Heights University Hospital

All Charges

Charge

Type

Setting

Price

US PREGNANCY < 14 WEEKS

Facility

$6,700.00

Service Code	HCPCS 76801
Hospital Charge Code	2301052
Hospital Revenue Code	402
Min. Negotiated Rate	$102.85
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	$102.85
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 PREGNANCY < 14 WEEKS

Facility

$6,700.00

Service Code	HCPCS 76801
Hospital Charge Code	64061508
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 PREGNANCY < 14 WEEKS

Facility

$6,700.00

Service Code	HCPCS 76801
Hospital Charge Code	64061508
Hospital Revenue Code	402
Min. Negotiated Rate	$102.85
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	$102.85
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 PREGNANCY < 14 WEEKS

Facility

$6,700.00

Service Code	HCPCS 76801
Hospital Charge Code	2301052
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 PREGNANCY > 14 WEEKS

Facility

$563.15

Service Code	HCPCS 76805
Hospital Charge Code	2301053
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US PREGNANCY > 14 WEEKS

Facility

$563.15

Service Code	HCPCS 76805
Hospital Charge Code	2301053
Hospital Revenue Code	402
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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	$120.80
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	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

US PREGNANCY COMPLETE W/DETAIL

Facility

$905.70

Service Code	HCPCS 76811
Hospital Charge Code	2301054
Hospital Revenue Code	402
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$135.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

US PREGNANCY COMPLETE W/DETAIL

Facility

$905.70

Service Code	HCPCS 76811
Hospital Charge Code	2301054
Hospital Revenue Code	402
Min. Negotiated Rate	$117.74
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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	$381.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.95
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.74
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.85
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

US PREGNT UTERUS LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	94061504A
Hospital Revenue Code	402
Min. Negotiated Rate	$65.45
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	$65.45
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 PREGNT UTERUS LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	94061504A
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 PREGN UTERUS COMPL

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	2101114
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 PREGN UTERUS COMPL

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	2101114
Hospital Revenue Code	402
Min. Negotiated Rate	$120.80
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	$120.80
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 PREGN UTERUS FOLLOW UP/REPE

Facility

$542.45

Service Code	HCPCS 76816
Hospital Charge Code	2101118
Hospital Revenue Code	402
Min. Negotiated Rate	$81.37
Max. Negotiated Rate	$81.37
Rate for Payer: Qualcare PPO/HMO/WC	$81.37

US PREGN UTERUS FOLLOW UP/REPE

Facility

$542.45

Service Code	HCPCS 76816
Hospital Charge Code	2101118
Hospital Revenue Code	402
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$399.68
Rate for Payer: Aetna Commercial	$162.74
Rate for Payer: Aetna Medicare Advantage	$162.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.52
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.37
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.67

US PRE OP WIRE LOCALIZATION BX

Facility

$996.25

Service Code	HCPCS 19083
Hospital Charge Code	2100240
Hospital Revenue Code	361
Min. Negotiated Rate	$129.51
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$298.88
Rate for Payer: Aetna Medicare Advantage	$298.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.04
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	$254.04
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.51
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.44
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

US PRE OP WIRE LOCALIZATION BX

Facility

$996.25

Service Code	HCPCS 19083
Hospital Charge Code	2100240
Hospital Revenue Code	361
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$149.44
Rate for Payer: Qualcare PPO/HMO/WC	$149.44

US PROSTATE TRANSRECTAL

Facility

$6,700.00

Service Code	HCPCS 76872
Hospital Charge Code	2301055
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 PROSTATE TRANSRECTAL

Facility

$6,700.00

Service Code	HCPCS 76872
Hospital Charge Code	2301055
Hospital Revenue Code	402
Min. Negotiated Rate	$151.47
Max. Negotiated Rate	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
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	$151.47
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: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US PROSTATE VOLUME

Facility

$563.15

Service Code	HCPCS 76873
Hospital Charge Code	2301056
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	$190.74
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 PROSTATE VOLUME

Facility

$563.15

Service Code	HCPCS 76873
Hospital Charge Code	2301056
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US PROSTATIC SEED IMPLANT (OR)

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2100352
Hospital Revenue Code	402
Min. Negotiated Rate	$112.88
Max. Negotiated Rate	$112.88
Rate for Payer: Qualcare PPO/HMO/WC	$112.88

US PROSTATIC SEED IMPLANT (OR)

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2100352
Hospital Revenue Code	402
Min. Negotiated Rate	$97.83
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$225.75
Rate for Payer: Aetna Medicare Advantage	$225.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.89
Rate for Payer: Cigna Commercial	$107.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.83
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.88
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-PSEUDOANEURYSM INJ

Facility

$908.00

Service Code	HCPCS 36002
Hospital Charge Code	2308001
Hospital Revenue Code	361
Min. Negotiated Rate	$118.04
Max. Negotiated Rate	$2,575.00
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	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.54
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.04
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.20
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

US-PSEUDOANEURYSM INJ

Facility

$908.00

Service Code	HCPCS 36002
Hospital Charge Code	2308001
Hospital Revenue Code	361
Min. Negotiated Rate	$136.20
Max. Negotiated Rate	$136.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.20

US PUNC/ASP CYST BREAST

Facility

$414.45

Service Code	HCPCS 19000
Hospital Charge Code	2100547
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

Know your out-of-pocket cost for care.

All Charges