Heights University Hospital

All Charges

Charge

Type

Setting

Price

ULTRAFLEX ESOPHAGEAL 6

Facility

$6,625.00

Hospital Charge Code	270604783
Hospital Revenue Code	270
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Qualcare PPO/HMO/WC	$993.75

ULTRAFLEX ESOPHAGEAL 6

Facility

$6,625.00

Hospital Charge Code	270604781
Hospital Revenue Code	270
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Qualcare PPO/HMO/WC	$993.75

ULTRAFLEX ESOPHAGEAL 6

Facility

$6,625.00

Hospital Charge Code	270604783
Hospital Revenue Code	270
Min. Negotiated Rate	$861.25
Max. Negotiated Rate	$3,312.50
Rate for Payer: Aetna Commercial	$1,987.50
Rate for Payer: Aetna Medicare Advantage	$1,987.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.38
Rate for Payer: Cigna Commercial	$3,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.25
Rate for Payer: Oxford Commercial	$3,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$993.75
Rate for Payer: UnitedHealthcare Commercial	$3,312.50

ULTRASLING EXTRA LARGE

Facility

$256.40

Hospital Charge Code	270666409
Hospital Revenue Code	270
Min. Negotiated Rate	$38.46
Max. Negotiated Rate	$38.46
Rate for Payer: Qualcare PPO/HMO/WC	$38.46

ULTRASLING EXTRA LARGE

Facility

$256.40

Hospital Charge Code	270666409
Hospital Revenue Code	270
Min. Negotiated Rate	$33.33
Max. Negotiated Rate	$128.20
Rate for Payer: Aetna Commercial	$76.92
Rate for Payer: Aetna Medicare Advantage	$76.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.38
Rate for Payer: Cigna Commercial	$128.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.33
Rate for Payer: Oxford Commercial	$128.20
Rate for Payer: Qualcare PPO/HMO/WC	$38.46
Rate for Payer: UnitedHealthcare Commercial	$128.20

ULTRASLING III BLK MEDIUM

Facility

$241.90

Hospital Charge Code	270669813
Hospital Revenue Code	270
Min. Negotiated Rate	$31.45
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$72.57
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.45
Rate for Payer: Oxford Commercial	$120.95
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Commercial	$120.95

ULTRASLING III BLK MEDIUM

Facility

$241.90

Hospital Charge Code	270669813
Hospital Revenue Code	270
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$36.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$129.35
Rate for Payer: Aetna Commercial	$77.61
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$129.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.63
Rate for Payer: Oxford Commercial	$129.35
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$129.35

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$36.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$31.45
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$72.57
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.45
Rate for Payer: Oxford Commercial	$120.95
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Commercial	$120.95

ULTRASLING II SAD LG 110449LG

Facility

$267.90

Hospital Charge Code	270636282
Hospital Revenue Code	270
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$40.19
Rate for Payer: Qualcare PPO/HMO/WC	$40.19

ULTRASLING II SAD LG 110449LG

Facility

$267.90

Hospital Charge Code	270636282
Hospital Revenue Code	270
Min. Negotiated Rate	$34.83
Max. Negotiated Rate	$133.95
Rate for Payer: Aetna Commercial	$80.37
Rate for Payer: Aetna Medicare Advantage	$80.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.31
Rate for Payer: Cigna Commercial	$133.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.83
Rate for Payer: Oxford Commercial	$133.95
Rate for Payer: Qualcare PPO/HMO/WC	$40.19
Rate for Payer: UnitedHealthcare Commercial	$133.95

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$32.39
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$74.75
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.39
Rate for Payer: Oxford Commercial	$124.58
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$124.58

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$32.39
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$74.75
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.39
Rate for Payer: Oxford Commercial	$124.58
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$124.58

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRA SONIC PROBE TRAY

Facility

$1,380.85

Hospital Charge Code	270665601
Hospital Revenue Code	270
Min. Negotiated Rate	$179.51
Max. Negotiated Rate	$690.42
Rate for Payer: Aetna Commercial	$414.25
Rate for Payer: Aetna Medicare Advantage	$414.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.12
Rate for Payer: Cigna Commercial	$690.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.51
Rate for Payer: Oxford Commercial	$690.42
Rate for Payer: Qualcare PPO/HMO/WC	$207.13
Rate for Payer: UnitedHealthcare Commercial	$690.42

ULTRA SONIC PROBE TRAY

Facility

$1,380.85

Hospital Charge Code	270665601
Hospital Revenue Code	270
Min. Negotiated Rate	$207.13
Max. Negotiated Rate	$207.13
Rate for Payer: Qualcare PPO/HMO/WC	$207.13

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC

Facility

$187,691.61

Service Code	MSDRG 278
Min. Negotiated Rate	$54,905.35
Max. Negotiated Rate	$187,691.61
Rate for Payer: Aetna Commercial	$187,691.61
Rate for Payer: Aetna Medicare Advantage	$60,741.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$57,795.10
Rate for Payer: Cigna Commercial	$119,790.19
Rate for Payer: Cigna Medicare Advantage	$57,795.10
Rate for Payer: Clover Medicare Advantage	$54,905.35
Rate for Payer: EmblemHealth Commercial	$173,385.30
Rate for Payer: Humana Medicare Advantage	$59,528.95
Rate for Payer: Oxford Commercial	$74,865.39
Rate for Payer: UnitedHealthcare Commercial	$84,979.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$57,795.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$61,262.81
Rate for Payer: Wellcare Medicare Advantage	$57,795.10

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC

Facility

$121,607.38

Service Code	MSDRG 279
Min. Negotiated Rate	$36,891.87
Max. Negotiated Rate	$121,607.38
Rate for Payer: Aetna Commercial	$121,607.38
Rate for Payer: Aetna Medicare Advantage	$39,355.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,833.55
Rate for Payer: Cigna Commercial	$77,613.33
Rate for Payer: Cigna Medicare Advantage	$38,833.55
Rate for Payer: Clover Medicare Advantage	$36,891.87
Rate for Payer: EmblemHealth Commercial	$116,500.65
Rate for Payer: Humana Medicare Advantage	$39,998.56
Rate for Payer: Oxford Commercial	$48,506.08
Rate for Payer: UnitedHealthcare Commercial	$55,058.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,833.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$41,163.56
Rate for Payer: Wellcare Medicare Advantage	$38,833.55

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM

Facility

$100,363.85

Service Code	MSDRG 173
Min. Negotiated Rate	$31,101.23
Max. Negotiated Rate	$100,363.85
Rate for Payer: Aetna Commercial	$100,363.85
Rate for Payer: Aetna Medicare Advantage	$32,480.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$32,738.14
Rate for Payer: Cigna Commercial	$64,055.10
Rate for Payer: Cigna Medicare Advantage	$32,738.14
Rate for Payer: Clover Medicare Advantage	$31,101.23
Rate for Payer: EmblemHealth Commercial	$98,214.42
Rate for Payer: Humana Medicare Advantage	$33,720.28
Rate for Payer: Oxford Commercial	$40,032.58
Rate for Payer: UnitedHealthcare Commercial	$45,440.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$32,738.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$34,702.43
Rate for Payer: Wellcare Medicare Advantage	$32,738.14

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
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	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$686.00

ULTRASOUND ECHOENCEPHALGRAPHY

Facility

$6,700.00

Service Code	HCPCS 76506
Hospital Charge Code	2100106
Hospital Revenue Code	402
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

Know your out-of-pocket cost for care.

All Charges