Heights University Hospital

All Charges

Charge

Type

Setting

Price

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74116026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74115026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74117026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO WITH CONTRAST

Facility

$5,900.00

Service Code	HCPCS 93351
Hospital Charge Code	36540020
Hospital Revenue Code	483
Min. Negotiated Rate	$160.43
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

STRESS ECHO WITH CONTRAST

Facility

$5,900.00

Service Code	HCPCS 93351
Hospital Charge Code	36540020
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS LEXISCAN THALLIUM

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053040
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS LEXISCAN THALLIUM

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053040
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TAB W/FE

Facility

$3.00

Hospital Charge Code	60634440
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

STRESS TAB W/FE

Facility

$3.00

Hospital Charge Code	60634440
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74116009
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	36540004
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74115009
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74115009
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053035
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74117009
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	5300058
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	36540004
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	5300058
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$3,249.40

Service Code	HCPCS 93017
Hospital Charge Code	36540019
Hospital Revenue Code	482
Min. Negotiated Rate	$487.41
Max. Negotiated Rate	$487.41
Rate for Payer: Qualcare PPO/HMO/WC	$487.41

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053035
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74117009
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$3,249.40

Service Code	HCPCS 93017
Hospital Charge Code	36540019
Hospital Revenue Code	482
Min. Negotiated Rate	$351.90
Max. Negotiated Rate	$3,188.00
Rate for Payer: Aetna Commercial	$974.82
Rate for Payer: Aetna Medicare Advantage	$974.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.60
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.42
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.41
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74116009
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	94053030
Hospital Revenue Code	482
Min. Negotiated Rate	$82.75
Max. Negotiated Rate	$3,188.00
Rate for Payer: Aetna Commercial	$650.88
Rate for Payer: Aetna Medicare Advantage	$650.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$553.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$553.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$553.25
Rate for Payer: Cigna Commercial	$82.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.05
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$325.44
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	74115008
Hospital Revenue Code	482
Min. Negotiated Rate	$82.75
Max. Negotiated Rate	$3,188.00
Rate for Payer: Aetna Commercial	$650.88
Rate for Payer: Aetna Medicare Advantage	$650.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$553.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$553.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$553.25
Rate for Payer: Cigna Commercial	$82.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.05
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$325.44
Rate for Payer: UnitedHealthcare Commercial	$3,188.00

Know your out-of-pocket cost for care.

All Charges