Heights University Hospital

All Charges

Charge

Type

Setting

Price

RT BASIC DOSIMETRY

Facility

$353.95

Service Code	HCPCS 77300
Hospital Charge Code	4800058
Hospital Revenue Code	333
Min. Negotiated Rate	$46.01
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$106.19
Rate for Payer: Aetna Medicare Advantage	$106.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.26
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.01
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.09
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT BRACHY SEED NUCLETRON I 192

Facility

$1,265.65

Hospital Charge Code	4500896
Hospital Revenue Code	272
Min. Negotiated Rate	$189.85
Max. Negotiated Rate	$189.85
Rate for Payer: Qualcare PPO/HMO/WC	$189.85

RT BRACHY SEED NUCLETRON I 192

Facility

$1,265.65

Hospital Charge Code	4500896
Hospital Revenue Code	272
Min. Negotiated Rate	$164.53
Max. Negotiated Rate	$632.83
Rate for Payer: Aetna Commercial	$379.69
Rate for Payer: Aetna Medicare Advantage	$379.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.74
Rate for Payer: Cigna Commercial	$632.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.53
Rate for Payer: Oxford Commercial	$632.83
Rate for Payer: Qualcare PPO/HMO/WC	$189.85
Rate for Payer: UnitedHealthcare Commercial	$632.83

RT BRACHYTH DOSE PLAN COMPLEX

Facility

$1,415.70

Service Code	HCPCS 77328
Hospital Charge Code	4800199
Hospital Revenue Code	333
Min. Negotiated Rate	$184.04
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$424.71
Rate for Payer: Aetna Medicare Advantage	$424.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.00
Rate for Payer: Cigna Commercial	$707.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.04
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.35
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT BRACHYTH DOSE PLAN COMPLEX

Facility

$1,415.70

Service Code	HCPCS 77328
Hospital Charge Code	4800199
Hospital Revenue Code	333
Min. Negotiated Rate	$212.35
Max. Negotiated Rate	$212.35
Rate for Payer: Qualcare PPO/HMO/WC	$212.35

RT BRACHYTH DOSE PLAN INTERM

Facility

$1,059.20

Service Code	HCPCS 77327
Hospital Charge Code	4800181
Hospital Revenue Code	333
Min. Negotiated Rate	$158.88
Max. Negotiated Rate	$158.88
Rate for Payer: Qualcare PPO/HMO/WC	$158.88

RT BRACHYTH DOSE PLAN INTERM

Facility

$1,059.20

Service Code	HCPCS 77327
Hospital Charge Code	4800181
Hospital Revenue Code	333
Min. Negotiated Rate	$137.70
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$317.76
Rate for Payer: Aetna Medicare Advantage	$317.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.10
Rate for Payer: Cigna Commercial	$529.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.70
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.88
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT BRACHYTH DOSE PLAN SIMPLE

Facility

$908.20

Service Code	HCPCS 77326
Hospital Charge Code	4800755
Hospital Revenue Code	333
Min. Negotiated Rate	$136.23
Max. Negotiated Rate	$136.23
Rate for Payer: Qualcare PPO/HMO/WC	$136.23

RT BRACHYTH DOSE PLAN SIMPLE

Facility

$908.20

Service Code	HCPCS 77326
Hospital Charge Code	4800755
Hospital Revenue Code	333
Min. Negotiated Rate	$118.07
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$272.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.59
Rate for Payer: Cigna Commercial	$454.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.07
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.23
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT BRACHYTH SEED PALLAD 103

Facility

$677.50

Hospital Charge Code	4800744
Hospital Revenue Code	278
Min. Negotiated Rate	$101.62
Max. Negotiated Rate	$163.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.96
Rate for Payer: Qualcare PPO/HMO/WC	$101.62

RT BRACHYTH SEED PALLAD 103

Facility

$677.50

Hospital Charge Code	4800744
Hospital Revenue Code	278
Min. Negotiated Rate	$101.62
Max. Negotiated Rate	$338.75
Rate for Payer: Aetna Commercial	$203.25
Rate for Payer: Aetna Medicare Advantage	$203.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.76
Rate for Payer: Cigna Commercial	$338.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.96
Rate for Payer: Qualcare PPO/HMO/WC	$101.62

RT BRONCH W/CATH FOR RADIOELEM

Facility

$1,148.80

Service Code	HCPCS 31643
Hospital Charge Code	4800785
Hospital Revenue Code	761
Min. Negotiated Rate	$172.32
Max. Negotiated Rate	$172.32
Rate for Payer: Qualcare PPO/HMO/WC	$172.32

