Heights University Hospital

All Charges

Charge

Type

Setting

Price

US GI ENDO W ENDO US

Facility

$833.65

Service Code	HCPCS 43259
Hospital Charge Code	2101139
Hospital Revenue Code	750
Min. Negotiated Rate	$108.37
Max. Negotiated Rate	$4,829.61
Rate for Payer: Aetna Better Health Medicaid	$4,734.91
Rate for Payer: Aetna Commercial	$250.09
Rate for Payer: Aetna Medicare Advantage	$250.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.58
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.37
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.05
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,829.61

US GI ENDO W ENDO US

Facility

$833.65

Service Code	HCPCS 43259
Hospital Charge Code	2101139
Hospital Revenue Code	750
Min. Negotiated Rate	$125.05
Max. Negotiated Rate	$125.05
Rate for Payer: Qualcare PPO/HMO/WC	$125.05

US GUIDANCE ABD PARACENTESIS

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100949
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$329.28
Rate for Payer: Aetna Medicare Advantage	$329.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.89
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	$279.89
Rate for Payer: Cigna Commercial	$72.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.69
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.64
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE ABD PARACENTESIS

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100949
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US GUIDANCE AMNIOCENTESIS

Facility

$953.35

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$38.23
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$286.00
Rate for Payer: Aetna Medicare Advantage	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.10
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.94
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE AMNIOCENTESIS

Facility

$953.35

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00

US GUIDANCE COMP PSEUDO-ANEUR

Facility

$3,485.00

Service Code	HCPCS 76936
Hospital Charge Code	2101105
Hospital Revenue Code	402
Min. Negotiated Rate	$326.26
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$1,045.50
Rate for Payer: Aetna Medicare Advantage	$1,045.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$888.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$888.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$326.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$888.67
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.05
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$522.75
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE COMP PSEUDO-ANEUR

Facility

$3,485.00

Service Code	HCPCS 76936
Hospital Charge Code	2101105
Hospital Revenue Code	402
Min. Negotiated Rate	$522.75
Max. Negotiated Rate	$522.75
Rate for Payer: Qualcare PPO/HMO/WC	$522.75

US GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
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	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$72.16
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
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	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$72.16
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
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 GUIDANCE PERICARDIOCENTESIS

Facility

$859.25

Service Code	HCPCS 76930
Hospital Charge Code	2100956
Hospital Revenue Code	402
Min. Negotiated Rate	$111.70
Max. Negotiated Rate	$1,981.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.89
Rate for Payer: Aetna Commercial	$257.77
Rate for Payer: Aetna Medicare Advantage	$257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.11
Rate for Payer: Cigna Commercial	$429.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.70
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE PERICARDIOCENTESIS

Facility

$859.25

Service Code	HCPCS 76930
Hospital Charge Code	2100956
Hospital Revenue Code	402
Min. Negotiated Rate	$128.89
Max. Negotiated Rate	$128.89
Rate for Payer: Qualcare PPO/HMO/WC	$128.89

US GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
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	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$72.16
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 GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
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 GUIDANCE TISSUE ABLATION

Facility

$1,521.25

Service Code	HCPCS 76940
Hospital Charge Code	2301016
Hospital Revenue Code	402
Min. Negotiated Rate	$228.19
Max. Negotiated Rate	$228.19
Rate for Payer: Qualcare PPO/HMO/WC	$228.19

US GUIDANCE TISSUE ABLATION

Facility

$1,521.25

Service Code	HCPCS 76940
Hospital Charge Code	2301016
Hospital Revenue Code	402
Min. Negotiated Rate	$197.76
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$456.38
Rate for Payer: Aetna Medicare Advantage	$456.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.92
Rate for Payer: Cigna Commercial	$760.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.76
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.19
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$69.19
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$428.70
Rate for Payer: Aetna Medicare Advantage	$428.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.39
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	$364.39
Rate for Payer: Cigna Commercial	$72.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.77
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.35
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$214.35
Max. Negotiated Rate	$214.35
Rate for Payer: Qualcare PPO/HMO/WC	$214.35

US-GUIDE ABSCESS DRAIN

Facility

$3,032.40

Hospital Charge Code	2309050
Hospital Revenue Code	320
Min. Negotiated Rate	$394.21
Max. Negotiated Rate	$1,516.20
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$909.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$773.26
Rate for Payer: Cigna Commercial	$1,516.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

US-GUIDE ABSCESS DRAIN

Facility

$3,032.40

Hospital Charge Code	2309050
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$100.91
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$232.88
Rate for Payer: Aetna Medicare Advantage	$232.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.94
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	$197.94
Rate for Payer: Cigna Commercial	$388.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.91
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BREAST LOC RT

Facility

$776.25

Service Code	HCPCS 19285RT
Hospital Charge Code	2309101A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

Know your out-of-pocket cost for care.

All Charges