Heights University Hospital

All Charges

Charge

Type

Setting

Price

US FETAL AGE

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	2100030
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 FETAL BIOPHYSICAL PROFILE

Facility

$6,700.00

Service Code	HCPCS 76818
Hospital Charge Code	2100287
Hospital Revenue Code	402
Min. Negotiated Rate	$113.14
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	$113.14
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 FETAL BIOPHYSICAL PROFILE

Facility

$6,700.00

Service Code	HCPCS 76818
Hospital Charge Code	94061504B
Hospital Revenue Code	402
Min. Negotiated Rate	$113.14
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	$113.14
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 FETAL BIOPHYSICAL PROFILE

Facility

$6,700.00

Service Code	HCPCS 76818
Hospital Charge Code	94061504B
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 FETAL BIOPHYSICAL PROFILE

Facility

$6,700.00

Service Code	HCPCS 76818
Hospital Charge Code	2100287
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 FETAL BIOPHYS PRFL W/O NSTR

Facility

$563.15

Service Code	HCPCS 76818
Hospital Charge Code	2301011
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US FETAL BIOPHYS PRFL W/O NSTR

Facility

$563.15

Service Code	HCPCS 76818
Hospital Charge Code	2301011
Hospital Revenue Code	402
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$168.94
Rate for Payer: Aetna Medicare Advantage	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.60
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.21
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-FETAL BIOPHYS WO NST

Facility

$632.85

Hospital Charge Code	2309020
Hospital Revenue Code	402
Min. Negotiated Rate	$82.27
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$189.85
Rate for Payer: Aetna Medicare Advantage	$189.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.38
Rate for Payer: Cigna Commercial	$316.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.93
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-FETAL BIOPHYS WO NST

Facility

$632.85

Hospital Charge Code	2309020
Hospital Revenue Code	402
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$94.93
Rate for Payer: Qualcare PPO/HMO/WC	$94.93

US FETAL DOPPLER ECHO

Facility

$594.40

Service Code	HCPCS 76827
Hospital Charge Code	2301012
Hospital Revenue Code	402
Min. Negotiated Rate	$89.16
Max. Negotiated Rate	$89.16
Rate for Payer: Qualcare PPO/HMO/WC	$89.16

US FETAL DOPPLER ECHO

Facility

$594.40

Service Code	HCPCS 76827
Hospital Charge Code	2301012
Hospital Revenue Code	402
Min. Negotiated Rate	$77.27
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$178.32
Rate for Payer: Aetna Medicare Advantage	$178.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.57
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.16
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FETAL DOPPLER ECHO FLLW UP

Facility

$536.20

Service Code	HCPCS 76828
Hospital Charge Code	2301013
Hospital Revenue Code	402
Min. Negotiated Rate	$69.71
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$160.86
Rate for Payer: Aetna Medicare Advantage	$160.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.73
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.71
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.43
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FETAL DOPPLER ECHO FLLW UP

Facility

$536.20

Service Code	HCPCS 76828
Hospital Charge Code	2301013
Hospital Revenue Code	402
Min. Negotiated Rate	$80.43
Max. Negotiated Rate	$80.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.43

US FETAL ECHO 2D

Facility

$594.40

Service Code	HCPCS 76825
Hospital Charge Code	2301014
Hospital Revenue Code	402
Min. Negotiated Rate	$89.16
Max. Negotiated Rate	$89.16
Rate for Payer: Qualcare PPO/HMO/WC	$89.16

US FETAL ECHO 2D

Facility

$594.40

Service Code	HCPCS 76825
Hospital Charge Code	2301014
Hospital Revenue Code	402
Min. Negotiated Rate	$77.27
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$178.32
Rate for Payer: Aetna Medicare Advantage	$178.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.57
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.16
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FETAL ECHO FOLLOW UP

Facility

$536.20

Service Code	HCPCS 76826
Hospital Charge Code	2301015
Hospital Revenue Code	402
Min. Negotiated Rate	$69.71
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$160.86
Rate for Payer: Aetna Medicare Advantage	$160.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.73
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.71
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.43
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FETAL ECHO FOLLOW UP

Facility

$536.20

Service Code	HCPCS 76826
Hospital Charge Code	2301015
Hospital Revenue Code	402
Min. Negotiated Rate	$80.43
Max. Negotiated Rate	$80.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.43

US FINE NDL ASP W/IMAGE GUIDE

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2101153
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

US FINE NDL ASP W/IMAGE GUIDE

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2101153
Hospital Revenue Code	361
Min. Negotiated Rate	$312.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$720.96
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.42
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

US FOLLOW UP STUDY

Facility

$511.25

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$66.46
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$153.38
Rate for Payer: Aetna Medicare Advantage	$153.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.37
Rate for Payer: Cigna Commercial	$255.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.46
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.69
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FOLLOW UP STUDY

Facility

$511.25

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$76.69
Max. Negotiated Rate	$76.69
Rate for Payer: Qualcare PPO/HMO/WC	$76.69

US GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
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 GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
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 GI ENDO SCOPE

Facility

$746.45

Service Code	HCPCS 76975
Hospital Charge Code	2101126
Hospital Revenue Code	402
Min. Negotiated Rate	$97.04
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$223.94
Rate for Payer: Aetna Medicare Advantage	$223.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.34
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.04
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.97
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GI ENDO SCOPE

Facility

$746.45

Service Code	HCPCS 76975
Hospital Charge Code	2101126
Hospital Revenue Code	402
Min. Negotiated Rate	$111.97
Max. Negotiated Rate	$111.97
Rate for Payer: Qualcare PPO/HMO/WC	$111.97

Know your out-of-pocket cost for care.

All Charges