Heights University Hospital

All Charges

Charge

Type

Setting

Price

US GUIDED THROM PSEUDOAN SURG

Facility

$1,003.57

Service Code	HCPCS 36002
Hospital Charge Code	23011001A
Hospital Revenue Code	361
Min. Negotiated Rate	$150.54
Max. Negotiated Rate	$150.54
Rate for Payer: Qualcare PPO/HMO/WC	$150.54

US GUIDE FOR CYST ASPIRATION

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100931
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 GUIDE FOR CYST ASPIRATION

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100931
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US GUIDE/MONITOR TISSUE ABLAT

Facility

$1,071.00

Service Code	HCPCS 76940
Hospital Charge Code	2100160
Hospital Revenue Code	402
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$160.65
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

US GUIDE/MONITOR TISSUE ABLAT

Facility

$1,071.00

Service Code	HCPCS 76940
Hospital Charge Code	2100160
Hospital Revenue Code	402
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$321.30
Rate for Payer: Aetna Medicare Advantage	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.11
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	$273.11
Rate for Payer: Cigna Commercial	$535.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.23
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.65
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDE PERICARDIOCENTESIS

Facility

$859.00

Service Code	HCPCS 76930
Hospital Charge Code	2680360
Hospital Revenue Code	402
Min. Negotiated Rate	$111.67
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$257.70
Rate for Payer: Aetna Medicare Advantage	$257.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.04
Rate for Payer: Cigna Commercial	$429.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.67
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.85
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US GUIDE PERICARDIOCENTESIS

Facility

$859.00

Service Code	HCPCS 76930
Hospital Charge Code	2680360
Hospital Revenue Code	402
Min. Negotiated Rate	$128.85
Max. Negotiated Rate	$128.85
Rate for Payer: Qualcare PPO/HMO/WC	$128.85

US GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	23001101
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 GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	2301101
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 GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	23001101
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
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	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
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 GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	2301101
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
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	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
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 GUID RENAL PELVIS ASPIRATON

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100105
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 GUID RENAL PELVIS ASPIRATON

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100105
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 GUI PERCUT DRN/PL OF CATH

Facility

$3,408.00

Service Code	HCPCS 75989
Hospital Charge Code	2100225
Hospital Revenue Code	402
Min. Negotiated Rate	$511.20
Max. Negotiated Rate	$511.20
Rate for Payer: Qualcare PPO/HMO/WC	$511.20

US GUI PERCUT DRN/PL OF CATH

Facility

$3,408.00

Service Code	HCPCS 75989
Hospital Charge Code	2100225
Hospital Revenue Code	402
Min. Negotiated Rate	$126.54
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$1,022.40
Rate for Payer: Aetna Medicare Advantage	$1,022.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.04
Rate for Payer: Cigna Commercial	$126.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.04
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.20
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US HEPATIC

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100055
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 HEPATIC

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100055
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-HYSTEROSONOGR W/WO DOPPLER

Facility

$908.00

Service Code	HCPCS 76831
Hospital Charge Code	2308005
Hospital Revenue Code	402
Min. Negotiated Rate	$136.20
Max. Negotiated Rate	$136.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.20

US-HYSTEROSONOGR W/WO DOPPLER

Facility

$908.00

Service Code	HCPCS 76831
Hospital Charge Code	2308005
Hospital Revenue Code	402
Min. Negotiated Rate	$118.04
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$272.40
Rate for Payer: Aetna Medicare Advantage	$272.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.54
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.04
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.20
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US ILIAC VASCULAT DPLX COMP BL

Facility

$757.65

Service Code	HCPCS 93978
Hospital Charge Code	2301023
Hospital Revenue Code	921
Min. Negotiated Rate	$113.65
Max. Negotiated Rate	$113.65
Rate for Payer: Qualcare PPO/HMO/WC	$113.65

US ILIAC VASCULAT DPLX COMP BL

Facility

$757.65

Service Code	HCPCS 93978
Hospital Charge Code	2301023
Hospital Revenue Code	921
Min. Negotiated Rate	$98.49
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$227.29
Rate for Payer: Aetna Medicare Advantage	$227.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.20
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	$193.20
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.49
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.65
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US ILIAC VASCULATURE DUPLX LFT

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	2301024
Hospital Revenue Code	921
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US ILIAC VASCULATURE DUPLX LFT

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	2301024
Hospital Revenue Code	921
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$5,061.00
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	$220.80
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	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US ILIAC VASCULATURE DUPLX RGT

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	2301025
Hospital Revenue Code	921
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$5,061.00
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	$220.80
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	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US ILIAC VASCULATURE DUPLX RGT

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	2301025
Hospital Revenue Code	921
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

Know your out-of-pocket cost for care.

All Charges