Heights University Hospital

All Charges

Charge

Type

Setting

Price

PURKINJE CYTOPLASMIC AB SCRN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3000717
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

PURKINJE CYTOPLASMIC AB SCRN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3000717
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$862.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PUSHER MT COIL MT PULM 401216

Facility

$694.45

Service Code	HCPCS C1884
Hospital Charge Code	270627378N
Hospital Revenue Code	278
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$168.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.06
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378S
Hospital Revenue Code	272
Min. Negotiated Rate	$116.14
Max. Negotiated Rate	$116.14
Rate for Payer: Qualcare PPO/HMO/WC	$116.14

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378S
Hospital Revenue Code	272
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$387.12
Rate for Payer: Aetna Commercial	$232.28
Rate for Payer: Aetna Medicare Advantage	$232.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.43
Rate for Payer: Cigna Commercial	$387.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.65
Rate for Payer: Oxford Commercial	$387.12
Rate for Payer: Qualcare PPO/HMO/WC	$116.14
Rate for Payer: UnitedHealthcare Commercial	$387.12

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378
Hospital Revenue Code	272
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$387.12
Rate for Payer: Aetna Commercial	$232.28
Rate for Payer: Aetna Medicare Advantage	$232.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.43
Rate for Payer: Cigna Commercial	$387.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.65
Rate for Payer: Oxford Commercial	$387.12
Rate for Payer: Qualcare PPO/HMO/WC	$116.14
Rate for Payer: UnitedHealthcare Commercial	$387.12

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378
Hospital Revenue Code	272
Min. Negotiated Rate	$116.14
Max. Negotiated Rate	$116.14
Rate for Payer: Qualcare PPO/HMO/WC	$116.14

PUSHER MT COIL MT PULM 401216

Facility

$694.45

Service Code	HCPCS C1884
Hospital Charge Code	270627378N
Hospital Revenue Code	278
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$208.34
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.06
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

PUSHER TOGGLELOC 909864

Facility

$790.00

Hospital Charge Code	270647898
Hospital Revenue Code	272
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$118.50
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

PUSHER TOGGLELOC 909864

Facility

$790.00

Hospital Charge Code	270647898
Hospital Revenue Code	272
Min. Negotiated Rate	$102.70
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$237.00
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.70
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Commercial	$395.00

PUSH/INFUSION COMBO LEVEL 1

Facility

$467.20

Service Code	HCPCS C8954
Hospital Charge Code	3401020
Hospital Revenue Code	335
Min. Negotiated Rate	$70.08
Max. Negotiated Rate	$70.08
Rate for Payer: Qualcare PPO/HMO/WC	$70.08

PUSH/INFUSION COMBO LEVEL 1

Facility

$467.20

Service Code	HCPCS C8954
Hospital Charge Code	3401020
Hospital Revenue Code	335
Min. Negotiated Rate	$60.74
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$140.16
Rate for Payer: Aetna Medicare Advantage	$140.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.14
Rate for Payer: Cigna Commercial	$233.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.74
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.08
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSH/INFUSION COMBO LEVEL 2

Facility

$738.60

Service Code	HCPCS 96415
Hospital Charge Code	3401021
Hospital Revenue Code	335
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$110.79
Rate for Payer: Qualcare PPO/HMO/WC	$110.79

PUSH/INFUSION COMBO LEVEL 2

Facility

$738.60

Service Code	HCPCS 96415
Hospital Charge Code	3401021
Hospital Revenue Code	335
Min. Negotiated Rate	$96.02
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$221.58
Rate for Payer: Aetna Medicare Advantage	$221.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.34
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.02
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.79
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSH/INFUSION COMBO LEVEL 3

Facility

$937.60

Service Code	HCPCS 96415
Hospital Charge Code	3401022
Hospital Revenue Code	335
Min. Negotiated Rate	$121.89
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$281.28
Rate for Payer: Aetna Medicare Advantage	$281.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.09
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.89
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.64
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSH/INFUSION COMBO LEVEL 3

Facility

$937.60

Service Code	HCPCS 96415
Hospital Charge Code	3401022
Hospital Revenue Code	335
Min. Negotiated Rate	$140.64
Max. Negotiated Rate	$140.64
Rate for Payer: Qualcare PPO/HMO/WC	$140.64

PUSH/INFUSION COMBO LEVEL 4

Facility

$1,141.80

Service Code	HCPCS C8954
Hospital Charge Code	3401023
Hospital Revenue Code	335
Min. Negotiated Rate	$148.43
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$342.54
Rate for Payer: Aetna Medicare Advantage	$342.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.16
Rate for Payer: Cigna Commercial	$570.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.43
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.27
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSH/INFUSION COMBO LEVEL 4

Facility

$1,141.80

Service Code	HCPCS C8954
Hospital Charge Code	3401023
Hospital Revenue Code	335
Min. Negotiated Rate	$171.27
Max. Negotiated Rate	$171.27
Rate for Payer: Qualcare PPO/HMO/WC	$171.27

PUSH/INFUSION COMBO LEVEL 5

Facility

$1,345.95

Service Code	HCPCS C8954
Hospital Charge Code	3401024
Hospital Revenue Code	335
Min. Negotiated Rate	$174.97
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$403.79
Rate for Payer: Aetna Medicare Advantage	$403.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$343.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$343.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$343.22
Rate for Payer: Cigna Commercial	$672.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.89
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSH/INFUSION COMBO LEVEL 5

Facility

$1,345.95

Service Code	HCPCS C8954
Hospital Charge Code	3401024
Hospital Revenue Code	335
Min. Negotiated Rate	$201.89
Max. Negotiated Rate	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$201.89

PUSH/INFUSION COMBO LEVEL 6

Facility

$1,550.10

Service Code	HCPCS C8954
Hospital Charge Code	3401025
Hospital Revenue Code	335
Min. Negotiated Rate	$232.51
Max. Negotiated Rate	$232.51
Rate for Payer: Qualcare PPO/HMO/WC	$232.51

PUSH/INFUSION COMBO LEVEL 6

Facility

$1,550.10

Service Code	HCPCS C8954
Hospital Charge Code	3401025
Hospital Revenue Code	335
Min. Negotiated Rate	$201.51
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$465.03
Rate for Payer: Aetna Medicare Advantage	$465.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.28
Rate for Payer: Cigna Commercial	$775.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.51
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.51
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PUSHLOCK 3.5 MM HIP

Facility

$875.00

Hospital Charge Code	270688378
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

Know your out-of-pocket cost for care.

All Charges