Heights University Hospital

All Charges

Charge

Type

Setting

Price

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77412
Hospital Charge Code	85000730
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000685
Hospital Revenue Code	333
Min. Negotiated Rate	$92.91
Max. Negotiated Rate	$92.91
Rate for Payer: Qualcare PPO/HMO/WC	$92.91

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77412
Hospital Charge Code	85000725
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

RADIATION TX DELIVERY

Facility

$1,548.50

Service Code	HCPCS 77407
Hospital Charge Code	85000715
Hospital Revenue Code	333
Min. Negotiated Rate	$232.28
Max. Negotiated Rate	$232.28
Rate for Payer: Qualcare PPO/HMO/WC	$232.28

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000695
Hospital Revenue Code	333
Min. Negotiated Rate	$92.91
Max. Negotiated Rate	$92.91
Rate for Payer: Qualcare PPO/HMO/WC	$92.91

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000690
Hospital Revenue Code	333
Min. Negotiated Rate	$80.52
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$185.81
Rate for Payer: Aetna Medicare Advantage	$185.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.94
Rate for Payer: Cigna Commercial	$242.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.52
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.91
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000690
Hospital Revenue Code	333
Min. Negotiated Rate	$92.91
Max. Negotiated Rate	$92.91
Rate for Payer: Qualcare PPO/HMO/WC	$92.91

RADIATION TX DOSE PLAN-GL

Facility

$711.65

Service Code	HCPCS 77300
Hospital Charge Code	85000445
Hospital Revenue Code	333
Min. Negotiated Rate	$92.51
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$213.50
Rate for Payer: Aetna Medicare Advantage	$213.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.47
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.51
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.75
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DOSE PLAN-GL

Facility

$711.65

Service Code	HCPCS 77300
Hospital Charge Code	85000445
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

RADIATION TX DOSE PLAN IMRT-GL

Facility

$6,384.91

Service Code	HCPCS 77301
Hospital Charge Code	85000460
Hospital Revenue Code	333
Min. Negotiated Rate	$830.04
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$1,915.47
Rate for Payer: Aetna Medicare Advantage	$1,915.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,628.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,628.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,628.15
Rate for Payer: Cigna Commercial	$3,296.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$830.04
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$957.74
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DOSE PLAN IMRT-GL

Facility

$6,384.91

Service Code	HCPCS 77301
Hospital Charge Code	85000460
Hospital Revenue Code	333
Min. Negotiated Rate	$957.74
Max. Negotiated Rate	$957.74
Rate for Payer: Qualcare PPO/HMO/WC	$957.74

RADIATION TX DOSE PLAN IMRT-PC

Facility

$2,132.40

Service Code	HCPCS 7730126
Hospital Charge Code	85000470
Hospital Revenue Code	333
Min. Negotiated Rate	$277.21
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$639.72
Rate for Payer: Aetna Medicare Advantage	$639.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.76
Rate for Payer: Cigna Commercial	$1,066.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.21
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.86
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DOSE PLAN IMRT-PC

Facility

$2,132.40

Service Code	HCPCS 7730126
Hospital Charge Code	85000470
Hospital Revenue Code	333
Min. Negotiated Rate	$319.86
Max. Negotiated Rate	$319.86
Rate for Payer: Qualcare PPO/HMO/WC	$319.86

RADIATION TX DOSE PLAN IMRT-TC

Facility

$9,428.85

Service Code	HCPCS 77301TC
Hospital Charge Code	85000465
Hospital Revenue Code	333
Min. Negotiated Rate	$1,414.33
Max. Negotiated Rate	$1,414.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.33

RADIATION TX DOSE PLAN IMRT-TC

Facility

$9,428.85

Service Code	HCPCS 77301TC
Hospital Charge Code	85000465
Hospital Revenue Code	333
Min. Negotiated Rate	$1,225.75
Max. Negotiated Rate	$4,714.43
Rate for Payer: Aetna Commercial	$2,828.66
Rate for Payer: Aetna Medicare Advantage	$2,828.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,404.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,404.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,404.36
Rate for Payer: Cigna Commercial	$4,714.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,225.75
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.33
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DOSE PLAN-PC

Facility

$165.95

Service Code	HCPCS 7730026
Hospital Charge Code	85000455
Hospital Revenue Code	333
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.57
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX DOSE PLAN-PC

Facility

$165.95

Service Code	HCPCS 7730026
Hospital Charge Code	85000455
Hospital Revenue Code	333
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

RADIATION TX DOSE PLAN-TC

Facility

$219.75

Service Code	HCPCS 77300TC
Hospital Charge Code	85000450
Hospital Revenue Code	333
Min. Negotiated Rate	$32.96
Max. Negotiated Rate	$32.96
Rate for Payer: Qualcare PPO/HMO/WC	$32.96

RADIATION TX DOSE PLAN-TC

Facility

$219.75

Service Code	HCPCS 77300TC
Hospital Charge Code	85000450
Hospital Revenue Code	333
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$65.92
Rate for Payer: Aetna Medicare Advantage	$65.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.04
Rate for Payer: Cigna Commercial	$109.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.57
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.96
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX INTERMEDIATE

Facility

$572.45

Service Code	HCPCS 77262
Hospital Charge Code	83000371
Hospital Revenue Code	333
Min. Negotiated Rate	$74.42
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$171.74
Rate for Payer: Aetna Medicare Advantage	$171.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.97
Rate for Payer: Cigna Commercial	$117.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.42
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.87
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX INTERMEDIATE

Facility

$572.45

Service Code	HCPCS 77262
Hospital Charge Code	83000371
Hospital Revenue Code	333
Min. Negotiated Rate	$85.87
Max. Negotiated Rate	$85.87
Rate for Payer: Qualcare PPO/HMO/WC	$85.87

RADIATION TX INTERMEDIATE

Facility

$572.45

Service Code	HCPCS 77262
Hospital Charge Code	85000371
Hospital Revenue Code	333
Min. Negotiated Rate	$74.42
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$171.74
Rate for Payer: Aetna Medicare Advantage	$171.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.97
Rate for Payer: Cigna Commercial	$117.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.42
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.87
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX INTERMEDIATE

Facility

$572.45

Service Code	HCPCS 77262
Hospital Charge Code	85000371
Hospital Revenue Code	333
Min. Negotiated Rate	$85.87
Max. Negotiated Rate	$85.87
Rate for Payer: Qualcare PPO/HMO/WC	$85.87

RADIATION TX MANAGEMENT

Facility

$530.15

Service Code	HCPCS 77431
Hospital Charge Code	85000785
Hospital Revenue Code	333
Min. Negotiated Rate	$68.92
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$159.04
Rate for Payer: Aetna Medicare Advantage	$159.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.19
Rate for Payer: Cigna Commercial	$117.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.92
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.52
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RADIATION TX MANAGEMENT

Facility

$530.15

Service Code	HCPCS 77431
Hospital Charge Code	85000785
Hospital Revenue Code	333
Min. Negotiated Rate	$79.52
Max. Negotiated Rate	$79.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.52

Know your out-of-pocket cost for care.

All Charges