Heights University Hospital

All Charges

Charge

Type

Setting

Price

US BREAST PERC VAC ASSIST

Facility

$6,419.95

Hospital Charge Code	21000920
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US BREAST RIGHT

Facility

$352.05

Service Code	HCPCS 76645
Hospital Charge Code	2301063
Hospital Revenue Code	402
Min. Negotiated Rate	$45.77
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$105.61
Rate for Payer: Aetna Medicare Advantage	$105.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.77
Rate for Payer: Cigna Commercial	$176.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.77
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.81
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US BREAST RIGHT

Facility

$352.05

Service Code	HCPCS 76645
Hospital Charge Code	2301063
Hospital Revenue Code	402
Min. Negotiated Rate	$52.81
Max. Negotiated Rate	$52.81
Rate for Payer: Qualcare PPO/HMO/WC	$52.81

US-BREAST-RT

Facility

$2,100.00

Hospital Charge Code	2309065
Hospital Revenue Code	402
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$630.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-BREAST-RT

Facility

$2,100.00

Hospital Charge Code	2309065
Hospital Revenue Code	402
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$315.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

US BX BREAST NEDLE CORE EA ADD

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	2309080
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US BX BREAST NEDLE CORE EA ADD

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	2309080
Hospital Revenue Code	361
Min. Negotiated Rate	$70.17
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$951.93
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$70.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

US BX NEEDLE ASPIRATION FINE

Facility

$3,355.30

Service Code	HCPCS 19083
Hospital Charge Code	2101146
Hospital Revenue Code	361
Min. Negotiated Rate	$436.19
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,006.59
Rate for Payer: Aetna Medicare Advantage	$1,006.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$855.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$855.60
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	$855.60
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.19
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$503.30
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

US BX NEEDLE ASPIRATION FINE

Facility

$3,355.30

Service Code	HCPCS 19083
Hospital Charge Code	2101146
Hospital Revenue Code	361
Min. Negotiated Rate	$503.30
Max. Negotiated Rate	$503.30
Rate for Payer: Qualcare PPO/HMO/WC	$503.30

US CAROTID DUPLEX RIGHT

Facility

$905.70

Service Code	HCPCS 93882
Hospital Charge Code	2301006
Hospital Revenue Code	921
Min. Negotiated Rate	$110.84
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$271.71
Rate for Payer: Aetna Medicare Advantage	$271.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.95
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.74
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.85
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US CAROTID DUPLEX RIGHT

Facility

$905.70

Service Code	HCPCS 93882
Hospital Charge Code	2301006
Hospital Revenue Code	921
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$135.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

US CARTOID DOPPLER BILATERAL

Facility

$568.05

Hospital Charge Code	2301005
Hospital Revenue Code	921
Min. Negotiated Rate	$73.85
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$170.41
Rate for Payer: Aetna Medicare Advantage	$170.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.85
Rate for Payer: Cigna Commercial	$284.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.85
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.21
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US CARTOID DOPPLER BILATERAL

Facility

$568.05

Hospital Charge Code	2301005
Hospital Revenue Code	921
Min. Negotiated Rate	$85.21
Max. Negotiated Rate	$85.21
Rate for Payer: Qualcare PPO/HMO/WC	$85.21

US COMMON BILE DUCT

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100212
Hospital Revenue Code	402
Min. Negotiated Rate	$82.28
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	$82.28
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

US COMMON BILE DUCT

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100212
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

US-DOPPLER ECHO FETAL HEA

Facility

$526.00

Hospital Charge Code	2309040
Hospital Revenue Code	402
Min. Negotiated Rate	$78.90
Max. Negotiated Rate	$78.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.90

US-DOPPLER ECHO FETAL HEA

Facility

$526.00

Hospital Charge Code	2309040
Hospital Revenue Code	402
Min. Negotiated Rate	$68.38
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$157.80
Rate for Payer: Aetna Medicare Advantage	$157.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.13
Rate for Payer: Cigna Commercial	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.38
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.90
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US DOPPLER FETAL HEART F/U

Facility

$462.00

Hospital Charge Code	2309045
Hospital Revenue Code	402
Min. Negotiated Rate	$60.06
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$138.60
Rate for Payer: Aetna Medicare Advantage	$138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.81
Rate for Payer: Cigna Commercial	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.06
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US DOPPLER FETAL HEART F/U

Facility

$462.00

Hospital Charge Code	2309045
Hospital Revenue Code	402
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

US DUPLEX AORTA, IVC, ILIAC

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	2100295
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX AORTA, IVC, ILIAC

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	2100295
Hospital Revenue Code	921
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX CAROTID/VERTEBRAL BI

Facility

$17,200.00

Service Code	HCPCS 93880
Hospital Charge Code	2100170
Hospital Revenue Code	921
Min. Negotiated Rate	$428.95
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX CAROTID/VERTEBRAL BI

Facility

$17,200.00

Service Code	HCPCS 93880
Hospital Charge Code	2100170
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX CAROTID/VERT.UNI/LTD

Facility

$17,200.00

Service Code	HCPCS 93882
Hospital Charge Code	2100964
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX CAROTID/VERT.UNI/LTD

Facility

$17,200.00

Service Code	HCPCS 93882
Hospital Charge Code	2100964
Hospital Revenue Code	921
Min. Negotiated Rate	$110.84
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

Know your out-of-pocket cost for care.

All Charges