Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR ATHERECTOMY PERQ RENAL ARTE

Facility

$40,990.35

Hospital Charge Code	5600112
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$20,495.17
Rate for Payer: Aetna Commercial	$12,297.10
Rate for Payer: Aetna Medicare Advantage	$12,297.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,452.54
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	$10,452.54
Rate for Payer: Cigna Commercial	$20,495.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.75
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR ATHERECTOMY PERQ RENAL ARTE

Facility

$40,990.35

Hospital Charge Code	5600112
Hospital Revenue Code	361
Min. Negotiated Rate	$6,148.55
Max. Negotiated Rate	$6,148.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR AV FISTULA OR GRAFT ARTERIA

Facility

$22,087.30

Service Code	HCPCS 35475
Hospital Charge Code	5600183
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,043.65
Rate for Payer: Aetna Commercial	$6,626.19
Rate for Payer: Aetna Medicare Advantage	$6,626.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,632.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,632.26
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	$5,632.26
Rate for Payer: Cigna Commercial	$11,043.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,871.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,313.09

XR AV FISTULA OR GRAFT ARTERIA

Facility

$22,087.30

Service Code	HCPCS 35475
Hospital Charge Code	5600183
Hospital Revenue Code	361
Min. Negotiated Rate	$3,313.09
Max. Negotiated Rate	$3,313.09
Rate for Payer: Qualcare PPO/HMO/WC	$3,313.09

X-RAY AORTA LEG ARTERIES

Facility

$12,462.85

Service Code	HCPCS 75630
Hospital Charge Code	411075630
Hospital Revenue Code	323
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

X-RAY AORTA LEG ARTERIES

Facility

$12,462.85

Service Code	HCPCS 75630
Hospital Charge Code	366875630
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

X-RAY AORTA LEG ARTERIES

Facility

$12,462.85

Service Code	HCPCS 75630
Hospital Charge Code	366875630
Hospital Revenue Code	323
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

X-RAY AORTA LEG ARTERIES

Facility

$12,462.85

Service Code	HCPCS 75630
Hospital Charge Code	411075630
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

X-RAY C/T SPINE DISK

Facility

$6,593.09

Service Code	HCPCS 72285
Hospital Charge Code	2011395
Hospital Revenue Code	320
Min. Negotiated Rate	$988.96
Max. Negotiated Rate	$988.96
Rate for Payer: Qualcare PPO/HMO/WC	$988.96

X-RAY C/T SPINE DISK

Facility

$6,593.09

Service Code	HCPCS 72285
Hospital Charge Code	2011395
Hospital Revenue Code	320
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$5,656.68
Rate for Payer: Aetna Better Health Medicaid	$5,545.76
Rate for Payer: Aetna Commercial	$1,977.93
Rate for Payer: Aetna Medicare Advantage	$1,977.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,681.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,681.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,681.24
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$857.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$988.96
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68

XRAY ENDOVASC THOR AO REPR

Facility

$5,100.00

Service Code	HCPCS 75957
Hospital Charge Code	321075957
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XRAY ENDOVASC THOR AO REPR

Facility

$5,100.00

Service Code	HCPCS 75957
Hospital Charge Code	321075957
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
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) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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

XRAY ENDOVASC THOR AO REPR

Facility

$1,645.10

Service Code	HCPCS 75957
Hospital Charge Code	7411735
Hospital Revenue Code	320
Min. Negotiated Rate	$246.76
Max. Negotiated Rate	$246.76
Rate for Payer: Qualcare PPO/HMO/WC	$246.76

XRAY ENDOVASC THOR AO REPR

Facility

$5,100.00

Service Code	HCPCS 75957
Hospital Charge Code	5701111
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
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) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
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

XRAY ENDOVASC THOR AO REPR

Facility

$1,645.10

Service Code	HCPCS 75957
Hospital Charge Code	7411735
Hospital Revenue Code	320
Min. Negotiated Rate	$213.86
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$493.53
Rate for Payer: Aetna Medicare Advantage	$493.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$419.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$419.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$419.50
Rate for Payer: Cigna Commercial	$822.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$246.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XRAY ENDOVASC THOR AO REPR

Facility

$5,100.00

Service Code	HCPCS 75957
Hospital Charge Code	5701111
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

X-ray exam of forearm

Facility

$181.95

Service Code	HCPCS 73090
Hospital Charge Code	2002201
Hospital Revenue Code	320
Min. Negotiated Rate	$27.29
Max. Negotiated Rate	$27.29
Rate for Payer: Qualcare PPO/HMO/WC	$27.29

X-ray exam of forearm

Facility

$181.95

Service Code	HCPCS 73090
Hospital Charge Code	2002201
Hospital Revenue Code	320
Min. Negotiated Rate	$23.65
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.40
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.29
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

X-RAY EXAM PERITONEUM S&I

Facility

$1,404.94

Service Code	HCPCS 74190
Hospital Charge Code	2408010
Hospital Revenue Code	320
Min. Negotiated Rate	$99.11
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$421.48
Rate for Payer: Aetna Medicare Advantage	$421.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.26
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.64
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.74
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

X-RAY EXAM PERITONEUM S&I

Facility

$1,404.94

Service Code	HCPCS 74190
Hospital Charge Code	2408010
Hospital Revenue Code	320
Min. Negotiated Rate	$210.74
Max. Negotiated Rate	$210.74
Rate for Payer: Qualcare PPO/HMO/WC	$210.74

XRAY FOR BONE AGE-26

Facility

$49.65

Service Code	HCPCS 7707226
Hospital Charge Code	85000215
Hospital Revenue Code	320
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$14.89
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.45
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XRAY FOR BONE AGE-26

Facility

$49.65

Service Code	HCPCS 7707226
Hospital Charge Code	85000215
Hospital Revenue Code	320
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

XRAY FOR BONE AGE-GL

Facility

$298.01

Service Code	HCPCS 77072
Hospital Charge Code	85000205
Hospital Revenue Code	320
Min. Negotiated Rate	$30.01
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$89.40
Rate for Payer: Aetna Medicare Advantage	$89.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.99
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.74
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.70
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XRAY FOR BONE AGE-GL

Facility

$298.01

Service Code	HCPCS 77072
Hospital Charge Code	85000205
Hospital Revenue Code	320
Min. Negotiated Rate	$44.70
Max. Negotiated Rate	$44.70
Rate for Payer: Qualcare PPO/HMO/WC	$44.70

XRAY FOR BONE AGE-TC

Facility

$84.55

Service Code	HCPCS 77072TC
Hospital Charge Code	85000210
Hospital Revenue Code	320
Min. Negotiated Rate	$12.68
Max. Negotiated Rate	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$12.68

Know your out-of-pocket cost for care.

All Charges