Heights University Hospital

All Charges

Charge

Type

Setting

Price

THERA SKIN SMALL 1x2

Facility

$4,730.00

Service Code	HCPCS Q4112
Hospital Charge Code	270647153
Hospital Revenue Code	278
Min. Negotiated Rate	$709.50
Max. Negotiated Rate	$2,365.00
Rate for Payer: Aetna Commercial	$1,419.00
Rate for Payer: Aetna Medicare Advantage	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,206.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,206.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,206.15
Rate for Payer: Cigna Commercial	$2,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,144.66
Rate for Payer: Qualcare PPO/HMO/WC	$709.50

THERA SKIN SMALL 1x2

Facility

$4,730.00

Service Code	HCPCS Q4112
Hospital Charge Code	270647153
Hospital Revenue Code	278
Min. Negotiated Rate	$709.50
Max. Negotiated Rate	$1,144.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,144.66
Rate for Payer: Qualcare PPO/HMO/WC	$709.50

THER INJECTION CARPAL TUNNEL

Facility

$1,449.20

Service Code	HCPCS 20526
Hospital Charge Code	412320526
Hospital Revenue Code	361
Min. Negotiated Rate	$188.40
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$434.76
Rate for Payer: Aetna Medicare Advantage	$434.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.55
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	$369.55
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.38
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

THER INJECTION CARPAL TUNNEL

Facility

$1,449.20

Service Code	HCPCS 20526
Hospital Charge Code	412320526
Hospital Revenue Code	361
Min. Negotiated Rate	$217.38
Max. Negotiated Rate	$217.38
Rate for Payer: Qualcare PPO/HMO/WC	$217.38

THER INJECTION CARP TUNNEL

Facility

$1,630.99

Service Code	HCPCS 20526
Hospital Charge Code	321520526
Hospital Revenue Code	361
Min. Negotiated Rate	$244.65
Max. Negotiated Rate	$244.65
Rate for Payer: Qualcare PPO/HMO/WC	$244.65

THER INJECTION CARP TUNNEL

Facility

$1,630.99

Service Code	HCPCS 20526
Hospital Charge Code	321520526
Hospital Revenue Code	361
Min. Negotiated Rate	$212.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$489.30
Rate for Payer: Aetna Medicare Advantage	$489.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.90
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	$415.90
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.03
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GO
Hospital Charge Code	420397129
Hospital Revenue Code	430
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$18.41
Rate for Payer: Qualcare PPO/HMO/WC	$18.41

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GO
Hospital Charge Code	409197129
Hospital Revenue Code	430
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$36.81
Rate for Payer: Aetna Medicare Advantage	$36.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.29
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	$31.29
Rate for Payer: Cigna Commercial	$61.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.95
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.41
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GO
Hospital Charge Code	420397129
Hospital Revenue Code	430
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$36.81
Rate for Payer: Aetna Medicare Advantage	$36.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.29
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	$31.29
Rate for Payer: Cigna Commercial	$61.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.95
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.41
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GN
Hospital Charge Code	420497129
Hospital Revenue Code	440
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$36.81
Rate for Payer: Aetna Medicare Advantage	$36.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.29
Rate for Payer: Cigna Commercial	$61.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.95
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.41
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GP
Hospital Charge Code	40919712P
Hospital Revenue Code	420
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$36.81
Rate for Payer: Aetna Medicare Advantage	$36.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.29
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	$31.29
Rate for Payer: Cigna Commercial	$61.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.95
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.41
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GN
Hospital Charge Code	420497129
Hospital Revenue Code	440
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$18.41
Rate for Payer: Qualcare PPO/HMO/WC	$18.41

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GP
Hospital Charge Code	40919712P
Hospital Revenue Code	420
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$18.41
Rate for Payer: Qualcare PPO/HMO/WC	$18.41

THER INVNTJ 1ST 15 MIN

Facility

$122.70

Service Code	HCPCS 97129GO
Hospital Charge Code	409197129
Hospital Revenue Code	430
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$18.41
Rate for Payer: Qualcare PPO/HMO/WC	$18.41

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GO
Hospital Charge Code	420397130
Hospital Revenue Code	430
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GO
Hospital Charge Code	409197130
Hospital Revenue Code	430
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GO
Hospital Charge Code	420397130
Hospital Revenue Code	430
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$35.19
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
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	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.25
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	40919713P
Hospital Revenue Code	420
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GO
Hospital Charge Code	409197130
Hospital Revenue Code	430
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$35.19
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
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	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.25
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GN
Hospital Charge Code	420497130
Hospital Revenue Code	440
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	40919713P
Hospital Revenue Code	420
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$35.19
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
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	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.25
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$686.00

THER INVNTJ EA ADDL 15 MIN

Facility

$117.30

Service Code	HCPCS 97130GN
Hospital Charge Code	420497130
Hospital Revenue Code	440
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$35.19
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.25
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$686.00

THERMACHOICE III UTERINE TC003

Facility

$6,795.93

Hospital Charge Code	270636329
Hospital Revenue Code	272
Min. Negotiated Rate	$883.47
Max. Negotiated Rate	$3,397.97
Rate for Payer: Aetna Commercial	$2,038.78
Rate for Payer: Aetna Medicare Advantage	$2,038.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,732.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,732.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,732.96
Rate for Payer: Cigna Commercial	$3,397.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$883.47
Rate for Payer: Oxford Commercial	$3,397.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.39
Rate for Payer: UnitedHealthcare Commercial	$3,397.97

THERMACHOICE III UTERINE TC003

Facility

$6,795.93

Hospital Charge Code	270636329
Hospital Revenue Code	272
Min. Negotiated Rate	$1,019.39
Max. Negotiated Rate	$1,019.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.39

THERMAL ENDOMETER TUMOR ABL LT

Facility

$32,257.60

Service Code	HCPCS 58353
Hospital Charge Code	1600000785
Hospital Revenue Code	360
Min. Negotiated Rate	$4,838.64
Max. Negotiated Rate	$4,838.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,838.64

Know your out-of-pocket cost for care.

All Charges