Heights University Hospital

All Charges

Charge

Type

Setting

Price

RP LOC TUMOR, W B, 2 OR > DAYS

Facility

$5,849.36

Service Code	HCPCS 78804
Hospital Charge Code	2680370
Hospital Revenue Code	341
Min. Negotiated Rate	$877.40
Max. Negotiated Rate	$877.40
Rate for Payer: Qualcare PPO/HMO/WC	$877.40

RP LOC TUMOR, W B, 2 OR > DAYS

Facility

$5,849.36

Service Code	HCPCS 78804
Hospital Charge Code	7411761
Hospital Revenue Code	341
Min. Negotiated Rate	$877.40
Max. Negotiated Rate	$877.40
Rate for Payer: Qualcare PPO/HMO/WC	$877.40

RP LOC TUMOR, W B, 2 OR > DAYS

Facility

$5,849.36

Service Code	HCPCS 78804
Hospital Charge Code	7411761
Hospital Revenue Code	341
Min. Negotiated Rate	$367.83
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,754.81
Rate for Payer: Aetna Medicare Advantage	$1,754.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.59
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$760.42
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.40
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RP LOC TUMOR, W B, 2 OR > DAYS

Facility

$5,849.36

Service Code	HCPCS 78804
Hospital Charge Code	2680370
Hospital Revenue Code	341
Min. Negotiated Rate	$367.83
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,754.81
Rate for Payer: Aetna Medicare Advantage	$1,754.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.59
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$760.42
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.40
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RPR

Facility

$667.59

Service Code	HCPCS 86592
Hospital Charge Code	3004694
Hospital Revenue Code	302
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

RPR

Facility

$667.59

Service Code	HCPCS 86592
Hospital Charge Code	3004694
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

RPR AA HRN 1ST > 10 NCR/STRN

Facility

$11,151.60

Service Code	HCPCS 49596
Hospital Charge Code	16000754
Hospital Revenue Code	360
Min. Negotiated Rate	$1,012.91
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$3,345.48
Rate for Payer: Aetna Medicare Advantage	$3,345.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,843.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,843.66
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	$2,843.66
Rate for Payer: Cigna Commercial	$1,012.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,449.71
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,672.74
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN 1ST > 10 NCR/STRN

Facility

$11,151.60

Service Code	HCPCS 49596
Hospital Charge Code	16000754
Hospital Revenue Code	360
Min. Negotiated Rate	$1,672.74
Max. Negotiated Rate	$1,672.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,672.74

RPR AA HRN 1ST 3-10 NCR/STRN

Facility

$25,013.88

Service Code	HCPCS 49594
Hospital Charge Code	160000184
Hospital Revenue Code	360
Min. Negotiated Rate	$3,752.08
Max. Negotiated Rate	$3,752.08
Rate for Payer: Qualcare PPO/HMO/WC	$3,752.08

RPR AA HRN 1ST 3-10 NCR/STRN

Facility

$25,013.88

Service Code	HCPCS 49594
Hospital Charge Code	160000184
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,504.16
Rate for Payer: Aetna Medicare Advantage	$7,504.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,378.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,378.54
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	$6,378.54
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,251.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,752.08
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN 1ST 3-10 RDC

Facility

$16,997.60

Service Code	HCPCS 49593
Hospital Charge Code	1600000382
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$5,099.28
Rate for Payer: Aetna Medicare Advantage	$5,099.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,334.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,334.39
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	$4,334.39
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,209.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RPR AA HRN 1ST 3-10 RDC

Facility

$16,997.60

Service Code	HCPCS 49593
Hospital Charge Code	1600000382
Hospital Revenue Code	360
Min. Negotiated Rate	$2,549.64
Max. Negotiated Rate	$2,549.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64

RPR AA HRN 1ST 3-10 RDC

Facility

$16,997.00

Service Code	HCPCS 49593
Hospital Charge Code	1600000265
Hospital Revenue Code	360
Min. Negotiated Rate	$2,549.55
Max. Negotiated Rate	$2,549.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.55

RPR AA HRN 1ST 3-10 RDC

Facility

$16,997.00

Service Code	HCPCS 49593
Hospital Charge Code	1600000265
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$5,099.10
Rate for Payer: Aetna Medicare Advantage	$5,099.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,334.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,334.23
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	$4,334.23
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,209.61
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.55
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RPR AA HRN 1ST < 3 CM RDC

Facility

$16,997.60

Service Code	HCPCS 49591
Hospital Charge Code	16000992
Hospital Revenue Code	360
Min. Negotiated Rate	$2,549.64
Max. Negotiated Rate	$2,549.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64

RPR AA HRN 1ST < 3 CM RDC

Facility

$16,997.60

Service Code	HCPCS 49591
Hospital Charge Code	16000992
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,099.28
Rate for Payer: Aetna Medicare Advantage	$5,099.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,334.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,334.39
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	$4,334.39
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,209.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RPR AA HRN 1ST < NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49592
Hospital Charge Code	1600000349
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.93
Max. Negotiated Rate	$3,751.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93

RPR AA HRN 1ST < NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49592
Hospital Charge Code	1600000349
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,503.86
Rate for Payer: Aetna Medicare Advantage	$7,503.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,378.28
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	$6,378.28
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,251.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN RCR > 10 NCR/STRN

Facility

$5,275.64

Service Code	HCPCS 49618
Hospital Charge Code	16000151
Hospital Revenue Code	360
Min. Negotiated Rate	$685.83
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$1,582.69
Rate for Payer: Aetna Medicare Advantage	$1,582.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,345.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,345.29
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	$1,345.29
Rate for Payer: Cigna Commercial	$1,223.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.83
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$791.35
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN RCR > 10 NCR/STRN

Facility

$5,275.64

Service Code	HCPCS 49618
Hospital Charge Code	16000151
Hospital Revenue Code	360
Min. Negotiated Rate	$791.35
Max. Negotiated Rate	$791.35
Rate for Payer: Qualcare PPO/HMO/WC	$791.35

RPR AA HRN RCR 3-10 NCR/STRN

Facility

$3,654.36

Service Code	HCPCS 49616
Hospital Charge Code	16000993
Hospital Revenue Code	360
Min. Negotiated Rate	$548.15
Max. Negotiated Rate	$548.15
Rate for Payer: Qualcare PPO/HMO/WC	$548.15

RPR AA HRN RCR 3-10 NCR/STRN

Facility

$3,654.36

Service Code	HCPCS 49616
Hospital Charge Code	16000993
Hospital Revenue Code	360
Min. Negotiated Rate	$475.07
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$1,096.31
Rate for Payer: Aetna Medicare Advantage	$1,096.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$931.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$931.86
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	$931.86
Rate for Payer: Cigna Commercial	$847.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.07
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$548.15
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN RCR < 3 NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49614
Hospital Charge Code	1600000300
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$7,503.86
Rate for Payer: Aetna Medicare Advantage	$7,503.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,378.28
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	$6,378.28
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,251.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RPR AA HRN RCR < 3 NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49614
Hospital Charge Code	1600000300
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.93
Max. Negotiated Rate	$3,751.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93

RPR AA HRN RCR < 3 RDC

Facility

$16,997.60

Service Code	HCPCS 49613
Hospital Charge Code	1600000579
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,099.28
Rate for Payer: Aetna Medicare Advantage	$5,099.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,334.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,334.39
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	$4,334.39
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,209.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges