Heights University Hospital

All Charges

Charge

Type

Setting

Price

US UE ARTRAL DPPLR SNGL UNI RT

Facility

$17,200.00

Service Code	HCPCS 9392252RT
Hospital Charge Code	2101103
Hospital Revenue Code	921
Min. Negotiated Rate	$2,236.00
Max. Negotiated Rate	$8,600.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$8,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US-UMBILICAL ARTERY

Facility

$721.00

Hospital Charge Code	2309025
Hospital Revenue Code	402
Min. Negotiated Rate	$108.15
Max. Negotiated Rate	$108.15
Rate for Payer: Qualcare PPO/HMO/WC	$108.15

US-UMBILICAL ARTERY

Facility

$721.00

Hospital Charge Code	2309025
Hospital Revenue Code	402
Min. Negotiated Rate	$93.73
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$216.30
Rate for Payer: Aetna Medicare Advantage	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.85
Rate for Payer: Cigna Commercial	$360.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.73
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.15
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US UNI.DUP SCAN-UPP.EXT.VEINS

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308030
Hospital Revenue Code	921
Min. Negotiated Rate	$136.76
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$315.60
Rate for Payer: Aetna Medicare Advantage	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.26
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.76
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.80
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US UNI.DUP SCAN-UPP.EXT.VEINS

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308030
Hospital Revenue Code	921
Min. Negotiated Rate	$157.80
Max. Negotiated Rate	$157.80
Rate for Payer: Qualcare PPO/HMO/WC	$157.80

US UNLISTED PROCEDURE

Facility

$228.75

Service Code	HCPCS 76999
Hospital Charge Code	2301090
Hospital Revenue Code	402
Min. Negotiated Rate	$29.74
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$68.62
Rate for Payer: Aetna Medicare Advantage	$68.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.33
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.74
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.31
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US UNLISTED PROCEDURE

Facility

$228.75

Service Code	HCPCS 76999
Hospital Charge Code	2301090
Hospital Revenue Code	402
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$34.31
Rate for Payer: Qualcare PPO/HMO/WC	$34.31

US VL-DUP SCAN LOWER EXT VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308020
Hospital Revenue Code	921
Min. Negotiated Rate	$136.76
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$315.60
Rate for Payer: Aetna Medicare Advantage	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.26
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.76
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.80
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US VL-DUP SCAN LOWER EXT VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308020
Hospital Revenue Code	921
Min. Negotiated Rate	$157.80
Max. Negotiated Rate	$157.80
Rate for Payer: Qualcare PPO/HMO/WC	$157.80

US VL-DUP.SCAN LOWER EXT.VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308025
Hospital Revenue Code	921
Min. Negotiated Rate	$136.76
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$315.60
Rate for Payer: Aetna Medicare Advantage	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.26
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.76
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.80
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US VL-DUP.SCAN LOWER EXT.VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308025
Hospital Revenue Code	921
Min. Negotiated Rate	$157.80
Max. Negotiated Rate	$157.80
Rate for Payer: Qualcare PPO/HMO/WC	$157.80

US VL-DUP SCAN-UPPER EXT.VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308015
Hospital Revenue Code	921
Min. Negotiated Rate	$136.76
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$315.60
Rate for Payer: Aetna Medicare Advantage	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.26
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.76
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.80
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US VL-DUP SCAN-UPPER EXT.VEIN-

Facility

$1,052.00

Service Code	HCPCS 93971
Hospital Charge Code	2308015
Hospital Revenue Code	921
Min. Negotiated Rate	$157.80
Max. Negotiated Rate	$157.80
Rate for Payer: Qualcare PPO/HMO/WC	$157.80

US XTR NON-VASC COMPLETE

Facility

$1,170.20

Service Code	HCPCS 76881
Hospital Charge Code	1600000790
Hospital Revenue Code	360
Min. Negotiated Rate	$175.53
Max. Negotiated Rate	$175.53
Rate for Payer: Qualcare PPO/HMO/WC	$175.53

US XTR NON-VASC COMPLETE

Facility

$1,170.20

Service Code	HCPCS 76881
Hospital Charge Code	1600000790
Hospital Revenue Code	360
Min. Negotiated Rate	$152.13
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$351.06
Rate for Payer: Aetna Medicare Advantage	$351.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.40
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	$298.40
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.13
Rate for Payer: Qualcare PPO/HMO/WC	$175.53

US XTR NON-VASC LMTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	2600210
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
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	$24.42
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	$298.19

US XTR NON-VASC LMTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	321076882
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 XTR NON-VASC LMTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	321076882
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
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	$24.42
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	$298.19

US XTR NON-VASC LMTD

Facility

$534.78

Service Code	HCPCS 76882
Hospital Charge Code	7411751
Hospital Revenue Code	402
Min. Negotiated Rate	$80.22
Max. Negotiated Rate	$80.22
Rate for Payer: Qualcare PPO/HMO/WC	$80.22

US XTR NON-VASC LMTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	2600210
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 XTR NON-VASC LMTD

Facility

$534.78

Service Code	HCPCS 76882
Hospital Charge Code	7411751
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
Rate for Payer: Aetna Commercial	$160.43
Rate for Payer: Aetna Medicare Advantage	$160.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.37
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.52
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.22
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$298.19

UTAH PRENDEVILLE LOOPS

Facility

$200.00

Hospital Charge Code	270332567
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

UTAH PRENDEVILLE LOOPS

Facility

$200.00

Hospital Charge Code	270332567
Hospital Revenue Code	272
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$100.00

UTERIAL BALLOON THERAPY GC-EAC

Facility

$16,250.00

Hospital Charge Code	270657455
Hospital Revenue Code	272
Min. Negotiated Rate	$2,437.50
Max. Negotiated Rate	$2,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.50

UTERIAL BALLOON THERAPY GC-EAC

Facility

$16,250.00

Hospital Charge Code	270657455
Hospital Revenue Code	272
Min. Negotiated Rate	$2,112.50
Max. Negotiated Rate	$8,125.00
Rate for Payer: Aetna Commercial	$4,875.00
Rate for Payer: Aetna Medicare Advantage	$4,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,143.75
Rate for Payer: Cigna Commercial	$8,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,112.50
Rate for Payer: Oxford Commercial	$8,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.50
Rate for Payer: UnitedHealthcare Commercial	$8,125.00

Know your out-of-pocket cost for care.

All Charges