Heights University Hospital

All Charges

Charge

Type

Setting

Price

BILE ACIDS

Facility

$117.25

Service Code	HCPCS 82239
Hospital Charge Code	3038072
Hospital Revenue Code	300
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.47
Rate for Payer: Aetna Medicare Advantage	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.12
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	$62.73
Rate for Payer: Cigna Commercial	$17.12
Rate for Payer: Cigna Medicare Advantage	$8.56
Rate for Payer: Clover Medicare Advantage	$16.26
Rate for Payer: EmblemHealth Commercial	$51.36
Rate for Payer: Humana Medicare Advantage	$17.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.15
Rate for Payer: Wellcare Medicare Advantage	$17.12

BILE ACIDS

Facility

$117.25

Service Code	HCPCS 82239
Hospital Charge Code	3038072
Hospital Revenue Code	300
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

BILE ACIDS

Facility

$343.00

Service Code	HCPCS 82240
Hospital Charge Code	38472743
Hospital Revenue Code	301
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.12
Rate for Payer: Aetna Medicare Advantage	$26.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.39
Rate for Payer: Cigna Commercial	$26.58
Rate for Payer: Cigna Medicare Advantage	$13.29
Rate for Payer: Clover Medicare Advantage	$25.25
Rate for Payer: EmblemHealth Commercial	$79.74
Rate for Payer: Humana Medicare Advantage	$27.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.17
Rate for Payer: Wellcare Medicare Advantage	$26.58

BILE ACIDS FRACTIONATED

Facility

$181.65

Service Code	HCPCS 82452
Hospital Charge Code	3038076
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

BILE ACIDS FRACTIONATED

Facility

$216.00

Service Code	HCPCS 83789
Hospital Charge Code	38478104
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

BILE ACIDS FRACTIONATED

Facility

$181.65

Service Code	HCPCS 82452
Hospital Charge Code	3038076
Hospital Revenue Code	301
Min. Negotiated Rate	$23.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.49
Rate for Payer: Aetna Medicare Advantage	$54.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.32
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

BILE ACIDS FRACTIONATED

Facility

$216.00

Service Code	HCPCS 83789
Hospital Charge Code	38478104
Hospital Revenue Code	301
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

BILE ACIDS,FRACT/TOT,PREG

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	39900339
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BILE ACIDS,FRACT/TOT,PREG

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	39900339
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

BILE ACIDS, TOTAL

Facility

$390.00

Service Code	HCPCS 82239
Hospital Charge Code	39900049
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BILE ACIDS, TOTAL

Facility

$390.00

Service Code	HCPCS 82239
Hospital Charge Code	39900049
Hospital Revenue Code	301
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.47
Rate for Payer: Aetna Medicare Advantage	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.12
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	$62.73
Rate for Payer: Cigna Commercial	$17.12
Rate for Payer: Cigna Medicare Advantage	$8.56
Rate for Payer: Clover Medicare Advantage	$16.26
Rate for Payer: EmblemHealth Commercial	$51.36
Rate for Payer: Humana Medicare Advantage	$17.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.15
Rate for Payer: Wellcare Medicare Advantage	$17.12

BILE ACIDS;TOTAL

Facility

$121.00

Service Code	HCPCS 82239
Hospital Charge Code	38477144
Hospital Revenue Code	301
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.47
Rate for Payer: Aetna Medicare Advantage	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.12
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	$62.73
Rate for Payer: Cigna Commercial	$17.12
Rate for Payer: Cigna Medicare Advantage	$8.56
Rate for Payer: Clover Medicare Advantage	$16.26
Rate for Payer: EmblemHealth Commercial	$51.36
Rate for Payer: Humana Medicare Advantage	$17.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.15
Rate for Payer: Wellcare Medicare Advantage	$17.12

BILE ACIDS;TOTAL

Facility

$121.00

Service Code	HCPCS 82239
Hospital Charge Code	38477144
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

BILE TRACT SURGERY PROCEDURE

Facility

$10,620.50

Service Code	HCPCS 47999
Hospital Charge Code	2209085
Hospital Revenue Code	361
Min. Negotiated Rate	$1,380.66
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$3,186.15
Rate for Payer: Aetna Medicare Advantage	$3,186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,708.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,708.23
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	$2,708.23
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,380.66
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.08
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

BILE TRACT SURGERY PROCEDURE

Facility

$10,620.50

Service Code	HCPCS 47999
Hospital Charge Code	2209085
Hospital Revenue Code	361
Min. Negotiated Rate	$1,593.08
Max. Negotiated Rate	$1,593.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.08

BILIAR STENT 6x30 6F P06030RXB

Facility

$10,725.00

Hospital Charge Code	270631755V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$2,595.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

BILIAR STENT 6x30 6F P06030RXB

Facility

$10,725.00

Hospital Charge Code	270631755V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$5,362.50
Rate for Payer: Aetna Commercial	$3,217.50
Rate for Payer: Aetna Medicare Advantage	$3,217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,734.88
Rate for Payer: Cigna Commercial	$5,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

BILIARY DILATOR

Facility

$146.00

Hospital Charge Code	270325606
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

BILIARY DILATOR

Facility

$146.00

Hospital Charge Code	270325606
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

BILIARY ENDOSCOPY THRU SKIN

Facility

$17,259.20

Service Code	HCPCS 47555
Hospital Charge Code	321047555
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

BILIARY ENDOSCOPY THRU SKIN

Facility

$10,885.55

Service Code	HCPCS 47555
Hospital Charge Code	5100831
Hospital Revenue Code	361
Min. Negotiated Rate	$1,415.12
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$3,265.66
Rate for Payer: Aetna Medicare Advantage	$3,265.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,775.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,775.82
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	$2,775.82
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.12
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

BILIARY ENDOSCOPY THRU SKIN

Facility

$10,885.55

Service Code	HCPCS 47555
Hospital Charge Code	5100831
Hospital Revenue Code	361
Min. Negotiated Rate	$1,632.83
Max. Negotiated Rate	$1,632.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83

BILIARY ENDOSCOPY THRU SKIN

Facility

$17,259.20

Service Code	HCPCS 47555
Hospital Charge Code	321047555
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

BILIARY FELXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000545
Hospital Revenue Code	272
Min. Negotiated Rate	$57.32
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$220.45
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$220.45

BILIARY FELXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000545
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

Know your out-of-pocket cost for care.

All Charges