Heights University Hospital

All Charges

Charge

Type

Setting

Price

REMOV PERM PACE W/REPLC SNG

Facility

$38,922.60

Service Code	HCPCS 33227
Hospital Charge Code	5100771
Hospital Revenue Code	361
Min. Negotiated Rate	$5,838.39
Max. Negotiated Rate	$5,838.39
Rate for Payer: Qualcare PPO/HMO/WC	$5,838.39

REMOV PERM PACE W/REPLC SNG

Facility

$38,922.60

Service Code	HCPCS 33227
Hospital Charge Code	74110072
Hospital Revenue Code	361
Min. Negotiated Rate	$5,838.39
Max. Negotiated Rate	$5,838.39
Rate for Payer: Qualcare PPO/HMO/WC	$5,838.39

REMOV PERM PM W/REPLC DUL LEAD

Facility

$42,670.00

Service Code	HCPCS 33228
Hospital Charge Code	5100772
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$12,801.00
Rate for Payer: Aetna Medicare Advantage	$12,801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,880.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,880.85
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	$10,880.85
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,547.10
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,400.50
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,790.24

REMOV PERM PM W/REPLC DUL LEAD

Facility

$42,670.00

Service Code	HCPCS 33228
Hospital Charge Code	74110073
Hospital Revenue Code	361
Min. Negotiated Rate	$6,400.50
Max. Negotiated Rate	$6,400.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,400.50

REMOV PERM PM W/REPLC DUL LEAD

Facility

$42,670.00

Service Code	HCPCS 33228
Hospital Charge Code	5100772
Hospital Revenue Code	361
Min. Negotiated Rate	$6,400.50
Max. Negotiated Rate	$6,400.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,400.50

REMOV PERM PM W/REPLC DUL LEAD

Facility

$42,670.00

Service Code	HCPCS 33228
Hospital Charge Code	74110073
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$12,801.00
Rate for Payer: Aetna Medicare Advantage	$12,801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,880.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,880.85
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	$10,880.85
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,547.10
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,400.50
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,790.24

REMOV TUNNL INTRAPER CATH

Facility

$6,578.00

Service Code	HCPCS 49422
Hospital Charge Code	7411589
Hospital Revenue Code	361
Min. Negotiated Rate	$986.70
Max. Negotiated Rate	$986.70
Rate for Payer: Qualcare PPO/HMO/WC	$986.70

REMOV TUNNL INTRAPER CATH

Facility

$12,462.85

Service Code	HCPCS 49422
Hospital Charge Code	366849422
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

REMOV TUNNL INTRAPER CATH

Facility

$15,468.50

Service Code	HCPCS 49422
Hospital Charge Code	321049422
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOV TUNNL INTRAPER CATH

Facility

$15,468.50

Service Code	HCPCS 49422
Hospital Charge Code	2690150
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOV TUNNL INTRAPER CATH

Facility

$12,462.85

Service Code	HCPCS 49422
Hospital Charge Code	411049422
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOV TUNNL INTRAPER CATH

Facility

$15,468.50

Service Code	HCPCS 49422
Hospital Charge Code	2690150
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

REMOV TUNNL INTRAPER CATH

Facility

$12,462.85

Service Code	HCPCS 49422
Hospital Charge Code	366849422
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOV TUNNL INTRAPER CATH

Facility

$12,462.85

Service Code	HCPCS 49422
Hospital Charge Code	411049422
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

REMOV TUNNL INTRAPER CATH

Facility

$15,468.50

Service Code	HCPCS 49422
Hospital Charge Code	321049422
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

REMOV TUNNL INTRAPER CATH

Facility

$6,578.00

Service Code	HCPCS 49422
Hospital Charge Code	7411589
Hospital Revenue Code	361
Min. Negotiated Rate	$855.14
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,973.40
Rate for Payer: Aetna Medicare Advantage	$1,973.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,677.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,677.39
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	$1,677.39
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$855.14
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$986.70
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REM P SEGMENT INSTRUMENT

Facility

$11,058.29

Service Code	HCPCS 22852
Hospital Charge Code	16000810
Hospital Revenue Code	360
Min. Negotiated Rate	$1,437.58
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$3,317.49
Rate for Payer: Aetna Medicare Advantage	$3,317.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,819.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,819.86
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	$2,819.86
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.58
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,658.74
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

REM P SEGMENT INSTRUMENT

Facility

$11,058.29

Service Code	HCPCS 22852
Hospital Charge Code	16000810
Hospital Revenue Code	360
Min. Negotiated Rate	$1,658.74
Max. Negotiated Rate	$1,658.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,658.74

REM&REPL NEPHROURET STENT

Facility

$6,757.27

Service Code	HCPCS 50387
Hospital Charge Code	7412031
Hospital Revenue Code	361
Min. Negotiated Rate	$878.45
Max. Negotiated Rate	$4,978.04
Rate for Payer: Aetna Commercial	$2,027.18
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$878.45
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REM&REPL NEPHROURET STENT

Facility

$6,757.27

Service Code	HCPCS 50387
Hospital Charge Code	7412031
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REM/REV LONG ARM/LEG CAST

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	5780160
Hospital Revenue Code	450
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$666.07
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

REM/REV LONG ARM/LEG CAST

Facility

$468.75

Service Code	HCPCS 29705
Hospital Charge Code	5780160
Hospital Revenue Code	450
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

REM RG T8MM 30 CM RS X70CM

Facility

$4,170.00

Hospital Charge Code	270658080
Hospital Revenue Code	278
Min. Negotiated Rate	$625.50
Max. Negotiated Rate	$1,009.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.14
Rate for Payer: Qualcare PPO/HMO/WC	$625.50

REM RG T8MM 30 CM RS X70CM

Facility

$4,170.00

Hospital Charge Code	270658080
Hospital Revenue Code	278
Min. Negotiated Rate	$625.50
Max. Negotiated Rate	$2,085.00
Rate for Payer: Aetna Commercial	$1,251.00
Rate for Payer: Aetna Medicare Advantage	$1,251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.35
Rate for Payer: Cigna Commercial	$2,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.14
Rate for Payer: Qualcare PPO/HMO/WC	$625.50

REM SUBQ CARD RHYTHM MONITOR

Facility

$3,396.55

Service Code	HCPCS 33286
Hospital Charge Code	703033286
Hospital Revenue Code	481
Min. Negotiated Rate	$441.55
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,018.97
Rate for Payer: Aetna Medicare Advantage	$1,018.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$866.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$866.12
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	$866.12
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.55
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$509.48
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

Know your out-of-pocket cost for care.

All Charges