Heights University Hospital

All Charges

Charge

Type

Setting

Price

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	74116008
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	74116008
Hospital Revenue Code	482
Min. Negotiated Rate	$325.44
Max. Negotiated Rate	$325.44
Rate for Payer: Qualcare PPO/HMO/WC	$325.44

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	74115008
Hospital Revenue Code	482
Min. Negotiated Rate	$325.44
Max. Negotiated Rate	$325.44
Rate for Payer: Qualcare PPO/HMO/WC	$325.44

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	5300055
Hospital Revenue Code	482
Min. Negotiated Rate	$325.44
Max. Negotiated Rate	$325.44
Rate for Payer: Qualcare PPO/HMO/WC	$325.44

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	94053030
Hospital Revenue Code	482
Min. Negotiated Rate	$325.44
Max. Negotiated Rate	$325.44
Rate for Payer: Qualcare PPO/HMO/WC	$325.44

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	74117008
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	74117008
Hospital Revenue Code	482
Min. Negotiated Rate	$325.44
Max. Negotiated Rate	$325.44
Rate for Payer: Qualcare PPO/HMO/WC	$325.44

STRESS TEST WITH S & I

Facility

$2,169.60

Service Code	HCPCS 93015
Hospital Charge Code	5300055
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 VIEWS ANY JOINT

Facility

$196.00

Service Code	HCPCS 77071
Hospital Charge Code	94061191
Hospital Revenue Code	320
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

STRESS VIEWS ANY JOINT

Facility

$196.00

Service Code	HCPCS 77071
Hospital Charge Code	94061191
Hospital Revenue Code	320
Min. Negotiated Rate	$23.06
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$58.80
Rate for Payer: Aetna Medicare Advantage	$58.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.98
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.40
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$61.05
Rate for Payer: Qualcare PPO/HMO/WC	$61.05

STRINGE FASTURN 150ML W/QUICK

Facility

$22.25

Hospital Charge Code	2706000595
Hospital Revenue Code	272
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$3.34
Rate for Payer: Qualcare PPO/HMO/WC	$3.34

STRINGE FASTURN 150ML W/QUICK

Facility

$22.25

Hospital Charge Code	2706000595
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$11.12
Rate for Payer: Aetna Commercial	$6.67
Rate for Payer: Aetna Medicare Advantage	$6.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.67
Rate for Payer: Cigna Commercial	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.89
Rate for Payer: Oxford Commercial	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.34
Rate for Payer: UnitedHealthcare Commercial	$11.12

STRIP BIO-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656124
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STRIP BIO-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656124
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STRIP BONE LAMINAR 20X40 82C

Facility

$2,759.25

Hospital Charge Code	270615463
Hospital Revenue Code	272
Min. Negotiated Rate	$413.89
Max. Negotiated Rate	$413.89
Rate for Payer: Qualcare PPO/HMO/WC	$413.89

STRIP BONE LAMINAR 20X40 82C

Facility

$2,759.25

Hospital Charge Code	270615463
Hospital Revenue Code	272
Min. Negotiated Rate	$358.70
Max. Negotiated Rate	$1,379.62
Rate for Payer: Aetna Commercial	$827.77
Rate for Payer: Aetna Medicare Advantage	$827.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.61
Rate for Payer: Cigna Commercial	$1,379.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.70
Rate for Payer: Oxford Commercial	$1,379.62
Rate for Payer: Qualcare PPO/HMO/WC	$413.89
Rate for Payer: UnitedHealthcare Commercial	$1,379.62

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$193.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$167.70
Max. Negotiated Rate	$645.00
Rate for Payer: Aetna Commercial	$387.00
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Oxford Commercial	$645.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Commercial	$645.00

STRIP ETHCN PROXI .5 X 4 104K

Facility

$12.38

Hospital Charge Code	270624929
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.86

STRIP ETHCN PROXI .5 X 4 104K

Facility

$12.38

Hospital Charge Code	270624929
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$6.19
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.16
Rate for Payer: Cigna Commercial	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.61
Rate for Payer: Oxford Commercial	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.86
Rate for Payer: UnitedHealthcare Commercial	$6.19

STRIP FIBER FUSE 1X10CM

Facility

$10,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270694063
Hospital Revenue Code	278
Min. Negotiated Rate	$1,547.81
Max. Negotiated Rate	$5,159.38
Rate for Payer: Aetna Commercial	$3,095.62
Rate for Payer: Aetna Medicare Advantage	$3,095.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,063.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,631.28
Rate for Payer: Cigna Commercial	$5,159.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,497.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,547.81

Know your out-of-pocket cost for care.

All Charges