Heights University Hospital

All Charges

Charge

Type

Setting

Price

RT P32 PER mCi

Facility

$285.45

Hospital Charge Code	4800686
Hospital Revenue Code	636
Min. Negotiated Rate	$42.82
Max. Negotiated Rate	$69.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.08
Rate for Payer: Qualcare PPO/HMO/WC	$42.82

RT P32 PER mCi

Facility

$285.45

Hospital Charge Code	4800686
Hospital Revenue Code	636
Min. Negotiated Rate	$42.82
Max. Negotiated Rate	$142.72
Rate for Payer: Aetna Commercial	$85.64
Rate for Payer: Aetna Medicare Advantage	$85.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.79
Rate for Payer: Cigna Commercial	$142.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.08
Rate for Payer: Qualcare PPO/HMO/WC	$42.82

RT P32 TREATMENT

Facility

$1,433.00

Service Code	HCPCS 79101
Hospital Charge Code	4800702
Hospital Revenue Code	342
Min. Negotiated Rate	$214.95
Max. Negotiated Rate	$214.95
Rate for Payer: Qualcare PPO/HMO/WC	$214.95

RT P32 TREATMENT

Facility

$1,433.00

Service Code	HCPCS 79101
Hospital Charge Code	4800702
Hospital Revenue Code	342
Min. Negotiated Rate	$186.29
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$429.90
Rate for Payer: Aetna Medicare Advantage	$429.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.42
Rate for Payer: Cigna Commercial	$555.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.29
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.95
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RT PORT FILMS

Facility

$201.60

Service Code	HCPCS 77417
Hospital Charge Code	4800124
Hospital Revenue Code	333
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$60.48
Rate for Payer: Aetna Medicare Advantage	$60.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.41
Rate for Payer: Cigna Commercial	$100.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.21
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.24
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT PORT FILMS

Facility

$201.60

Service Code	HCPCS 77417
Hospital Charge Code	4800124
Hospital Revenue Code	333
Min. Negotiated Rate	$30.24
Max. Negotiated Rate	$30.24
Rate for Payer: Qualcare PPO/HMO/WC	$30.24

RT PROSTATE VOL FR BRACHYTH TX

Facility

$810.25

Service Code	HCPCS 76873
Hospital Charge Code	4800795
Hospital Revenue Code	402
Min. Negotiated Rate	$105.33
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$243.07
Rate for Payer: Aetna Medicare Advantage	$243.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.61
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.33
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.54
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

RT PROSTATE VOL FR BRACHYTH TX

Facility

$810.25

Service Code	HCPCS 76873
Hospital Charge Code	4800795
Hospital Revenue Code	402
Min. Negotiated Rate	$121.54
Max. Negotiated Rate	$121.54
Rate for Payer: Qualcare PPO/HMO/WC	$121.54

RT RADIOELEMENT HANDLING/LOAD

Facility

$419.85

Service Code	HCPCS 77790
Hospital Charge Code	4800371
Hospital Revenue Code	333
Min. Negotiated Rate	$21.64
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$125.95
Rate for Payer: Aetna Medicare Advantage	$125.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.06
Rate for Payer: Cigna Commercial	$21.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.58
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.98
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEMENT HANDLING/LOAD

Facility

$419.85

Service Code	HCPCS 77790
Hospital Charge Code	4800371
Hospital Revenue Code	333
Min. Negotiated Rate	$62.98
Max. Negotiated Rate	$62.98
Rate for Payer: Qualcare PPO/HMO/WC	$62.98

RT RADIOELEMENT SURFACE APPLIC

Facility

$419.85

Service Code	HCPCS 77789
Hospital Charge Code	4800363
Hospital Revenue Code	333
Min. Negotiated Rate	$54.58
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$125.95
Rate for Payer: Aetna Medicare Advantage	$125.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.06
Rate for Payer: Cigna Commercial	$242.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.58
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.98
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEMENT SURFACE APPLIC

Facility

$419.85

Service Code	HCPCS 77789
Hospital Charge Code	4800363
Hospital Revenue Code	333
Min. Negotiated Rate	$62.98
Max. Negotiated Rate	$62.98
Rate for Payer: Qualcare PPO/HMO/WC	$62.98

RT RADIOELEM INTERSTIT COMPLEX

Facility

$3,106.50

Service Code	HCPCS 77778
Hospital Charge Code	4800314
Hospital Revenue Code	342
Min. Negotiated Rate	$357.04
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$931.95
Rate for Payer: Aetna Medicare Advantage	$931.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$792.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$792.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$792.16
Rate for Payer: Cigna Commercial	$1,658.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.85
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.98
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RT RADIOELEM INTERSTIT COMPLEX

