Heights University Hospital

All Charges

Charge

Type

Setting

Price

SLEEP STUDY ATTENDED PAP-NAP

Facility

$4,688.00

Service Code	HCPCS 9580752
Hospital Charge Code	90000025
Hospital Revenue Code	740
Min. Negotiated Rate	$609.44
Max. Negotiated Rate	$11,682.00
Rate for Payer: Aetna Commercial	$1,406.40
Rate for Payer: Aetna Medicare Advantage	$1,406.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,195.44
Rate for Payer: Cigna Commercial	$2,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.44
Rate for Payer: Oxford Commercial	$10,292.00
Rate for Payer: Qualcare PPO/HMO/WC	$703.20
Rate for Payer: UnitedHealthcare Commercial	$11,682.00

SLEEP STUDY ATTENDED PAP-NAP

Facility

$4,688.00

Service Code	HCPCS 9580752
Hospital Charge Code	90000025
Hospital Revenue Code	740
Min. Negotiated Rate	$703.20
Max. Negotiated Rate	$703.20
Rate for Payer: Qualcare PPO/HMO/WC	$703.20

SLEEP STUDY UNATTENDED

Facility

$1,004.00

Service Code	HCPCS 95800
Hospital Charge Code	90000001
Hospital Revenue Code	920
Min. Negotiated Rate	$130.52
Max. Negotiated Rate	$8,761.00
Rate for Payer: Aetna Commercial	$301.20
Rate for Payer: Aetna Medicare Advantage	$301.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.02
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.52
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$8,761.00

SLEEP STUDY UNATTENDED

Facility

$1,004.00

Service Code	HCPCS 95800
Hospital Charge Code	90000001
Hospital Revenue Code	920
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$257.00
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$12,000.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,200.00
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$8,761.00

SLEEP STUDY UNATT W/RESP ANAL

Facility

$1,004.00

Service Code	HCPCS 95801
Hospital Charge Code	90000005
Hospital Revenue Code	740
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

SLEEP STUDY UNATT W/RESP ANAL

Facility

$1,004.00

Service Code	HCPCS 95801
Hospital Charge Code	90000005
Hospital Revenue Code	740
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$8,761.00
Rate for Payer: Aetna Commercial	$301.20
Rate for Payer: Aetna Medicare Advantage	$301.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.02
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.52
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$8,761.00

SLEEVE 2MM MINIPORT 171312

Facility

$220.85

Hospital Charge Code	270612743
Hospital Revenue Code	272
Min. Negotiated Rate	$33.13
Max. Negotiated Rate	$33.13
Rate for Payer: Qualcare PPO/HMO/WC	$33.13

SLEEVE 2MM MINIPORT 171312

Facility

$220.85

Hospital Charge Code	270612743
Hospital Revenue Code	272
Min. Negotiated Rate	$28.71
Max. Negotiated Rate	$110.42
Rate for Payer: Aetna Commercial	$66.25
Rate for Payer: Aetna Medicare Advantage	$66.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.32
Rate for Payer: Cigna Commercial	$110.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.71
Rate for Payer: Oxford Commercial	$110.42
Rate for Payer: Qualcare PPO/HMO/WC	$33.13
Rate for Payer: UnitedHealthcare Commercial	$110.42

SLEEVE 5 X 100 STABILITY OPT

Facility

$90.00

Hospital Charge Code	270669196
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SLEEVE 5 X 100 STABILITY OPT

Facility

$90.00

Hospital Charge Code	270669196
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

SLEEVE ADAPTER FEMORAL 5MM

Facility

$2,015.00

Service Code	HCPCS C1776
Hospital Charge Code	270696296
Hospital Revenue Code	278
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$487.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

SLEEVE ADAPTER FEMORAL 5MM

Facility

$2,015.00

Service Code	HCPCS C1776
Hospital Charge Code	270696296
Hospital Revenue Code	278
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$1,007.50
Rate for Payer: Aetna Commercial	$604.50
Rate for Payer: Aetna Medicare Advantage	$604.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$513.83
Rate for Payer: Cigna Commercial	$1,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

SLEEVE BIOLOX DELTA CERAMIC

Facility

$525.00

Service Code	HCPCS C1776
Hospital Charge Code	270692214
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SLEEVE BIOLOX DELTA CERAMIC

Facility

$525.00

Service Code	HCPCS C1776
Hospital Charge Code	270692214
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SLEEVE BLOOD PRESSURE XL

Facility

$89.96

Hospital Charge Code	270655514
Hospital Revenue Code	270
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$44.98
Rate for Payer: Aetna Commercial	$26.99
Rate for Payer: Aetna Medicare Advantage	$26.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.94
Rate for Payer: Cigna Commercial	$44.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.69
Rate for Payer: Oxford Commercial	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.49
Rate for Payer: UnitedHealthcare Commercial	$44.98

SLEEVE BLOOD PRESSURE XL

Facility

$89.96

Hospital Charge Code	270655514
Hospital Revenue Code	270
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$13.49
Rate for Payer: Qualcare PPO/HMO/WC	$13.49

SLEEVE BMT CTR 10MM 113793

Facility

$981.65

Hospital Charge Code	270617587
Hospital Revenue Code	272
Min. Negotiated Rate	$127.61
Max. Negotiated Rate	$490.82
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.32
Rate for Payer: Cigna Commercial	$490.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.61
Rate for Payer: Oxford Commercial	$490.82
Rate for Payer: Qualcare PPO/HMO/WC	$147.25
Rate for Payer: UnitedHealthcare Commercial	$490.82

SLEEVE BMT CTR 10MM 113793

Facility

$981.65

Hospital Charge Code	270617587
Hospital Revenue Code	272
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$147.25
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

SLEEVE BMT CTR 7MM 113790

Facility

$981.65

Hospital Charge Code	270619989
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$490.82
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.32
Rate for Payer: Cigna Commercial	$490.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.56
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

SLEEVE BMT CTR 7MM 113790

Facility

$981.65

Hospital Charge Code	270619989
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$237.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.56
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

SLEEVE BMT CTR 8MM 113791

Facility

$764.00

Hospital Charge Code	270627728
Hospital Revenue Code	272
Min. Negotiated Rate	$114.60
Max. Negotiated Rate	$114.60
Rate for Payer: Qualcare PPO/HMO/WC	$114.60

SLEEVE BMT CTR 8MM 113791

Facility

$764.00

Hospital Charge Code	270627728
Hospital Revenue Code	272
Min. Negotiated Rate	$99.32
Max. Negotiated Rate	$382.00
Rate for Payer: Aetna Commercial	$229.20
Rate for Payer: Aetna Medicare Advantage	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.82
Rate for Payer: Cigna Commercial	$382.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.32
Rate for Payer: Oxford Commercial	$382.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.60
Rate for Payer: UnitedHealthcare Commercial	$382.00

SLEEVE BMT CTR 9MM 113792

Facility

$981.65

Hospital Charge Code	270620287
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$490.82
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.32
Rate for Payer: Cigna Commercial	$490.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.56
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

Know your out-of-pocket cost for care.

All Charges