Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERI FETAL DOPPLER-UMBIL ART

Facility

$6,700.00

Service Code	HCPCS 76820
Hospital Charge Code	74308160
Hospital Revenue Code	402
Min. Negotiated Rate	$48.64
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

PERI FETAL DOPPLER-UMBIL ART

Facility

$6,700.00

Service Code	HCPCS 76820
Hospital Charge Code	74308160
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

PERI FETAL ECHO INITIAL

Facility

$424.00

Service Code	HCPCS 76825
Hospital Charge Code	74308170
Hospital Revenue Code	402
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

PERI FETAL ECHO INITIAL

Facility

$424.00

Service Code	HCPCS 76825
Hospital Charge Code	74308170
Hospital Revenue Code	402
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$127.20
Rate for Payer: Aetna Medicare Advantage	$127.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.12
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.12
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

PERI FETAL ECHO REPEAT

Facility

$269.00

Service Code	HCPCS 76826
Hospital Charge Code	74308175
Hospital Revenue Code	402
Min. Negotiated Rate	$40.35
Max. Negotiated Rate	$40.35
Rate for Payer: Qualcare PPO/HMO/WC	$40.35

PERI FETAL ECHO REPEAT

Facility

$269.00

Service Code	HCPCS 76826
Hospital Charge Code	74308175
Hospital Revenue Code	402
Min. Negotiated Rate	$34.97
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$80.70
Rate for Payer: Aetna Medicare Advantage	$80.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.59
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.97
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.35
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

PERI FINGRERSTICK

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	74308010
Hospital Revenue Code	300
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

PERI FINGRERSTICK

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	74308010
Hospital Revenue Code	300
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

PERI FREE BETA CHAIN

Facility

$110.00

Service Code	HCPCS 84704
Hospital Charge Code	74308210
Hospital Revenue Code	301
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$114.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: Aetna Commercial	$49.54
Rate for Payer: Aetna Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.02
Rate for Payer: Cigna Commercial	$15.29
Rate for Payer: Cigna Medicare Advantage	$7.64
Rate for Payer: Clover Medicare Advantage	$14.53
Rate for Payer: EmblemHealth Commercial	$45.87
Rate for Payer: Humana Medicare Advantage	$15.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.21
Rate for Payer: Wellcare Medicare Advantage	$15.29

PERI FREE BETA CHAIN

Facility

$110.00

Service Code	HCPCS 84704
Hospital Charge Code	74308210
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

PERI-GYN KIT

Facility

$44.00

Hospital Charge Code	270338755
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

PERI-GYN KIT

Facility

$44.00

Hospital Charge Code	270338755
Hospital Revenue Code	272
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

PERI L & D NURSE LOC W/NO PROC

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	74308295
Hospital Revenue Code	514
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$95.89
Rate for Payer: Aetna Commercial	$95.89
Rate for Payer: Aetna Medicare Advantage	$95.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.51
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

PERI L & D NURSE LOC W/NO PROC

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	74308295
Hospital Revenue Code	514
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

PERI LOCKING SCREW 3.5MM X 44M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684874
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 44M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684874
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 50M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684875
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 50M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684875
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 54M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684876
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 54M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684876
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 58M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684877
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 58M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684877
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 60M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684878
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5MM X 60M

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270684878
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

PERI LOCKING SCREW 3.5.MM X 65

Facility

$577.50

Service Code	HCPCS C1713
Hospital Charge Code	270684879
Hospital Revenue Code	278
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$139.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.75
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

Know your out-of-pocket cost for care.

All Charges