Heights University Hospital

All Charges

Charge

Type

Setting

Price

TCU SPORTS TAPE

Facility

$44.00

Hospital Charge Code	1008390
Hospital Revenue Code	270
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

TCU SPORTS TAPE

Facility

$44.00

Hospital Charge Code	1008390
Hospital Revenue Code	270
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

TCU ST:CO-TX (GRP) 15 MIN

Facility

$244.00

Service Code	HCPCS 97150GN
Hospital Charge Code	1008270
Hospital Revenue Code	440
Min. Negotiated Rate	$36.60
Max. Negotiated Rate	$36.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.60

TCU ST:CO-TX (GRP) 15 MIN

Facility

$244.00

Service Code	HCPCS 97150GN
Hospital Charge Code	1008270
Hospital Revenue Code	440
Min. Negotiated Rate	$31.72
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$73.20
Rate for Payer: Aetna Medicare Advantage	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.22
Rate for Payer: Cigna Commercial	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.60
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST:CO-TX (IND) 15 MIN

Facility

$434.00

Service Code	HCPCS 97110GN
Hospital Charge Code	1008205
Hospital Revenue Code	440
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

TCU ST:CO-TX (IND) 15 MIN

Facility

$434.00

Service Code	HCPCS 97110GN
Hospital Charge Code	1008205
Hospital Revenue Code	440
Min. Negotiated Rate	$56.42
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$130.20
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST DYSPHAGIA EVAL

Facility

$601.00

Service Code	HCPCS 92610GN
Hospital Charge Code	1008100
Hospital Revenue Code	444
Min. Negotiated Rate	$90.15
Max. Negotiated Rate	$90.15
Rate for Payer: Qualcare PPO/HMO/WC	$90.15

TCU ST DYSPHAGIA EVAL

Facility

$601.00

Service Code	HCPCS 92610GN
Hospital Charge Code	1008100
Hospital Revenue Code	444
Min. Negotiated Rate	$78.13
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$180.30
Rate for Payer: Aetna Medicare Advantage	$180.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.25
Rate for Payer: Cigna Commercial	$300.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.13
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST DYSPHAGIA TX

Facility

$245.00

Service Code	HCPCS 92526GN
Hospital Charge Code	1008095
Hospital Revenue Code	442
Min. Negotiated Rate	$31.85
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST DYSPHAGIA TX

Facility

$245.00

Service Code	HCPCS 92526GN
Hospital Charge Code	1008095
Hospital Revenue Code	442
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

TCU ST EVALUATION

Facility

$358.00

Service Code	HCPCS 92506GN
Hospital Charge Code	1008085
Hospital Revenue Code	444
Min. Negotiated Rate	$53.70
Max. Negotiated Rate	$53.70
Rate for Payer: Qualcare PPO/HMO/WC	$53.70

TCU ST EVALUATION

Facility

$358.00

Service Code	HCPCS 92506GN
Hospital Charge Code	1008085
Hospital Revenue Code	444
Min. Negotiated Rate	$46.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$107.40
Rate for Payer: Aetna Medicare Advantage	$107.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.29
Rate for Payer: Cigna Commercial	$179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST:GROUP TX

Facility

$47.00

Service Code	HCPCS 92508
Hospital Charge Code	1008020
Hospital Revenue Code	443
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$14.10
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU ST:GROUP TX

Facility

$47.00

Service Code	HCPCS 92508
Hospital Charge Code	1008020
Hospital Revenue Code	443
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

TCU STRAPPING ANKLE

Facility

$458.00

Service Code	HCPCS 29540
Hospital Charge Code	1008075
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

TCU STRAPPING ANKLE

Facility

$458.00

Service Code	HCPCS 29540
Hospital Charge Code	1008075
Hospital Revenue Code	420
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU STRAPPING CHEST-TORA

Facility

$458.00

Service Code	HCPCS 29240
Hospital Charge Code	1008050
Hospital Revenue Code	420
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU STRAPPING CHEST-TORA

Facility

$458.00

Service Code	HCPCS 29240
Hospital Charge Code	1008050
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

TCU STRAPPING CHEST-TORAX

Facility

$458.00

Service Code	HCPCS 29200
Hospital Charge Code	1008045
Hospital Revenue Code	429
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU STRAPPING CHEST-TORAX

Facility

$458.00

Service Code	HCPCS 29200
Hospital Charge Code	1008045
Hospital Revenue Code	429
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

TCU STRAPPING ELBOW OR WRIST

Facility

$458.00

Service Code	HCPCS 29260
Hospital Charge Code	1008055
Hospital Revenue Code	420
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU STRAPPING ELBOW OR WRIST

Facility

$458.00

Service Code	HCPCS 29260
Hospital Charge Code	1008055
Hospital Revenue Code	420
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

TCU STRAPPING HAND FINGER

Facility

$458.00

Service Code	HCPCS 29280
Hospital Charge Code	1008010
Hospital Revenue Code	430
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

TCU STRAPPING HAND FINGER

Facility

$458.00

Service Code	HCPCS 29280
Hospital Charge Code	1008010
Hospital Revenue Code	430
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

TCU STRAPPING HAND/FINGER

Facility

$458.00

Service Code	HCPCS 29280
Hospital Charge Code	1008001
Hospital Revenue Code	420
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges