Heights University Hospital

All Charges

Charge

Type

Setting

Price

SET RADIATION TX FIELD

Facility

$1,884.55

Service Code	HCPCS 77290
Hospital Charge Code	321077290
Hospital Revenue Code	333
Min. Negotiated Rate	$282.68
Max. Negotiated Rate	$282.68
Rate for Payer: Qualcare PPO/HMO/WC	$282.68

SET RADIATION TX FIELD

Facility

$1,884.55

Service Code	HCPCS 77290
Hospital Charge Code	404677290
Hospital Revenue Code	333
Min. Negotiated Rate	$282.68
Max. Negotiated Rate	$282.68
Rate for Payer: Qualcare PPO/HMO/WC	$282.68

SET RADIATION TX FIELD-GL

Facility

$1,887.22

Service Code	HCPCS 77290
Hospital Charge Code	85000415
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	$566.17
Rate for Payer: Aetna Medicare Advantage	$566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.24
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.34
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.08
Rate for Payer: UnitedHealthcare Commercial	$4,435.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$107.30

SET RADIATION TX FIELD-GL

Facility

$711.65

Service Code	HCPCS 77280
Hospital Charge Code	85000385
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

SET RADIATION TX FIELD-GL

Facility

$1,887.22

Service Code	HCPCS 77290
Hospital Charge Code	85000415
Hospital Revenue Code	333
Min. Negotiated Rate	$283.08
Max. Negotiated Rate	$283.08
Rate for Payer: Qualcare PPO/HMO/WC	$283.08

SET RADIATION TX FIELD-GL

Facility

$6,384.91

Service Code	HCPCS 77295
Hospital Charge Code	85000430
Hospital Revenue Code	333
Min. Negotiated Rate	$957.74
Max. Negotiated Rate	$957.74
Rate for Payer: Qualcare PPO/HMO/WC	$957.74

SET RADIATION TX FIELD-GL

Facility

$6,384.91

Service Code	HCPCS 77295
Hospital Charge Code	85000430
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

SET RADIATION TX FIELD-GL

Facility

$1,887.22

Service Code	HCPCS 77285
Hospital Charge Code	85000400
Hospital Revenue Code	333
Min. Negotiated Rate	$283.08
Max. Negotiated Rate	$283.08
Rate for Payer: Qualcare PPO/HMO/WC	$283.08

SET RADIATION TX FIELD-GL

Facility

$711.65

Service Code	HCPCS 77280
Hospital Charge Code	85000385
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

SET RADIATION TX FIELD-GL

Facility

$1,887.22

Service Code	HCPCS 77285
Hospital Charge Code	85000400
Hospital Revenue Code	333
Min. Negotiated Rate	$245.34
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$566.17
Rate for Payer: Aetna Medicare Advantage	$566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.24
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.34
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.08
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-PC

Facility

$414.75

Service Code	HCPCS 7729026
Hospital Charge Code	85000425
Hospital Revenue Code	333
Min. Negotiated Rate	$62.21
Max. Negotiated Rate	$62.21
Rate for Payer: Qualcare PPO/HMO/WC	$62.21

SET RADIATION TX FIELD-PC

Facility

$186.20

Service Code	HCPCS 7728026
Hospital Charge Code	85000395
Hospital Revenue Code	333
Min. Negotiated Rate	$27.93
Max. Negotiated Rate	$27.93
Rate for Payer: Qualcare PPO/HMO/WC	$27.93

SET RADIATION TX FIELD-PC

Facility

$1,218.20

Service Code	HCPCS 7729526
Hospital Charge Code	85000440
Hospital Revenue Code	333
Min. Negotiated Rate	$158.37
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$365.46
Rate for Payer: Aetna Medicare Advantage	$365.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.64
Rate for Payer: Cigna Commercial	$609.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.37
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.73
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-PC

Facility

$414.75

Service Code	HCPCS 7729026
Hospital Charge Code	85000425
Hospital Revenue Code	333
Min. Negotiated Rate	$53.92
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$124.42
Rate for Payer: Aetna Medicare Advantage	$124.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.76
Rate for Payer: Cigna Commercial	$207.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.92
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.21
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-PC

Facility

$1,218.20

Service Code	HCPCS 7729526
Hospital Charge Code	85000440
Hospital Revenue Code	333
Min. Negotiated Rate	$182.73
Max. Negotiated Rate	$182.73
Rate for Payer: Qualcare PPO/HMO/WC	$182.73

SET RADIATION TX FIELD-PC

Facility

$280.25

Service Code	HCPCS 7728526
Hospital Charge Code	85000410
Hospital Revenue Code	333
Min. Negotiated Rate	$36.43
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$84.08
Rate for Payer: Aetna Medicare Advantage	$84.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.46
Rate for Payer: Cigna Commercial	$140.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.43
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.04
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-PC

Facility

$280.25

Service Code	HCPCS 7728526
Hospital Charge Code	85000410
Hospital Revenue Code	333
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$42.04
Rate for Payer: Qualcare PPO/HMO/WC	$42.04

SET RADIATION TX FIELD-PC

Facility

$186.20

Service Code	HCPCS 7728026
Hospital Charge Code	85000395
Hospital Revenue Code	333
Min. Negotiated Rate	$24.21
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$55.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.48
Rate for Payer: Cigna Commercial	$93.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.21
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.93
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-TC

Facility

$1,656.90

Service Code	HCPCS 77285TC
Hospital Charge Code	85000405
Hospital Revenue Code	333
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$248.53
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

SET RADIATION TX FIELD-TC

Facility

$908.05

Service Code	HCPCS 77280TC
Hospital Charge Code	85000390
Hospital Revenue Code	333
Min. Negotiated Rate	$136.21
Max. Negotiated Rate	$136.21
Rate for Payer: Qualcare PPO/HMO/WC	$136.21

SET RADIATION TX FIELD-TC

Facility

$908.05

Service Code	HCPCS 77280TC
Hospital Charge Code	85000390
Hospital Revenue Code	333
Min. Negotiated Rate	$118.05
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$272.42
Rate for Payer: Aetna Medicare Advantage	$272.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.55
Rate for Payer: Cigna Commercial	$454.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.05
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.21
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-TC

Facility

$2,724.65

Service Code	HCPCS 77290TC
Hospital Charge Code	85000420
Hospital Revenue Code	333
Min. Negotiated Rate	$408.70
Max. Negotiated Rate	$408.70
Rate for Payer: Qualcare PPO/HMO/WC	$408.70

SET RADIATION TX FIELD-TC

Facility

$1,629.95

Service Code	HCPCS 77295TC
Hospital Charge Code	85000435
Hospital Revenue Code	333
Min. Negotiated Rate	$244.49
Max. Negotiated Rate	$244.49
Rate for Payer: Qualcare PPO/HMO/WC	$244.49

SET RADIATION TX FIELD-TC

Facility

$2,724.65

Service Code	HCPCS 77290TC
Hospital Charge Code	85000420
Hospital Revenue Code	333
Min. Negotiated Rate	$354.20
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$817.39
Rate for Payer: Aetna Medicare Advantage	$817.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.79
Rate for Payer: Cigna Commercial	$1,362.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.20
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$408.70
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SET RADIATION TX FIELD-TC

Facility

$1,629.95

Service Code	HCPCS 77295TC
Hospital Charge Code	85000435
Hospital Revenue Code	333
Min. Negotiated Rate	$211.89
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$488.99
Rate for Payer: Aetna Medicare Advantage	$488.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.64
Rate for Payer: Cigna Commercial	$814.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.89
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.49
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

Know your out-of-pocket cost for care.

All Charges