Heights University Hospital

All Charges

Charge

Type

Setting

Price

T CELLS TOTAL COUNT

Facility

$431.00

Service Code	HCPCS 86359
Hospital Charge Code	38476262
Hospital Revenue Code	302
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$138.24
Rate for Payer: Aetna Commercial	$122.25
Rate for Payer: Aetna Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.24
Rate for Payer: Cigna Commercial	$37.73
Rate for Payer: Cigna Medicare Advantage	$18.86
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39.99
Rate for Payer: Wellcare Medicare Advantage	$37.73

T CELLS TOTAL COUNT

Facility

$431.00

Service Code	HCPCS 86359
Hospital Charge Code	38476262
Hospital Revenue Code	302
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

T CELLS, TOTAL COUNT

Facility

$432.00

Service Code	HCPCS 86539
Hospital Charge Code	38476296
Hospital Revenue Code	302
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$64.80
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

T CELLS, TOTAL COUNT

Facility

$432.00

Service Code	HCPCS 86539
Hospital Charge Code	38476296
Hospital Revenue Code	302
Min. Negotiated Rate	$56.16
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$129.60
Rate for Payer: Aetna Medicare Advantage	$129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.16
Rate for Payer: Cigna Commercial	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

TCM 12 LEAD EKG W INTERP

Facility

$2,050.00

Service Code	HCPCS 93000
Hospital Charge Code	93950113
Hospital Revenue Code	730
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$615.00
Rate for Payer: Aetna Commercial	$615.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$17.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$603.00

TCM 12 LEAD EKG W INTERP

Facility

$2,050.00

Service Code	HCPCS 93000
Hospital Charge Code	93950113
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

TCM APIRATION SYNOVIAL CYST

Facility

$372.00

Service Code	HCPCS 20612
Hospital Charge Code	93950039
Hospital Revenue Code	761
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

TCM APIRATION SYNOVIAL CYST

Facility

$372.00

Service Code	HCPCS 20612
Hospital Charge Code	93950039
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

TCM CARPAL TUNNEL INJECTION

Facility

$500.00

Service Code	HCPCS 20526
Hospital Charge Code	93950031
Hospital Revenue Code	761
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TCM CARPAL TUNNEL INJECTION

Facility

$500.00

Service Code	HCPCS 20526
Hospital Charge Code	93950031
Hospital Revenue Code	761
Min. Negotiated Rate	$34.51
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

TCM CERUMEN REMOVAL

Facility

$274.00

Service Code	HCPCS 69120
Hospital Charge Code	93950047
Hospital Revenue Code	361
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

TCM CERUMEN REMOVAL

Facility

$274.00

Service Code	HCPCS 69120
Hospital Charge Code	93950047
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$14,097.46
Rate for Payer: Aetna Commercial	$82.20
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
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	$69.87
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

TCM COMEDONE REMOVAL

Facility

$372.00

Service Code	HCPCS 10040
Hospital Charge Code	93950001
Hospital Revenue Code	761
Min. Negotiated Rate	$42.99
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

TCM COMEDONE REMOVAL

Facility

$372.00

Service Code	HCPCS 10040
Hospital Charge Code	93950001
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

TCM CRITICAL CARE HSPTL ADMIT

Facility

$200.00

Service Code	HCPCS 99292
Hospital Charge Code	93950171
Hospital Revenue Code	510
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$108.24
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$108.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

TCM CRITICAL CARE HSPTL ADMIT

Facility

$200.00

Service Code	HCPCS 99292
Hospital Charge Code	93950171
Hospital Revenue Code	510
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

TCM DISCHARGE DAY

Facility

$150.00

Service Code	HCPCS 99238
Hospital Charge Code	93950167
Hospital Revenue Code	510
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

TCM DISCHARGE DAY

Facility

$150.00

Service Code	HCPCS 99238
Hospital Charge Code	93950167
Hospital Revenue Code	510
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$81.56
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$81.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

TCM DRE FECAL OCCLT BLOOD TST

Facility

$125.00

Service Code	HCPCS 82272
Hospital Charge Code	93950053
Hospital Revenue Code	301
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TCM DRE FECAL OCCLT BLOOD TST

Facility

$125.00

Service Code	HCPCS 82272
Hospital Charge Code	93950053
Hospital Revenue Code	301
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.50
Rate for Payer: Cigna Commercial	$4.23
Rate for Payer: Cigna Medicare Advantage	$2.12
Rate for Payer: Clover Medicare Advantage	$4.02
Rate for Payer: EmblemHealth Commercial	$12.69
Rate for Payer: Humana Medicare Advantage	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.23
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.48
Rate for Payer: Wellcare Medicare Advantage	$4.23

TCM EAR PIERCING

Facility

$100.00

Service Code	HCPCS 69090
Hospital Charge Code	93950045
Hospital Revenue Code	761
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

TCM EAR PIERCING

Facility

$100.00

Service Code	HCPCS 69090
Hospital Charge Code	93950045
Hospital Revenue Code	761
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

TCM ENDOMETRIAL BX

Facility

$669.00

Service Code	HCPCS 58100
Hospital Charge Code	93950043
Hospital Revenue Code	761
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

TCM ENDOMETRIAL BX

Facility

$669.00

Service Code	HCPCS 58100
Hospital Charge Code	93950043
Hospital Revenue Code	761
Min. Negotiated Rate	$71.29
Max. Negotiated Rate	$481.45
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.59
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$334.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$334.50

TCM EXCISION BENIGN <1-2 CM

Facility

$1,049.00

Service Code	HCPCS 11402
Hospital Charge Code	93950017
Hospital Revenue Code	761
Min. Negotiated Rate	$157.35
Max. Negotiated Rate	$157.35
Rate for Payer: Qualcare PPO/HMO/WC	$157.35

Know your out-of-pocket cost for care.

All Charges