital Revenue Code	272
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

PACK CYSTO 3 K/C

Facility

$100.00

Hospital Charge Code	270654020
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

PACK CYSTO DISP 88631

Facility

$139.25

Hospital Charge Code	270600149
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

PACK CYSTO DISP 88631

Facility

$139.25

Hospital Charge Code	270600149
Hospital Revenue Code	272
Min. Negotiated Rate	$18.10
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.10
Rate for Payer: Oxford Commercial	$69.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$69.62

PACK CYSTO III K/C

Facility

$91.67

Hospital Charge Code	270653791
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$45.84
Rate for Payer: Aetna Commercial	$27.50
Rate for Payer: Aetna Medicare Advantage	$27.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.38
Rate for Payer: Cigna Commercial	$45.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.92
Rate for Payer: Oxford Commercial	$45.84
Rate for Payer: Qualcare PPO/HMO/WC	$13.75
Rate for Payer: UnitedHealthcare Commercial	$45.84

PACK CYSTO III K/C

Facility

$91.67

Hospital Charge Code	270653791
Hospital Revenue Code	272
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$13.75
Rate for Payer: Qualcare PPO/HMO/WC	$13.75

PACK CYSTOSCOPY ***********

Facility

$55.00

Hospital Charge Code	1607092
Hospital Revenue Code	251
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

PACK CYSTOSCOPY ***********

Facility

$55.00

Hospital Charge Code	1607092
Hospital Revenue Code	251
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

PACK CYSTOSCOPY IV 88618

Facility

$24.90

Hospital Charge Code	270609204
Hospital Revenue Code	272
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$12.45
Rate for Payer: Aetna Commercial	$7.47
Rate for Payer: Aetna Medicare Advantage	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.35
Rate for Payer: Cigna Commercial	$12.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.24
Rate for Payer: Oxford Commercial	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.45

PACK CYSTOSCOPY IV 88618

Facility

$24.90

Hospital Charge Code	270609204
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

PACK D & C HYSTEROSCOPY

Facility

$111.10

Hospital Charge Code	270653804
Hospital Revenue Code	272
Min. Negotiated Rate	$14.44
Max. Negotiated Rate	$55.55
Rate for Payer: Aetna Commercial	$33.33
Rate for Payer: Aetna Medicare Advantage	$33.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.33
Rate for Payer: Cigna Commercial	$55.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.44
Rate for Payer: Oxford Commercial	$55.55
Rate for Payer: Qualcare PPO/HMO/WC	$16.66
Rate for Payer: UnitedHealthcare Commercial	$55.55

PACK D & C HYSTEROSCOPY

Facility

$111.10

Hospital Charge Code	270653804
Hospital Revenue Code	272
Min. Negotiated Rate	$16.66
Max. Negotiated Rate	$16.66
Rate for Payer: Qualcare PPO/HMO/WC	$16.66

PACK DELIVERY OBM090B

Facility

$396.00

Hospital Charge Code	270600576
Hospital Revenue Code	272
Min. Negotiated Rate	$51.48
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$118.80
Rate for Payer: Aetna Medicare Advantage	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.98
Rate for Payer: Cigna Commercial	$198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.48
Rate for Payer: Oxford Commercial	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.40
Rate for Payer: UnitedHealthcare Commercial	$198.00

PACK DELIVERY OBM090B

Facility

$396.00

Hospital Charge Code	270600576
Hospital Revenue Code	272
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$59.40

PACK DIAGNOSTIC CATH LAB (4CS)

Facility

$340.47

Hospital Charge Code	2707500026
Hospital Revenue Code	272
Min. Negotiated Rate	$44.26
Max. Negotiated Rate	$170.24
Rate for Payer: Aetna Commercial	$102.14
Rate for Payer: Aetna Medicare Advantage	$102.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.82
Rate for Payer: Cigna Commercial	$170.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.26
Rate for Payer: Oxford Commercial	$170.24
Rate for Payer: Qualcare PPO/HMO/WC	$51.07
Rate for Payer: UnitedHealthcare Commercial	$170.24

PACK DIAGNOSTIC CATH LAB (4CS)

Facility

$340.47

Hospital Charge Code	2707500026
Hospital Revenue Code	272
Min. Negotiated Rate	$51.07
Max. Negotiated Rate	$51.07
Rate for Payer: Qualcare PPO/HMO/WC	$51.07

PACK DIAGNOSTIC CATH LAB(4CS)

Facility

$364.25

Hospital Charge Code	270653723
Hospital Revenue Code	272
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$54.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.64

PACK DIAGNOSTIC CATH LAB(4CS)

Facility

$364.25

Hospital Charge Code	270653723
Hospital Revenue Code	272
Min. Negotiated Rate	$47.35
Max. Negotiated Rate	$182.12
Rate for Payer: Aetna Commercial	$109.28
Rate for Payer: Aetna Medicare Advantage	$109.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.88
Rate for Payer: Cigna Commercial	$182.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.35
Rate for Payer: Oxford Commercial	$182.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.64
Rate for Payer: UnitedHealthcare Commercial	$182.12

PACKED CELLS

Facility

$330.90

Hospital Charge Code	3100039
Hospital Revenue Code	390
Min. Negotiated Rate	$49.63
Max. Negotiated Rate	$49.63
Rate for Payer: Qualcare PPO/HMO/WC	$49.63

PACKED CELLS

Facility

$330.90

Hospital Charge Code	3100039
Hospital Revenue Code	390
Min. Negotiated Rate	$43.02
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$99.27
Rate for Payer: Aetna Medicare Advantage	$99.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.38
Rate for Payer: Cigna Commercial	$165.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.02
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.63
Rate for Payer: UnitedHealthcare Commercial	$756.00

PACK EENT 88037

Facility

$104.85

Hospital Charge Code	270609213
Hospital Revenue Code	272
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$52.42
Rate for Payer: Aetna Commercial	$31.45
Rate for Payer: Aetna Medicare Advantage	$31.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.74
Rate for Payer: Cigna Commercial	$52.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.63
Rate for Payer: Oxford Commercial	$52.42
Rate for Payer: Qualcare PPO/HMO/WC	$15.73
Rate for Payer: UnitedHealthcare Commercial	$52.42

PACK EENT 88037

Facility

$104.85

Hospital Charge Code	270609213
Hospital Revenue Code	272
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$15.73

PACKER CELL CHA-010

Facility

$100.00

Hospital Charge Code	270622963
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

PACKER CELL CHA-010

Facility

$100.00

Hospital Charge Code	270622963
Hospital Revenue Code	272
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

PACK EXTREMITY LOWER III

Facility

$517.68

Hospital Charge Code	270653807
Hospital Revenue Code	272
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$77.65
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

Know your out-of-pocket cost for care.

All Charges