Heights University Hospital

All Charges

Charge

Type

Setting

Price

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	5100847
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2692139
Hospital Revenue Code	361
Min. Negotiated Rate	$107.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$248.96
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.61
Rate for Payer: Cigna Commercial	$137.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2692139
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	7412068
Hospital Revenue Code	361
Min. Negotiated Rate	$107.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$248.96
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.61
Rate for Payer: Cigna Commercial	$137.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	366837249
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2709034
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	321037249
Hospital Revenue Code	361
Min. Negotiated Rate	$107.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$248.96
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.61
Rate for Payer: Cigna Commercial	$137.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	321037249
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2709034
Hospital Revenue Code	361
Min. Negotiated Rate	$107.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$248.96
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.61
Rate for Payer: Cigna Commercial	$137.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	7412068
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA PERIPH DIALYSIS SEGMENT

Facility

$27,397.00

Service Code	HCPCS 36902
Hospital Charge Code	321036902
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	2709023
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	7412057
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	2709023
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$27,397.00

Service Code	HCPCS 36902
Hospital Charge Code	321036902
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	5100836
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	366836902
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	7412057
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	5100836
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA PERIPH DIALYSIS SEGMENT

Facility

$27,397.00

Service Code	HCPCS 36902
Hospital Charge Code	2692128
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	366836902
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA PERIPH DIALYSIS SEGMENT

Facility

$27,397.00

Service Code	HCPCS 36902
Hospital Charge Code	2692128
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

T-BAR***

Facility

$27.00

Hospital Charge Code	9500455
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

T-BAR***

Facility

$27.00

Hospital Charge Code	9500455
Hospital Revenue Code	279
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

TBG

Facility

$390.00

Service Code	HCPCS 84442
Hospital Charge Code	39900140
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges