Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR ABDMEN SERIES W/CHEST 1VIEW

Facility

$440.25

Service Code	HCPCS 74022
Hospital Charge Code	2011305
Hospital Revenue Code	320
Min. Negotiated Rate	$66.04
Max. Negotiated Rate	$66.04
Rate for Payer: Qualcare PPO/HMO/WC	$66.04

XR ABDMEN SERIES W/CHEST 1VIEW

Facility

$440.25

Service Code	HCPCS 74022
Hospital Charge Code	2011305
Hospital Revenue Code	320
Min. Negotiated Rate	$51.42
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$132.07
Rate for Payer: Aetna Medicare Advantage	$132.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.26
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.23
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.04
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR ABDOMEN 1 VIEW PORTABLE

Facility

$5,100.00

Service Code	HCPCS 74018
Hospital Charge Code	2002780
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ABDOMEN 1 VIEW PORTABLE

Facility

$5,100.00

Service Code	HCPCS 74018
Hospital Charge Code	2002780
Hospital Revenue Code	320
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ABDOMEN 2 VWS W DECUB ERECT

Facility

$204.00

Service Code	HCPCS 74020
Hospital Charge Code	2000206
Hospital Revenue Code	320
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

XR ABDOMEN 2 VWS W DECUB ERECT

Facility

$204.00

Service Code	HCPCS 74020
Hospital Charge Code	2000206
Hospital Revenue Code	320
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

XR ABDOMEN MULT VIEWS

Facility

$6,601.19

Service Code	HCPCS 74022
Hospital Charge Code	2000214
Hospital Revenue Code	320
Min. Negotiated Rate	$51.42
Max. Negotiated Rate	$1,980.36
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR ABDOMEN MULT VIEWS

Facility

$6,601.19

Service Code	HCPCS 74022
Hospital Charge Code	2000214
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ABDOMEN ONE VIEW

Facility

$6,601.19

Service Code	HCPCS 74018
Hospital Charge Code	2000198
Hospital Revenue Code	320
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$1,980.36
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ABDOMEN ONE VIEW

Facility

$6,601.19

Service Code	HCPCS 74018
Hospital Charge Code	2000198
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ABDOMEN TWO VIEWS PORTABLE

Facility

$5,100.00

Service Code	HCPCS 74019
Hospital Charge Code	2003051
Hospital Revenue Code	320
Min. Negotiated Rate	$37.25
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ABDOMEN TWO VIEWS PORTABLE

Facility

$5,100.00

Service Code	HCPCS 74019
Hospital Charge Code	2003051
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ABLATE BONE TUMOR(S) PERQ

Facility

$20,597.50

Service Code	HCPCS 20982
Hospital Charge Code	7411348
Hospital Revenue Code	361
Min. Negotiated Rate	$3,089.62
Max. Negotiated Rate	$3,089.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,089.62

XR ABLATE BONE TUMOR(S) PERQ

Facility

$33,376.25

Service Code	HCPCS 20982
Hospital Charge Code	5600102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$10,012.88
Rate for Payer: Aetna Medicare Advantage	$10,012.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,510.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,510.94
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	$8,510.94
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,338.91
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,006.44
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

XR ABLATE BONE TUMOR(S) PERQ

Facility

$33,376.25

Service Code	HCPCS 20982
Hospital Charge Code	321020982
Hospital Revenue Code	361
Min. Negotiated Rate	$5,006.44
Max. Negotiated Rate	$5,006.44
Rate for Payer: Qualcare PPO/HMO/WC	$5,006.44

XR ABLATE BONE TUMOR(S) PERQ

Facility

$33,376.25

Service Code	HCPCS 20982
Hospital Charge Code	321020982
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$10,012.88
Rate for Payer: Aetna Medicare Advantage	$10,012.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,510.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,510.94
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	$8,510.94
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,338.91
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,006.44
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

XR ABLATE BONE TUMOR(S) PERQ

Facility

$20,597.50

Service Code	HCPCS 20982
Hospital Charge Code	7411348
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$6,179.25
Rate for Payer: Aetna Medicare Advantage	$6,179.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,252.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,252.36
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	$5,252.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,677.68
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,089.62
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

XR ABLATE BONE TUMOR(S) PERQ

Facility

$33,376.25

Service Code	HCPCS 20982
Hospital Charge Code	5600102
Hospital Revenue Code	361
Min. Negotiated Rate	$5,006.44
Max. Negotiated Rate	$5,006.44
Rate for Payer: Qualcare PPO/HMO/WC	$5,006.44

XR AC JOINTS BILATERAL W/ WTS

Facility

$258.70

Service Code	HCPCS 73050
Hospital Charge Code	2011306
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$77.61
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

XR AC JOINTS BILATERAL W/ WTS

Facility

$258.70

Service Code	HCPCS 73050
Hospital Charge Code	2011306
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR ACROMIOCL JNTS BI

Facility

$5,100.00

Service Code	HCPCS 73050
Hospital Charge Code	2000099
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ACROMIOCL JNTS BI

Facility

$5,100.00

Service Code	HCPCS 73050
Hospital Charge Code	2000099
Hospital Revenue Code	320
Min. Negotiated Rate	$33.66
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

XR ANGIOPLASTY FEMORAL ARTE***

Facility

$2,063.00

Service Code	HCPCS 75962
Hospital Charge Code	2002376
Hospital Revenue Code	329
Min. Negotiated Rate	$268.19
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$618.90
Rate for Payer: Aetna Medicare Advantage	$618.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$526.07
Rate for Payer: Cigna Commercial	$1,031.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.19
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.45
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ANGIOPLASTY FEMORAL ARTE***

Facility

$2,063.00

Service Code	HCPCS 75962
Hospital Charge Code	2002376
Hospital Revenue Code	329
Min. Negotiated Rate	$309.45
Max. Negotiated Rate	$309.45
Rate for Payer: Qualcare PPO/HMO/WC	$309.45

XR ANGIOPLASTY ILIAC ARTERY***

Facility

$1,815.00

Service Code	HCPCS 75962
Hospital Charge Code	2002368
Hospital Revenue Code	329
Min. Negotiated Rate	$235.95
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$544.50
Rate for Payer: Aetna Medicare Advantage	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$462.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$462.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$462.82
Rate for Payer: Cigna Commercial	$907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$272.25
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges