Heights University Hospital

All Charges

Charge

Type

Setting

Price

US OPHTHLMC A-SCAN INTCLR LEFT

Facility

$563.15

Service Code	HCPCS 76519LT
Hospital Charge Code	2301038
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC A-SCAN INTCLR LEFT

Facility

$563.15

Service Code	HCPCS 76519LT
Hospital Charge Code	2301038
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC A-SCAN INTCLR RGHT

Facility

$563.15

Service Code	HCPCS 76519RT
Hospital Charge Code	2301039
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC A-SCAN INTCLR RGHT

Facility

$563.15

Service Code	HCPCS 76519RT
Hospital Charge Code	2301039
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC BIMTRY A-SCAN BLTL

Facility

$1,126.30

Service Code	HCPCS 7651150
Hospital Charge Code	2301042
Hospital Revenue Code	402
Min. Negotiated Rate	$168.94
Max. Negotiated Rate	$168.94
Rate for Payer: Qualcare PPO/HMO/WC	$168.94

US OPHTHLMC BIMTRY A-SCAN BLTL

Facility

$1,126.30

Service Code	HCPCS 7651150
Hospital Charge Code	2301042
Hospital Revenue Code	402
Min. Negotiated Rate	$146.42
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$337.89
Rate for Payer: Aetna Medicare Advantage	$337.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.21
Rate for Payer: Cigna Commercial	$563.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.42
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.94
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US OPHTHLMC BIMTRY A-SCAN LEFT

Facility

$563.15

Service Code	HCPCS 76511LT
Hospital Charge Code	2301043
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC BIMTRY A-SCAN LEFT

Facility

$563.15

Service Code	HCPCS 76511LT
Hospital Charge Code	2301043
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC BIMTRY A-SCAN RGHT

Facility

$563.15

Service Code	HCPCS 76511RT
Hospital Charge Code	2301044
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC BIMTRY A-SCAN RGHT

Facility

$563.15

Service Code	HCPCS 76511RT
Hospital Charge Code	2301044
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC B-SCAN H2O BTH BLT

Facility

$563.15

Service Code	HCPCS 76513
Hospital Charge Code	2301046
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC B-SCAN H2O BTH BLT

Facility

$563.15

Service Code	HCPCS 76513
Hospital Charge Code	2301046
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	$123.42
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 OPHTHLMC B-SCAN H2O BTH LFT

Facility

$563.15

Service Code	HCPCS 76513LT
Hospital Charge Code	2301047
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC B-SCAN H2O BTH LFT

Facility

$563.15

Service Code	HCPCS 76513LT
Hospital Charge Code	2301047
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC B-SCAN H2O BTH RGT

Facility

$563.15

Service Code	HCPCS 76513RT
Hospital Charge Code	2301048
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) PPO	$143.60
Rate for Payer: Cigna Commercial	$281.57
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 OPHTHLMC B-SCAN H2O BTH RGT

Facility

$563.15

Service Code	HCPCS 76513RT
Hospital Charge Code	2301048
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US OPHTHLMC FOREGN BODY LCLZTN

Facility

$352.05

Service Code	HCPCS 76529
Hospital Charge Code	2301051
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) NJ Health	$106.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.77
Rate for Payer: Cigna Commercial	$207.24
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 OPHTHLMC FOREGN BODY LCLZTN

Facility

$352.05

Service Code	HCPCS 76529
Hospital Charge Code	2301051
Hospital Revenue Code	402
Min. Negotiated Rate	$52.81
Max. Negotiated Rate	$52.81
Rate for Payer: Qualcare PPO/HMO/WC	$52.81

US PANCREAS

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100063
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 PANCREAS

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100063
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 PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	2100485
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
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	$617.78
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

US PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	2100485
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

US PELVIS COMPL

Facility

$6,700.00

Service Code	HCPCS 76856
Hospital Charge Code	2100071
Hospital Revenue Code	402
Min. Negotiated Rate	$123.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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	$123.42
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

US PELVIS COMPL

Facility

$6,700.00

Service Code	HCPCS 76856
Hospital Charge Code	2100071
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 PELVIS DUPLEX COMPLETE

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	2101108
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

Know your out-of-pocket cost for care.

All Charges