RT BRONCH W/CATH FOR RADIOELEM

Facility

$1,148.80

Service Code	HCPCS 31643
Hospital Charge Code	4800785
Hospital Revenue Code	761
Min. Negotiated Rate	$149.34
Max. Negotiated Rate	$4,238.63
Rate for Payer: Aetna Commercial	$344.64
Rate for Payer: Aetna Medicare Advantage	$344.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.94
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.34
Rate for Payer: Oxford Commercial	$574.40
Rate for Payer: Qualcare PPO/HMO/WC	$172.32
Rate for Payer: UnitedHealthcare Commercial	$574.40

RT CONTINUING PHYSICS COURSE

Facility

$644.50

Service Code	HCPCS 77336
Hospital Charge Code	4800132
Hospital Revenue Code	333
Min. Negotiated Rate	$83.78
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$193.35
Rate for Payer: Aetna Medicare Advantage	$193.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.35
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.78
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.67
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT CONTINUING PHYSICS COURSE

Facility

$644.50

Service Code	HCPCS 77336
Hospital Charge Code	4800132
Hospital Revenue Code	333
Min. Negotiated Rate	$96.67
Max. Negotiated Rate	$96.67
Rate for Payer: Qualcare PPO/HMO/WC	$96.67

RT EST PT VS LEVEL 1 - 5 MIN**

Facility

$300.74

Service Code	HCPCS 99211
Hospital Charge Code	4800454
Hospital Revenue Code	510
Min. Negotiated Rate	$45.11
Max. Negotiated Rate	$45.11
Rate for Payer: Qualcare PPO/HMO/WC	$45.11

RT EST PT VS LEVEL 1 - 5 MIN**

Facility

$300.74

Service Code	HCPCS 99211
Hospital Charge Code	4800454
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$90.22
Rate for Payer: Aetna Commercial	$90.22
Rate for Payer: Aetna Medicare Advantage	$90.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.69
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.10
Rate for Payer: Qualcare PPO/HMO/WC	$45.11

RT EST PT VS LEVEL 2 - 10 MIN

Facility

$147.00

Service Code	HCPCS 99212
Hospital Charge Code	4800470
Hospital Revenue Code	510
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$44.10
Rate for Payer: Aetna Commercial	$44.10
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.11
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

RT EST PT VS LEVEL 2 - 10 MIN

Facility

$147.00

Service Code	HCPCS 99212
Hospital Charge Code	4800470
Hospital Revenue Code	510
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

RT EST PT VS LEVEL 3 - 15 MIN

Facility

$159.00

Service Code	HCPCS 99213
Hospital Charge Code	4800488
Hospital Revenue Code	510
Min. Negotiated Rate	$20.67
Max. Negotiated Rate	$62.15
Rate for Payer: Aetna Commercial	$47.70
Rate for Payer: Aetna Medicare Advantage	$47.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.55
Rate for Payer: Cigna Commercial	$62.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.67
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

RT EST PT VS LEVEL 3 - 15 MIN

Facility

$159.00

Service Code	HCPCS 99213
Hospital Charge Code	4800488
Hospital Revenue Code	510
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

RT EST PT VS LEVEL 4 - 25 MIN

Facility

$192.00

Service Code	HCPCS 99214
Hospital Charge Code	4800496
Hospital Revenue Code	510
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$28.80
Rate for Payer: Qualcare PPO/HMO/WC	$28.80

RT EST PT VS LEVEL 4 - 25 MIN

Facility

$192.00

Service Code	HCPCS 99214
Hospital Charge Code	4800496
Hospital Revenue Code	510
Min. Negotiated Rate	$24.96
Max. Negotiated Rate	$91.37
Rate for Payer: Aetna Commercial	$57.60
Rate for Payer: Aetna Medicare Advantage	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.96
Rate for Payer: Cigna Commercial	$91.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.96
Rate for Payer: Qualcare PPO/HMO/WC	$28.80

RT EST PT VS LEVEL 5 - 40 MIN

Facility

$805.00

Service Code	HCPCS 99215
Hospital Charge Code	4800780
Hospital Revenue Code	510
Min. Negotiated Rate	$104.65
Max. Negotiated Rate	$241.50
Rate for Payer: Qualcare PPO/HMO/WC	$120.75
Rate for Payer: Aetna Commercial	$241.50
Rate for Payer: Aetna Medicare Advantage	$241.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.28
Rate for Payer: Cigna Commercial	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.65

RT EST PT VS LEVEL 5 - 40 MIN

Facility

$805.00

Service Code	HCPCS 99215
Hospital Charge Code	4800780
Hospital Revenue Code	510
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$120.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.75

Know your out-of-pocket cost for care.

All Charges