Heights University Hospital

All Charges

Charge

Type

Setting

Price

T-SLING W/CENSORB 21X2 CALTS02

Facility

$3,447.25

Hospital Charge Code	270632448
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$834.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

T-SLING W/CENSORB 21X2 CALTS02

Facility

$3,447.25

Hospital Charge Code	270632448
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$1,723.62
Rate for Payer: Aetna Commercial	$1,034.17
Rate for Payer: Aetna Medicare Advantage	$1,034.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.05
Rate for Payer: Cigna Commercial	$1,723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

T-SPOT TB TEST

Facility

$855.89

Service Code	HCPCS 86481
Hospital Charge Code	401186481
Hospital Revenue Code	302
Min. Negotiated Rate	$128.38
Max. Negotiated Rate	$128.38
Rate for Payer: Qualcare PPO/HMO/WC	$128.38

T-SPOT TB TEST

Facility

$855.89

Service Code	HCPCS 86481
Hospital Charge Code	401186481
Hospital Revenue Code	302
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$366.40
Rate for Payer: Aetna Commercial	$324.00
Rate for Payer: Aetna Medicare Advantage	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.40
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: Cigna Medicare Advantage	$50.00
Rate for Payer: Clover Medicare Advantage	$95.00
Rate for Payer: EmblemHealth Commercial	$300.00
Rate for Payer: Humana Medicare Advantage	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.38
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$100.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$106.00
Rate for Payer: Wellcare Medicare Advantage	$100.00

TSSE HUMAN MICRNZD INJCTBL 2CC

Facility

$1,910.00

Hospital Charge Code	270645717
Hospital Revenue Code	636
Min. Negotiated Rate	$286.50
Max. Negotiated Rate	$462.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.22
Rate for Payer: Qualcare PPO/HMO/WC	$286.50

TSSE HUMAN MICRNZD INJCTBL 2CC

Facility

$1,910.00

Hospital Charge Code	270645717
Hospital Revenue Code	636
Min. Negotiated Rate	$286.50
Max. Negotiated Rate	$955.00
Rate for Payer: Aetna Commercial	$573.00
Rate for Payer: Aetna Medicare Advantage	$573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.05
Rate for Payer: Cigna Commercial	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.22
Rate for Payer: Qualcare PPO/HMO/WC	$286.50

TSS PRESS FIT STEM SZ 13

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690411
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$1,915.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

TSS PRESS FIT STEM SZ 13

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688779
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$2,860.65
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

TSS PRESS FIT STEM SZ 13

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690411
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$3,957.38
Rate for Payer: Aetna Commercial	$2,374.43
Rate for Payer: Aetna Medicare Advantage	$2,374.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.26
Rate for Payer: Cigna Commercial	$3,957.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

TSS PRESS FIT STEM SZ 13

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688779
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$2,307.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

TSS PRESS FIT STEM SZ 6

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

TSS PRESS FIT STEM SZ 6

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

TSS PRESS FIT STEM SZ 7

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704896
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

TSS PRESS FIT STEM SZ 7

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704896
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

TTE FOLLOW-UP OR LIMITED

Facility

$1,615.00

Service Code	HCPCS 93308
Hospital Charge Code	395093308
Hospital Revenue Code	480
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$242.25
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

TTE FOLLOW-UP OR LIMITED

Facility

$1,615.00

Service Code	HCPCS 93308
Hospital Charge Code	395093308
Hospital Revenue Code	480
Min. Negotiated Rate	$209.95
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.95
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$242.25
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74116080
Hospital Revenue Code	483
Min. Negotiated Rate	$531.43
Max. Negotiated Rate	$2,043.95
Rate for Payer: Aetna Commercial	$1,226.37
Rate for Payer: Aetna Medicare Advantage	$1,226.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.41
Rate for Payer: Cigna Commercial	$2,043.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.43
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.18
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74116080
Hospital Revenue Code	483
Min. Negotiated Rate	$613.18
Max. Negotiated Rate	$613.18
Rate for Payer: Qualcare PPO/HMO/WC	$613.18

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74115080
Hospital Revenue Code	483
Min. Negotiated Rate	$613.18
Max. Negotiated Rate	$613.18
Rate for Payer: Qualcare PPO/HMO/WC	$613.18

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74115080
Hospital Revenue Code	483
Min. Negotiated Rate	$531.43
Max. Negotiated Rate	$2,043.95
Rate for Payer: Aetna Commercial	$1,226.37
Rate for Payer: Aetna Medicare Advantage	$1,226.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.41
Rate for Payer: Cigna Commercial	$2,043.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.43
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.18
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	44053305
Hospital Revenue Code	483
Min. Negotiated Rate	$531.43
Max. Negotiated Rate	$2,043.95
Rate for Payer: Aetna Commercial	$1,226.37
Rate for Payer: Aetna Medicare Advantage	$1,226.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.41
Rate for Payer: Cigna Commercial	$2,043.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.43
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.18
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74117080
Hospital Revenue Code	483
Min. Negotiated Rate	$613.18
Max. Negotiated Rate	$613.18
Rate for Payer: Qualcare PPO/HMO/WC	$613.18

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	74117080
Hospital Revenue Code	483
Min. Negotiated Rate	$531.43
Max. Negotiated Rate	$2,043.95
Rate for Payer: Aetna Commercial	$1,226.37
Rate for Payer: Aetna Medicare Advantage	$1,226.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.41
Rate for Payer: Cigna Commercial	$2,043.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.43
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.18
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	5309045
Hospital Revenue Code	483
Min. Negotiated Rate	$613.18
Max. Negotiated Rate	$613.18
Rate for Payer: Qualcare PPO/HMO/WC	$613.18

TTE W CONTRAST OR W/O & W COMP

Facility

$4,087.90

Hospital Charge Code	5309045
Hospital Revenue Code	483
Min. Negotiated Rate	$531.43
Max. Negotiated Rate	$2,043.95
Rate for Payer: Aetna Commercial	$1,226.37
Rate for Payer: Aetna Medicare Advantage	$1,226.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,042.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,042.41
Rate for Payer: Cigna Commercial	$2,043.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.43
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.18
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

Know your out-of-pocket cost for care.

All Charges