Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47540
Hospital Charge Code	2011571
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

$26,912.85

Service Code	HCPCS 47540
Hospital Charge Code	2600234
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$8,073.85
Rate for Payer: Aetna Medicare Advantage	$8,073.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,862.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,862.78
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	$6,862.78
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,498.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47538
Hospital Charge Code	2011569
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 47538
Hospital Charge Code	7411567
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 REMOVAL OF KIDNEY STONE

Facility

$49,882.40

Service Code	HCPCS 50080
Hospital Charge Code	404650080
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$22,543.37
Rate for Payer: Aetna Commercial	$14,964.72
Rate for Payer: Aetna Medicare Advantage	$14,964.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,720.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,720.01
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	$12,720.01
Rate for Payer: Cigna Commercial	$22,543.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,484.71
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,482.36
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

PERQ REMOVAL OF KIDNEY STONE

Facility

$49,882.40

Service Code	HCPCS 50080
Hospital Charge Code	404650080
Hospital Revenue Code	360
Min. Negotiated Rate	$7,482.36
Max. Negotiated Rate	$7,482.36
Rate for Payer: Qualcare PPO/HMO/WC	$7,482.36

PERQ TRLUML CORONRY LITHOTRP

Facility

$13,012.00

Service Code	HCPCS 92972
Hospital Charge Code	74110108
Hospital Revenue Code	481
Min. Negotiated Rate	$131.77
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$3,903.60
Rate for Payer: Aetna Medicare Advantage	$3,903.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,318.06
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	$3,318.06
Rate for Payer: Cigna Commercial	$131.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PERQ TRLUML CORONRY LITHOTRP

Facility

$13,012.00

Service Code	HCPCS 92972
Hospital Charge Code	74110108
Hospital Revenue Code	481
Min. Negotiated Rate	$1,951.80
Max. Negotiated Rate	$1,951.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PERQ VERTEBRAL AUGMENTATION

Facility

$33,638.52

Service Code	HCPCS 22514
Hospital Charge Code	1600000450
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$10,091.56
Rate for Payer: Aetna Medicare Advantage	$10,091.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,577.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,577.82
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	$8,577.82
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,373.01
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,045.78
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	411022514
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	366822515
Hospital Revenue Code	320
Min. Negotiated Rate	$204.23
Max. Negotiated Rate	$4,633.15
Rate for Payer: Aetna Commercial	$4,633.15
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,046.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$204.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,007.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	366822515
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	5701108
Hospital Revenue Code	320
Min. Negotiated Rate	$204.23
Max. Negotiated Rate	$4,633.15
Rate for Payer: Aetna Commercial	$4,633.15
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,046.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$204.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,007.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	411022513
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,260.34
Rate for Payer: Aetna Medicare Advantage	$11,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,571.29
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,879.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	366822514
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,260.34
Rate for Payer: Aetna Medicare Advantage	$11,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,015.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,571.29
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,879.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	7411355
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,260.34
Rate for Payer: Aetna Medicare Advantage	$11,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,571.29
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,879.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	5701108
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	366822513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	7411355
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	7411356
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,260.34
Rate for Payer: Aetna Medicare Advantage	$11,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,015.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,571.29
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,879.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	321022513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$33,638.52

Service Code	HCPCS 22514
Hospital Charge Code	1600000450
Hospital Revenue Code	360
Min. Negotiated Rate	$5,045.78
Max. Negotiated Rate	$5,045.78
Rate for Payer: Qualcare PPO/HMO/WC	$5,045.78

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	7411357
Hospital Revenue Code	320
Min. Negotiated Rate	$204.23
Max. Negotiated Rate	$4,633.15
Rate for Payer: Aetna Commercial	$4,633.15
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,046.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$204.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,007.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	321022515
Hospital Revenue Code	320
Min. Negotiated Rate	$204.23
Max. Negotiated Rate	$4,633.15
Rate for Payer: Aetna Commercial	$4,633.15
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,046.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$204.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,007.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	321022514
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,260.34
Rate for Payer: Aetna Medicare Advantage	$11,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,015.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,571.29
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,879.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges