Heights University Hospital

All Charges

Charge

Type

Setting

Price

US DUPLEX PENILE ART/VEINS CMP

Facility

$905.70

Service Code	HCPCS 93980
Hospital Charge Code	2301007
Hospital Revenue Code	921
Min. Negotiated Rate	$108.38
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	$108.38
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-EA ADD GESTATION

Facility

$275.00

Hospital Charge Code	2309005
Hospital Revenue Code	402
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-EA ADD GESTATION

Facility

$275.00

Hospital Charge Code	2309005
Hospital Revenue Code	402
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

US-ECHOENCEPHALALOGRAPHY

Facility

$1,109.00

Service Code	HCPCS 76506
Hospital Charge Code	2307005
Hospital Revenue Code	402
Min. Negotiated Rate	$166.35
Max. Negotiated Rate	$166.35
Rate for Payer: Qualcare PPO/HMO/WC	$166.35

US-ECHOENCEPHALALOGRAPHY

Facility

$1,109.00

Service Code	HCPCS 76506
Hospital Charge Code	2307005
Hospital Revenue Code	402
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$332.70
Rate for Payer: Aetna Medicare Advantage	$332.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.80
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	$282.80
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.17
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$166.35
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US ECHOENCEPHALOGRAPHY

Facility

$629.65

Service Code	HCPCS 76506
Hospital Charge Code	2101112
Hospital Revenue Code	402
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$188.90
Rate for Payer: Aetna Medicare Advantage	$188.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.56
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	$160.56
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.85
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.45
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US ECHOENCEPHALOGRAPHY

Facility

$629.65

Service Code	HCPCS 76506
Hospital Charge Code	2101112
Hospital Revenue Code	402
Min. Negotiated Rate	$94.45
Max. Negotiated Rate	$94.45
Rate for Payer: Qualcare PPO/HMO/WC	$94.45

US-ECHO EXAM FETAL HEART

Facility

$526.00

Hospital Charge Code	2309030
Hospital Revenue Code	402
Min. Negotiated Rate	$78.90
Max. Negotiated Rate	$78.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.90

US-ECHO EXAM FETAL HEART

Facility

$526.00

Hospital Charge Code	2309030
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-ECHO FETAL HEART F/U

Facility

$462.00

Hospital Charge Code	2309035
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-ECHO FETAL HEART F/U

Facility

$462.00

Hospital Charge Code	2309035
Hospital Revenue Code	402
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

US ECHO INFANT HIPS DYNAMIC

Facility

$421.65

Service Code	HCPCS 76885
Hospital Charge Code	2100016
Hospital Revenue Code	402
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$126.50
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.81
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US ECHO INFANT HIPS DYNAMIC

Facility

$421.65

Service Code	HCPCS 76885
Hospital Charge Code	2100016
Hospital Revenue Code	402
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

US ECHO INFANT HIPS STATIC

Facility

$6,700.00

Service Code	HCPCS 76886
Hospital Charge Code	2100017
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 ECHO INFANT HIPS STATIC

Facility

$6,700.00

Service Code	HCPCS 76886
Hospital Charge Code	2100017
Hospital Revenue Code	402
Min. Negotiated Rate	$75.21
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	$75.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$207.24
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 ECHO INTRAOPERATIVE

Facility

$1,981.25

Service Code	HCPCS 76998
Hospital Charge Code	2101128
Hospital Revenue Code	402
Min. Negotiated Rate	$132.51
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$594.38
Rate for Payer: Aetna Medicare Advantage	$594.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$505.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$505.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$505.22
Rate for Payer: Cigna Commercial	$990.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.56
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.19
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US ECHO INTRAOPERATIVE

Facility

$1,981.25

Service Code	HCPCS 76998
Hospital Charge Code	2101128
Hospital Revenue Code	402
Min. Negotiated Rate	$297.19
Max. Negotiated Rate	$297.19
Rate for Payer: Qualcare PPO/HMO/WC	$297.19

US EXT NON VASC COMPLETE LT

Facility

$6,700.00

Service Code	HCPCS 76881LT
Hospital Charge Code	2307025
Hospital Revenue Code	402
Min. Negotiated Rate	$871.00
Max. Negotiated Rate	$3,350.00
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) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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 EXT NON VASC COMPLETE LT

Facility

$6,700.00

Service Code	HCPCS 76881LT
Hospital Charge Code	2307025
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 EXT NON VASC COMPLETE RT

Facility

$6,700.00

Service Code	HCPCS 76881RT
Hospital Charge Code	2307020
Hospital Revenue Code	402
Min. Negotiated Rate	$871.00
Max. Negotiated Rate	$3,350.00
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) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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 EXT NON VASC COMPLETE RT

Facility

$6,700.00

Service Code	HCPCS 76881RT
Hospital Charge Code	2307020
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 EXT NON VASC LTD BIL

Facility

$891.00

Service Code	HCPCS 7688250
Hospital Charge Code	7412035
Hospital Revenue Code	891
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$133.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

US EXT NON VASC LTD BIL

Facility

$891.00

Service Code	HCPCS 7688250
Hospital Charge Code	2308010
Hospital Revenue Code	402
Min. Negotiated Rate	$115.83
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$267.30
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.83
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$133.65
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXT NON VASC LTD BIL

Facility

$891.00

Service Code	HCPCS 7688250
Hospital Charge Code	2308010
Hospital Revenue Code	402
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$133.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

US EXT NON VASC LTD BIL

Facility

$891.00

Service Code	HCPCS 7688250
Hospital Charge Code	7412035
Hospital Revenue Code	891
Min. Negotiated Rate	$115.83
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$267.30
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.83
Rate for Payer: Oxford Commercial	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$133.65
Rate for Payer: UnitedHealthcare Commercial	$445.50

Know your out-of-pocket cost for care.

All Charges