Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	7411352
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	5701103
Hospital Revenue Code	320
Min. Negotiated Rate	$1,191.93
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,634.16
Rate for Payer: Aetna Medicare Advantage	$4,634.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,191.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,939.04
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ DEV BREAST 1ST STRTCTC

Facility

$1,167.00

Service Code	HCPCS 19283
Hospital Charge Code	16000534
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

PERQ DEV BREAST 1ST STRTCTC

Facility

$1,167.00

Service Code	HCPCS 19283
Hospital Charge Code	16000534
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
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	$297.58
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

PERQ DEV BREAST 1ST US IMAG

Facility

$1,167.00

Service Code	HCPCS 19285
Hospital Charge Code	16000195
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

PERQ DEV BREAST 1ST US IMAG

Facility

$1,167.00

Service Code	HCPCS 19285
Hospital Charge Code	16000195
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
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	$297.58
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

PERQ DEVICE BREAST 1ST IMAG

Facility

$1,167.00

Service Code	HCPCS 19281
Hospital Charge Code	16000188
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

PERQ DEVICE BREAST 1ST IMAG

Facility

$1,167.00

Service Code	HCPCS 19281
Hospital Charge Code	16000188
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
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	$297.58
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

PERQ LAMOT/LAM LUMBAR

Facility

$33,651.56

Service Code	HCPCS 62330
Hospital Charge Code	1600000390
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$10,095.47
Rate for Payer: Aetna Medicare Advantage	$10,095.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,581.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,581.15
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	$8,581.15
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,374.70
Rate for Payer: Qualcare PPO/HMO/WC	$5,047.73

PERQ LAMOT/LAM LUMBAR

Facility

$33,651.56

Service Code	HCPCS 62330
Hospital Charge Code	1600000390
Hospital Revenue Code	360
Min. Negotiated Rate	$5,047.73
Max. Negotiated Rate	$5,047.73
Rate for Payer: Qualcare PPO/HMO/WC	$5,047.73

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	5701104
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	7411353
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	321022511
Hospital Revenue Code	320
Min. Negotiated Rate	$1,182.51
Max. Negotiated Rate	$8,822.27
Rate for Payer: Aetna Better Health Medicaid	$8,649.28
Rate for Payer: Aetna Commercial	$4,634.16
Rate for Payer: Aetna Medicare Advantage	$4,634.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,182.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,939.04
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	321022511
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	5701104
Hospital Revenue Code	320
Min. Negotiated Rate	$1,182.51
Max. Negotiated Rate	$8,822.27
Rate for Payer: Aetna Better Health Medicaid	$8,649.28
Rate for Payer: Aetna Commercial	$4,634.16
Rate for Payer: Aetna Medicare Advantage	$4,634.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,182.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,939.04
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27

PERQ LUMBOSACRAL INJECTION

Facility

$15,447.21

Service Code	HCPCS 22511
Hospital Charge Code	7411353
Hospital Revenue Code	320
Min. Negotiated Rate	$1,182.51
Max. Negotiated Rate	$8,822.27
Rate for Payer: Aetna Better Health Medicaid	$8,649.28
Rate for Payer: Aetna Commercial	$4,634.16
Rate for Payer: Aetna Medicare Advantage	$4,634.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,939.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,182.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,939.04
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27

PERQ NJX ALGC FLUOR LMBR 1ST

Facility

$59,508.84

Service Code	HCPCS 0627T
Hospital Charge Code	1600000770
Hospital Revenue Code	360
Min. Negotiated Rate	$8,926.33
Max. Negotiated Rate	$8,926.33
Rate for Payer: Qualcare PPO/HMO/WC	$8,926.33

PERQ NJX ALGC FLUOR LMBR 1ST

Facility

$59,508.84

Service Code	HCPCS 0627T
Hospital Charge Code	1600000770
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$17,852.65
Rate for Payer: Aetna Medicare Advantage	$17,852.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,174.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,174.75
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	$15,174.75
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,736.15
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,926.33
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47538
Hospital Charge Code	404647538
Hospital Revenue Code	481
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47540
Hospital Charge Code	7411569
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47538
Hospital Charge Code	404647538
Hospital Revenue Code	481
Min. Negotiated Rate	$3,154.35
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,279.26
Rate for Payer: Aetna Medicare Advantage	$7,279.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,187.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,187.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,187.37
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,154.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47540
Hospital Charge Code	7411569
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,279.26
Rate for Payer: Aetna Medicare Advantage	$7,279.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,187.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,187.37
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	$6,187.37
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,154.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47539
Hospital Charge Code	7411568
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT

Facility

$24,264.20

Service Code	HCPCS 47539
Hospital Charge Code	7411568
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,279.26
Rate for Payer: Aetna Medicare Advantage	$7,279.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,187.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,187.37
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	$6,187.37
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,154.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47539
Hospital Charge Code	2011570
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,279.26
Rate for Payer: Aetna Medicare Advantage	$7,279.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,187.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,187.37
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	$6,187.37
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,154.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Know your out-of-pocket cost for care.

All Charges