Heights University Hospital

All Charges

Charge

Type

Setting

Price

PL-VAS OV PROBLEM FOCUSED

Facility

$260.00

Service Code	HCPCS 99201
Hospital Charge Code	83033020
Hospital Revenue Code	510
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

PM1110 ACCENT SR PACEMKR U_US

Facility

$26,435.00

Hospital Charge Code	270656343
Hospital Revenue Code	278
Min. Negotiated Rate	$3,965.25
Max. Negotiated Rate	$13,217.50
Rate for Payer: Aetna Commercial	$7,930.50
Rate for Payer: Aetna Medicare Advantage	$7,930.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,740.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,740.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,287.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,740.93
Rate for Payer: Cigna Commercial	$13,217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,397.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,965.25

PM1110 ACCENT SR PACEMKR U_US

Facility

$26,435.00

Hospital Charge Code	270656343
Hospital Revenue Code	278
Min. Negotiated Rate	$3,965.25
Max. Negotiated Rate	$6,397.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,397.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,965.25

PMAKER REVO MRI SURESCN RVDR01

Facility

$29,730.00

Hospital Charge Code	270645703
Hospital Revenue Code	275
Min. Negotiated Rate	$4,459.50
Max. Negotiated Rate	$14,865.00
Rate for Payer: Aetna Commercial	$8,919.00
Rate for Payer: Aetna Medicare Advantage	$8,919.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,581.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,581.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,946.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,581.15
Rate for Payer: Cigna Commercial	$14,865.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,194.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,459.50

PMAKER REVO MRI SURESCN RVDR01

Facility

$29,730.00

Hospital Charge Code	270645703
Hospital Revenue Code	275
Min. Negotiated Rate	$4,459.50
Max. Negotiated Rate	$7,194.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,194.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,459.50

P-MASTECTOMY W/LN REMOVAL BL

Facility

$42,601.70

Service Code	HCPCS 19302
Hospital Charge Code	16000439
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

P-MASTECTOMY W/LN REMOVAL BL

Facility

$42,601.70

Service Code	HCPCS 19302
Hospital Charge Code	16000439
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,812.86
Rate for Payer: Aetna Commercial	$12,780.51
Rate for Payer: Aetna Medicare Advantage	$12,780.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,863.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,863.43
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	$10,863.43
Rate for Payer: Cigna Commercial	$15,812.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,538.22
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

PML RARA T (15:17)) QUANT PCR

Facility

$1,414.15

Service Code	HCPCS 81315
Hospital Charge Code	39708015C
Hospital Revenue Code	301
Min. Negotiated Rate	$212.12
Max. Negotiated Rate	$212.12
Rate for Payer: Qualcare PPO/HMO/WC	$212.12

PML RARA T (15:17)) QUANT PCR

Facility

$1,414.15

Service Code	HCPCS 81315
Hospital Charge Code	39708015C
Hospital Revenue Code	301
Min. Negotiated Rate	$87.93
Max. Negotiated Rate	$759.58
Rate for Payer: Aetna Commercial	$671.68
Rate for Payer: Aetna Medicare Advantage	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.58
Rate for Payer: Cigna Commercial	$207.31
Rate for Payer: Cigna Medicare Advantage	$103.66
Rate for Payer: Clover Medicare Advantage	$196.94
Rate for Payer: EmblemHealth Commercial	$621.93
Rate for Payer: Humana Medicare Advantage	$213.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.12
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$207.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$219.75
Rate for Payer: Wellcare Medicare Advantage	$207.31

PML RARA T (1517) QUANT PCR

Facility

$1,414.15

Service Code	HCPCS 81315
Hospital Charge Code	39708019
Hospital Revenue Code	310
Min. Negotiated Rate	$212.12
Max. Negotiated Rate	$212.12
Rate for Payer: Qualcare PPO/HMO/WC	$212.12

PML RARA T (1517) QUANT PCR

Facility

$1,414.15

Service Code	HCPCS 81315
Hospital Charge Code	39708019
Hospital Revenue Code	310
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$759.58
Rate for Payer: Aetna Commercial	$671.68
Rate for Payer: Aetna Medicare Advantage	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.58
Rate for Payer: Cigna Commercial	$207.31
Rate for Payer: Cigna Medicare Advantage	$103.66
Rate for Payer: Clover Medicare Advantage	$196.94
Rate for Payer: EmblemHealth Commercial	$621.93
Rate for Payer: Humana Medicare Advantage	$213.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.12
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$207.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$219.75
Rate for Payer: Wellcare Medicare Advantage	$207.31

