Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404633017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404133017
Hospital Revenue Code	361
Min. Negotiated Rate	$230.58
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$230.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	321033017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	411033017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404633017
Hospital Revenue Code	361
Min. Negotiated Rate	$230.58
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$230.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	411033017
Hospital Revenue Code	361
Min. Negotiated Rate	$230.58
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$230.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404133017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	321033019
Hospital Revenue Code	361
Min. Negotiated Rate	$192.95
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$192.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	411033019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	411033019
Hospital Revenue Code	361
Min. Negotiated Rate	$192.95
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$192.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404633019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404133019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	321033019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404133019
Hospital Revenue Code	361
Min. Negotiated Rate	$192.95
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$192.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404633019
Hospital Revenue Code	361
Min. Negotiated Rate	$192.95
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$192.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

PERICARDIOCENTESIS

Facility

$984.00

Service Code	HCPCS 33010
Hospital Charge Code	7411005
Hospital Revenue Code	361
Min. Negotiated Rate	$127.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$295.20
Rate for Payer: Aetna Medicare Advantage	$295.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.92
Rate for Payer: Cigna Commercial	$492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.92
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PERICARDIOCENTESIS

Facility

$984.00

Service Code	HCPCS 33010
Hospital Charge Code	7411005
Hospital Revenue Code	361
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$147.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	366833010
Hospital Revenue Code	361
Min. Negotiated Rate	$209.69
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$483.90
Rate for Payer: Aetna Medicare Advantage	$483.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.31
Rate for Payer: Cigna Commercial	$806.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.69
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	7411007
Hospital Revenue Code	361
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	7411007
Hospital Revenue Code	361
Min. Negotiated Rate	$209.69
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$483.90
Rate for Payer: Aetna Medicare Advantage	$483.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.31
Rate for Payer: Cigna Commercial	$806.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.69
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	366833010
Hospital Revenue Code	361
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	5100225
Hospital Revenue Code	361
Min. Negotiated Rate	$455.53
Max. Negotiated Rate	$455.53
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	74110025
Hospital Revenue Code	361
Min. Negotiated Rate	$455.53
Max. Negotiated Rate	$455.53
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	5100225
Hospital Revenue Code	361
Min. Negotiated Rate	$394.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$911.05
Rate for Payer: Aetna Medicare Advantage	$911.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.40
Rate for Payer: Cigna Commercial	$1,518.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.79
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	74110025
Hospital Revenue Code	361
Min. Negotiated Rate	$394.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$911.05
Rate for Payer: Aetna Medicare Advantage	$911.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.40
Rate for Payer: Cigna Commercial	$1,518.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.79
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

Know your out-of-pocket cost for care.

All Charges