Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPECEMENT TRAP

Facility

$58.00

Hospital Charge Code	270325604
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

SPECEMENT TRAP

Facility

$58.00

Hospital Charge Code	270325604
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

SPECIAL ANTIBODY CONFIRMATION

Facility

$514.00

Service Code	HCPCS 86689
Hospital Charge Code	38476135
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

SPECIAL ANTIBODY CONFIRMATION

Facility

$514.00

Service Code	HCPCS 86689
Hospital Charge Code	38476135
Hospital Revenue Code	302
Min. Negotiated Rate	$77.10
Max. Negotiated Rate	$77.10
Rate for Payer: Qualcare PPO/HMO/WC	$77.10

SPECIAL ANTIBODY II SCREEN

Facility

$458.00

Service Code	HCPCS 86702
Hospital Charge Code	38476133
Hospital Revenue Code	302
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.54
Rate for Payer: Cigna Commercial	$13.52
Rate for Payer: Cigna Medicare Advantage	$6.76
Rate for Payer: Clover Medicare Advantage	$12.84
Rate for Payer: EmblemHealth Commercial	$40.56
Rate for Payer: Humana Medicare Advantage	$13.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.33
Rate for Payer: Wellcare Medicare Advantage	$13.52

SPECIAL ANTIBODY II SCREEN

Facility

$458.00

Service Code	HCPCS 86702
Hospital Charge Code	38476133
Hospital Revenue Code	302
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

SPECIAL ANTIBODY SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38476132
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

SPECIAL ANTIBODY SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38476132
Hospital Revenue Code	302
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.80
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.57
Rate for Payer: Cigna Commercial	$8.89
Rate for Payer: Cigna Medicare Advantage	$4.45
Rate for Payer: Clover Medicare Advantage	$8.45
Rate for Payer: EmblemHealth Commercial	$26.67
Rate for Payer: Humana Medicare Advantage	$9.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.42
Rate for Payer: Wellcare Medicare Advantage	$8.89

SPECIALIZED TRACHEOST TUBE****

Facility

$340.00

Hospital Charge Code	8004400
Hospital Revenue Code	279
Min. Negotiated Rate	$44.20
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$170.00

SPECIALIZED TRACHEOST TUBE****

Facility

$340.00

Hospital Charge Code	8004400
Hospital Revenue Code	279
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SPECIAL MED PHYSICS CONSULT

Facility

$515.20

Service Code	HCPCS 77370
Hospital Charge Code	4800546
Hospital Revenue Code	333
Min. Negotiated Rate	$77.28
Max. Negotiated Rate	$77.28
Rate for Payer: Qualcare PPO/HMO/WC	$77.28

SPECIAL MED PHYSICS CONSULT

Facility

$515.20

Service Code	HCPCS 77370
Hospital Charge Code	4800546
Hospital Revenue Code	333
Min. Negotiated Rate	$66.98
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$154.56
Rate for Payer: Aetna Medicare Advantage	$154.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.38
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.98
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.28
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SPECIAL PROCEDURES

Facility

$22.50

Hospital Charge Code	270636399+
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$6.75
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$11.25

SPECIAL PROCEDURES

Facility

$1,295.00

Hospital Charge Code	270640732C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SPECIAL PROCEDURES

Facility

$22.50

Hospital Charge Code	270636399+
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

SPECIAL PROCEDURES

Facility

$1,295.00

Hospital Charge Code	270640732C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SPECIAL RADIATION DOSIMETRY-GL

Facility

$711.65

Service Code	HCPCS 77331
Hospital Charge Code	85000580
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

SPECIAL RADIATION DOSIMETRY-GL

Facility

$711.65

Service Code	HCPCS 77331
Hospital Charge Code	85000580
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

SPECIAL RADIATION DOSIMETRY-PC

Facility

$232.35

Service Code	HCPCS 7733126
Hospital Charge Code	85000590
Hospital Revenue Code	333
Min. Negotiated Rate	$34.85
Max. Negotiated Rate	$34.85
Rate for Payer: Qualcare PPO/HMO/WC	$34.85

SPECIAL RADIATION DOSIMETRY-PC

Facility

$232.35

Service Code	HCPCS 7733126
Hospital Charge Code	85000590
Hospital Revenue Code	333
Min. Negotiated Rate	$30.21
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$69.70
Rate for Payer: Aetna Medicare Advantage	$69.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.25
Rate for Payer: Cigna Commercial	$116.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.21
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.85
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SPECIAL RADIATION DOSIMETRY-TC

Facility

$112.80

Service Code	HCPCS 77331TC
Hospital Charge Code	85000585
Hospital Revenue Code	333
Min. Negotiated Rate	$14.66
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$33.84
Rate for Payer: Aetna Medicare Advantage	$33.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.76
Rate for Payer: Cigna Commercial	$56.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.66
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.92
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SPECIAL RADIATION DOSIMETRY-TC

Facility

$112.80

Service Code	HCPCS 77331TC
Hospital Charge Code	85000585
Hospital Revenue Code	333
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$16.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.92

SPECIAL RADIATION TREATMENT

Facility

$2,544.98

Service Code	HCPCS 77470
Hospital Charge Code	85000805
Hospital Revenue Code	333
Min. Negotiated Rate	$381.75
Max. Negotiated Rate	$381.75
Rate for Payer: Qualcare PPO/HMO/WC	$381.75

SPECIAL RADIATION TREATMENT

Facility

$2,544.98

Service Code	HCPCS 77470
Hospital Charge Code	85000805
Hospital Revenue Code	333
Min. Negotiated Rate	$330.85
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$763.49
Rate for Payer: Aetna Medicare Advantage	$763.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$648.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$648.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$648.97
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.85
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$381.75
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

SPECIAL RADIATION TREATMENT-PC

Facility

$556.65

Service Code	HCPCS 7747026
Hospital Charge Code	85000815
Hospital Revenue Code	333
Min. Negotiated Rate	$72.36
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.95
Rate for Payer: Cigna Commercial	$278.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.36
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.50
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

Know your out-of-pocket cost for care.

All Charges