PM Oxycodone Quant Urine

Facility

$499.75

Service Code	HCPCS 80365
Hospital Charge Code	39900531
Hospital Revenue Code	301
Min. Negotiated Rate	$64.97
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$149.93
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$114.00

PM Oxycodone Quant Urine

Facility

$499.75

Service Code	HCPCS 80365
Hospital Charge Code	39900531
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

PM RPR RUPT ACHLS TNDN W GRFT

Facility

$65,621.54

Service Code	HCPCS 27652
Hospital Charge Code	16000379
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,686.46
Rate for Payer: Aetna Commercial	$19,686.46
Rate for Payer: Aetna Medicare Advantage	$19,686.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,733.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,733.49
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	$16,733.49
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.80
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,843.23
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

PM RPR RUPT ACHLS TNDN W GRFT

Facility

$65,621.54

Service Code	HCPCS 27652
Hospital Charge Code	16000379
Hospital Revenue Code	360
Min. Negotiated Rate	$9,843.23
Max. Negotiated Rate	$9,843.23
Rate for Payer: Qualcare PPO/HMO/WC	$9,843.23

PM-UR OV EP EXPANDED PROB FOCU

Facility

$655.20

Service Code	HCPCS 99213
Hospital Charge Code	75190220
Hospital Revenue Code	510
Min. Negotiated Rate	$98.28
Max. Negotiated Rate	$98.28
Rate for Payer: Qualcare PPO/HMO/WC	$98.28

PM-UR OV EP EXPANDED PROB FOCU

Facility

$655.20

Service Code	HCPCS 99213
Hospital Charge Code	75190220
Hospital Revenue Code	510
Min. Negotiated Rate	$62.15
Max. Negotiated Rate	$196.56
Rate for Payer: Cigna Commercial	$62.15
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$196.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.18
Rate for Payer: Qualcare PPO/HMO/WC	$98.28

PM-UR OV NP EXPANDED FOCUSED

Facility

$319.65

Service Code	HCPCS 99201
Hospital Charge Code	75190170
Hospital Revenue Code	510
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

PM-UR OV NP EXPANDED FOCUSED

Facility

$319.65

Service Code	HCPCS 99201
Hospital Charge Code	75190170
Hospital Revenue Code	510
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$159.82
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	$159.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

PNA FISH I

Facility

$234.17

Service Code	HCPCS 87149
Hospital Charge Code	39880001A
Hospital Revenue Code	309
Min. Negotiated Rate	$35.13
Max. Negotiated Rate	$35.13
Rate for Payer: Qualcare PPO/HMO/WC	$35.13

PNA FISH I

Facility

$234.17

Service Code	HCPCS 87149
Hospital Charge Code	39880001A
Hospital Revenue Code	309
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$64.96
Rate for Payer: Aetna Medicare Advantage	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.46
Rate for Payer: Cigna Commercial	$20.05
Rate for Payer: Cigna Medicare Advantage	$10.03
Rate for Payer: Clover Medicare Advantage	$19.05
Rate for Payer: EmblemHealth Commercial	$60.15
Rate for Payer: Humana Medicare Advantage	$20.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.25
Rate for Payer: Wellcare Medicare Advantage	$20.05

PNA FISH II

Facility

$234.17

Service Code	HCPCS 8714959
Hospital Charge Code	39880001B
Hospital Revenue Code	309
Min. Negotiated Rate	$30.44
Max. Negotiated Rate	$117.08
Rate for Payer: Aetna Commercial	$70.25
Rate for Payer: Aetna Medicare Advantage	$70.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.71
Rate for Payer: Cigna Commercial	$117.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.13
Rate for Payer: UnitedHealthcare Commercial	$114.00

PNA FISH II

Facility

$234.17

Service Code	HCPCS 8714959
Hospital Charge Code	39880001B
Hospital Revenue Code	309
Min. Negotiated Rate	$35.13
Max. Negotiated Rate	$35.13
Rate for Payer: Qualcare PPO/HMO/WC	$35.13

PNEUMGRAM

Facility

$1,233.00

Service Code	HCPCS 94772
Hospital Charge Code	83090015
Hospital Revenue Code	460
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$369.90
Rate for Payer: Aetna Medicare Advantage	$369.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.42
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.29
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$184.95
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PNEUMGRAM

Facility

$1,233.00

Service Code	HCPCS 94772
Hospital Charge Code	83090015
Hospital Revenue Code	460
Min. Negotiated Rate	$184.95
Max. Negotiated Rate	$184.95
Rate for Payer: Qualcare PPO/HMO/WC	$184.95

Know your out-of-pocket cost for care.

All Charges