Heights University Hospital

All Charges

Charge

Type

Setting

Price

PT CONTRAST BATH EACH 15 MIN

Facility

$106.00

Service Code	HCPCS 97034
Hospital Charge Code	9108045
Hospital Revenue Code	420
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$15.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT CONTRAST BATH EACH 15 MIN

Facility

$63.00

Service Code	HCPCS 97034GP
Hospital Charge Code	1008185
Hospital Revenue Code	420
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT-CONTRAST BATHS 15 MIN

Facility

$67.00

Service Code	HCPCS 97034GP
Hospital Charge Code	9109045
Hospital Revenue Code	420
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

PT-CONTRAST BATHS 15 MIN

Facility

$67.00

Service Code	HCPCS 97034GP
Hospital Charge Code	9109045
Hospital Revenue Code	420
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT CRYOMATIC*****

Facility

$87.00

Hospital Charge Code	9000381
Hospital Revenue Code	429
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

PT CRYOMATIC*****

Facility

$87.00

Hospital Charge Code	9000381
Hospital Revenue Code	429
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$26.10
Rate for Payer: Aetna Medicare Advantage	$26.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.31
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT CYBEX EVALUATION

Facility

$113.30

Service Code	HCPCS 97750GP
Hospital Charge Code	9009978
Hospital Revenue Code	420
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$33.99
Rate for Payer: Aetna Medicare Advantage	$33.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.89
Rate for Payer: Cigna Commercial	$56.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.73
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT CYBEX EVALUATION

Facility

$113.30

Service Code	HCPCS 97750GP
Hospital Charge Code	9009978
Hospital Revenue Code	420
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.00

PT CYBEX EVALUATION****

Facility

$160.00

Hospital Charge Code	90009978
Hospital Revenue Code	429
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

PT CYBEX EVALUATION****

Facility

$160.00

Hospital Charge Code	90009978
Hospital Revenue Code	429
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT CYBEX TREATMENT EA 15 MIN**

Facility

$140.40

Service Code	HCPCS 97110
Hospital Charge Code	9009960
Hospital Revenue Code	420
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$21.06
Rate for Payer: Qualcare PPO/HMO/WC	$21.06

PT CYBEX TREATMENT EA 15 MIN**

Facility

$140.40

Service Code	HCPCS 97110
Hospital Charge Code	9009960
Hospital Revenue Code	420
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$42.12
Rate for Payer: Aetna Medicare Advantage	$42.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.80
Rate for Payer: Cigna Commercial	$32.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.25
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.06
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT-DEBRIDEMENT SKIN-PARTI

Facility

$573.00

Hospital Charge Code	9109020
Hospital Revenue Code	361
Min. Negotiated Rate	$74.49
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$171.90
Rate for Payer: Aetna Medicare Advantage	$171.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.12
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	$146.12
Rate for Payer: Cigna Commercial	$286.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.49
Rate for Payer: Qualcare PPO/HMO/WC	$85.95

PT-DEBRIDEMENT SKIN-PARTI

Facility

$573.00

Hospital Charge Code	9109020
Hospital Revenue Code	361
Min. Negotiated Rate	$85.95
Max. Negotiated Rate	$85.95
Rate for Payer: Qualcare PPO/HMO/WC	$85.95

PT DEBR NON-SELECTIVE W/O ANES

Facility

$1,105.55

Service Code	HCPCS 97602GP
Hospital Charge Code	422597602
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DEBR NON-SELECTIVE W/O ANES

Facility

$1,105.55

Service Code	HCPCS 97602GP
Hospital Charge Code	422597602
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$331.67
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT DEBR/REM DEV TISS <20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97597GP
Hospital Charge Code	422597597
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$331.67
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT DEBR/REM DEV TISS <20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97597GP
Hospital Charge Code	422597597
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DEBR/REM TISS ADDL 20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97598GP
Hospital Charge Code	422597598
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$331.67
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT DEBR/REM TISS ADDL 20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97598GP
Hospital Charge Code	422597598
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DEVELOPMENTAL TESTING: EXTE

Facility

$256.65

Service Code	HCPCS 96111
Hospital Charge Code	9100100
Hospital Revenue Code	918
Min. Negotiated Rate	$33.36
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$77.00
Rate for Payer: Aetna Medicare Advantage	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.45
Rate for Payer: Cigna Commercial	$128.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.36
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.50
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

PT DEVELOPMENTAL TESTING: EXTE

Facility

$256.65

Service Code	HCPCS 96111
Hospital Charge Code	9100100
Hospital Revenue Code	918
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.50

PT DEVELOPMENTAL TESTING: LIMI

Facility

$204.80

Service Code	HCPCS 96110
Hospital Charge Code	9100095
Hospital Revenue Code	918
Min. Negotiated Rate	$30.72
Max. Negotiated Rate	$30.72
Rate for Payer: Qualcare PPO/HMO/WC	$30.72

PT DEVELOPMENTAL TESTING: LIMI

Facility

$204.80

Service Code	HCPCS 96110
Hospital Charge Code	9100095
Hospital Revenue Code	918
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$61.44
Rate for Payer: Aetna Medicare Advantage	$61.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.22
Rate for Payer: Cigna Commercial	$102.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.72
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

PT DIATHERMY THRPY

Facility

$120.75

Service Code	HCPCS 97024GP
Hospital Charge Code	422597024
Hospital Revenue Code	420
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$36.23
Rate for Payer: Aetna Medicare Advantage	$36.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.79
Rate for Payer: Cigna Commercial	$60.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.70
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.11
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges