Heights University Hospital

All Charges

Charge

Type

Setting

Price

TC99 PERTECHNETATE PER MCI

Facility

$78.62

Service Code	HCPCS A9512
Hospital Charge Code	4509088
Hospital Revenue Code	343
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$39.31
Rate for Payer: Aetna Commercial	$23.59
Rate for Payer: Aetna Medicare Advantage	$23.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.05
Rate for Payer: Cigna Commercial	$39.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.22
Rate for Payer: Qualcare PPO/HMO/WC	$11.79

TC99 PERTECHNETATE PER MCI

Facility

$78.62

Service Code	HCPCS A9512
Hospital Charge Code	4509088
Hospital Revenue Code	343
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$11.79
Rate for Payer: Qualcare PPO/HMO/WC	$11.79

TC99 PERTECHNET PER MCI

Facility

$54.00

Hospital Charge Code	74117076
Hospital Revenue Code	343
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNET PER MCI

Facility

$54.00

Service Code	HCPCS A9512
Hospital Charge Code	74115076
Hospital Revenue Code	343
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNET PER MCI

Facility

$54.00

Service Code	HCPCS A9512
Hospital Charge Code	74116076
Hospital Revenue Code	343
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNET PER MCI

Facility

$54.00

Hospital Charge Code	74117076
Hospital Revenue Code	343
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNET PER MCI

Facility

$54.00

Service Code	HCPCS A9512
Hospital Charge Code	74116076
Hospital Revenue Code	343
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNET PER MCI

Facility

$54.00

Service Code	HCPCS A9512
Hospital Charge Code	74115076
Hospital Revenue Code	343
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNETPERMCIUP TO 75

Facility

$54.00

Service Code	HCPCS A9567
Hospital Charge Code	5309030
Hospital Revenue Code	343
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PERTECHNETPERMCIUP TO 75

Facility

$54.00

Service Code	HCPCS A9567
Hospital Charge Code	5309030
Hospital Revenue Code	343
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$41.14
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	5309035
Hospital Revenue Code	343
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Hospital Charge Code	94053145
Hospital Revenue Code	343
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	5309035
Hospital Revenue Code	343
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74117067
Hospital Revenue Code	343
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74117067
Hospital Revenue Code	343
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74115067
Hospital Revenue Code	343
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Hospital Charge Code	94053145
Hospital Revenue Code	343
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74115067
Hospital Revenue Code	343
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74116067
Hospital Revenue Code	343
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYP UP TO 25 MCI

Facility

$106.00

Service Code	HCPCS A9538
Hospital Charge Code	74116067
Hospital Revenue Code	343
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

TC99 PYROPHOSPHATE UP TO 25MCI

Facility

$125.48

Service Code	HCPCS A9538
Hospital Charge Code	4509086
Hospital Revenue Code	343
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$18.82

TC99 PYROPHOSPHATE UP TO 25MCI

Facility

$125.48

Service Code	HCPCS A9538
Hospital Charge Code	4509086
Hospital Revenue Code	343
Min. Negotiated Rate	$16.31
Max. Negotiated Rate	$62.74
Rate for Payer: Aetna Commercial	$37.64
Rate for Payer: Aetna Medicare Advantage	$37.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.00
Rate for Payer: Cigna Commercial	$62.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.31
Rate for Payer: Qualcare PPO/HMO/WC	$18.82

TCAT INSJ/RPL PERM LDLS PM

Facility

$90,132.56

Service Code	HCPCS 33274
Hospital Charge Code	69008137
Hospital Revenue Code	481
Min. Negotiated Rate	$13,519.88
Max. Negotiated Rate	$13,519.88
Rate for Payer: Qualcare PPO/HMO/WC	$13,519.88

TCAT INSJ/RPL PERM LDLS PM

Facility

$90,132.56

Service Code	HCPCS 33274
Hospital Charge Code	69008137
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$45,869.69
Rate for Payer: Aetna Commercial	$27,039.77
Rate for Payer: Aetna Medicare Advantage	$27,039.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,983.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,983.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,983.80
Rate for Payer: Cigna Commercial	$45,869.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,717.23
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,519.88
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

TCC CUTIMED OFF-LOADER

Facility

$391.90

Hospital Charge Code	270676385
Hospital Revenue Code	272
Min. Negotiated Rate	$58.78
Max. Negotiated Rate	$58.78
Rate for Payer: Qualcare PPO/HMO/WC	$58.78

Know your out-of-pocket cost for care.

All Charges