Facility

$3,106.50

Service Code	HCPCS 77778
Hospital Charge Code	4800314
Hospital Revenue Code	342
Min. Negotiated Rate	$465.98
Max. Negotiated Rate	$465.98
Rate for Payer: Qualcare PPO/HMO/WC	$465.98

RT RADIOELEM INTERSTIT INTERM

Facility

$935.70

Service Code	HCPCS 77777
Hospital Charge Code	4800306
Hospital Revenue Code	333
Min. Negotiated Rate	$140.35
Max. Negotiated Rate	$140.35
Rate for Payer: Qualcare PPO/HMO/WC	$140.35

RT RADIOELEM INTERSTIT INTERM

Facility

$935.70

Service Code	HCPCS 77777
Hospital Charge Code	4800306
Hospital Revenue Code	333
Min. Negotiated Rate	$121.64
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$280.71
Rate for Payer: Aetna Medicare Advantage	$280.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.60
Rate for Payer: Cigna Commercial	$467.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.64
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.35
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEM INTERSTIT SIMPLE

Facility

$842.25

Service Code	HCPCS 77776
Hospital Charge Code	4800790
Hospital Revenue Code	333
Min. Negotiated Rate	$109.49
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$252.68
Rate for Payer: Aetna Medicare Advantage	$252.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.77
Rate for Payer: Cigna Commercial	$421.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.49
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.34
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEM INTERSTIT SIMPLE

Facility

$842.25

Service Code	HCPCS 77776
Hospital Charge Code	4800790
Hospital Revenue Code	333
Min. Negotiated Rate	$126.34
Max. Negotiated Rate	$126.34
Rate for Payer: Qualcare PPO/HMO/WC	$126.34

RT RADIOELEM INTRACAV COMPLEX

Facility

$773.80

Service Code	HCPCS 77763
Hospital Charge Code	4800280
Hospital Revenue Code	333
Min. Negotiated Rate	$116.07
Max. Negotiated Rate	$116.07
Rate for Payer: Qualcare PPO/HMO/WC	$116.07

RT RADIOELEM INTRACAV COMPLEX

Facility

$773.80

Service Code	HCPCS 77763
Hospital Charge Code	4800280
Hospital Revenue Code	333
Min. Negotiated Rate	$100.59
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$232.14
Rate for Payer: Aetna Medicare Advantage	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.32
Rate for Payer: Cigna Commercial	$1,658.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.59
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.07
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEM INTRACAV INTERM

Facility

$642.60

Service Code	HCPCS 77762
Hospital Charge Code	4800272
Hospital Revenue Code	333
Min. Negotiated Rate	$83.54
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$192.78
Rate for Payer: Aetna Medicare Advantage	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.86
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.54
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.39
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT RADIOELEM INTRACAV INTERM

Facility

$642.60

Service Code	HCPCS 77762
Hospital Charge Code	4800272
Hospital Revenue Code	333
Min. Negotiated Rate	$96.39
Max. Negotiated Rate	$96.39
Rate for Payer: Qualcare PPO/HMO/WC	$96.39

RT RADIOELEM INTRACAV SIMPLE

Facility

$2,368.63

Service Code	HCPCS 77761
Hospital Charge Code	4800264
Hospital Revenue Code	333
Min. Negotiated Rate	$355.29
Max. Negotiated Rate	$355.29
Rate for Payer: Qualcare PPO/HMO/WC	$355.29

RT RADIOELEM INTRACAV SIMPLE

Facility

$2,368.63

Service Code	HCPCS 77761
Hospital Charge Code	4800264
Hospital Revenue Code	333
Min. Negotiated Rate	$307.92
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$710.59
Rate for Payer: Aetna Medicare Advantage	$710.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.00
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.92
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$355.29
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

RT SIMULATION COMPLEX

Facility

$1,394.60

Service Code	HCPCS 77290
Hospital Charge Code	4800041
Hospital Revenue Code	333
Min. Negotiated Rate	$105.20
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Better Health Medicaid	$105.20
Rate for Payer: Aetna Commercial	$418.38
Rate for Payer: Aetna Medicare Advantage	$418.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.62
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.30
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$209.19
Rate for Payer: UnitedHealthcare Commercial	$4,435.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$107.30

Know your out-of-pocket cost for care.

All Charges