Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR EPIDUROGRAPHY

Facility

$1,033.95

Service Code	HCPCS 72275
Hospital Charge Code	2011335
Hospital Revenue Code	320
Min. Negotiated Rate	$155.09
Max. Negotiated Rate	$155.09
Rate for Payer: Qualcare PPO/HMO/WC	$155.09

XR EPIDUROGRAPHY

Facility

$1,033.95

Service Code	HCPCS 72275
Hospital Charge Code	2011335
Hospital Revenue Code	320
Min. Negotiated Rate	$134.41
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$310.19
Rate for Payer: Aetna Medicare Advantage	$310.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.66
Rate for Payer: Cigna Commercial	$516.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.41
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.09
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ERCP

Facility

$5,100.00

Service Code	HCPCS 74330
Hospital Charge Code	2001584
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ERCP

Facility

$5,100.00

Service Code	HCPCS 74330
Hospital Charge Code	2001584
Hospital Revenue Code	320
Min. Negotiated Rate	$142.12
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) NJ Health	$142.12
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

XR ESOPHAGUS

Facility

$6,601.19

Service Code	HCPCS 74220
Hospital Charge Code	2000222
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ESOPHAGUS

Facility

$6,601.19

Service Code	HCPCS 74220
Hospital Charge Code	2000222
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
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	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$417.70
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 ESTABLISH ACCESS TO ARTERY

Facility

$57.70

Service Code	HCPCS 36100
Hospital Charge Code	5600035
Hospital Revenue Code	361
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
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	$14.71
Rate for Payer: Cigna Commercial	$143.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR ESTABLISH ACCESS TO ARTERY

Facility

$57.70

Service Code	HCPCS 36100
Hospital Charge Code	7411420
Hospital Revenue Code	361
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

XR ESTABLISH ACCESS TO ARTERY

Facility

$57.70

Service Code	HCPCS 36100
Hospital Charge Code	5600035
Hospital Revenue Code	361
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

XR ESTABLISH ACCESS TO ARTERY

Facility

$57.70

Service Code	HCPCS 36100
Hospital Charge Code	7411420
Hospital Revenue Code	361
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
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	$14.71
Rate for Payer: Cigna Commercial	$143.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR EXTERNAL CANNULA DECLOTTING

Facility

$1,113.85

Service Code	HCPCS 36860
Hospital Charge Code	5600141
Hospital Revenue Code	361
Min. Negotiated Rate	$167.08
Max. Negotiated Rate	$167.08
Rate for Payer: Qualcare PPO/HMO/WC	$167.08

XR EXTERNAL CANNULA DECLOTTING

Facility

$1,113.85

Service Code	HCPCS 36860
Hospital Charge Code	5600141
Hospital Revenue Code	361
Min. Negotiated Rate	$144.80
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$334.15
Rate for Payer: Aetna Medicare Advantage	$334.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.03
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	$284.03
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.80
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.08
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR EXTERNAL CANNULA DECLOTTING

Facility

$1,113.85

Service Code	HCPCS 36860
Hospital Charge Code	7411488
Hospital Revenue Code	361
Min. Negotiated Rate	$167.08
Max. Negotiated Rate	$167.08
Rate for Payer: Qualcare PPO/HMO/WC	$167.08

XR EXTERNAL CANNULA DECLOTTING

Facility

$1,113.85

Service Code	HCPCS 36860
Hospital Charge Code	7411488
Hospital Revenue Code	361
Min. Negotiated Rate	$144.80
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$334.15
Rate for Payer: Aetna Medicare Advantage	$334.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.03
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	$284.03
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.80
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.08
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR EYE/FOREIGN BODY LT

Facility

$5,100.00

Service Code	HCPCS 70030LT
Hospital Charge Code	2000420
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

XR EYE/FOREIGN BODY LT

Facility

$5,100.00

Service Code	HCPCS 70030LT
Hospital Charge Code	2000420
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR EYE/FOREIGN BODY RT

Facility

$376.85

Service Code	HCPCS 70030RT
Hospital Charge Code	2000421
Hospital Revenue Code	320
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$113.06
Rate for Payer: Aetna Medicare Advantage	$113.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.10
Rate for Payer: Cigna Commercial	$188.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.53
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR EYE/FOREIGN BODY RT

Facility

$376.85

Service Code	HCPCS 70030RT
Hospital Charge Code	2000421
Hospital Revenue Code	320
Min. Negotiated Rate	$56.53
Max. Negotiated Rate	$56.53
Rate for Payer: Qualcare PPO/HMO/WC	$56.53

XR FACIAL BONES < 3 VIEW

Facility

$5,100.00

Service Code	HCPCS 70140
Hospital Charge Code	2011085
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FACIAL BONES < 3 VIEW

Facility

$5,100.00

Service Code	HCPCS 70140
Hospital Charge Code	2011085
Hospital Revenue Code	320
Min. Negotiated Rate	$28.05
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	$28.05
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 FACIAL BONES MIN 3 VWS

Facility

$5,100.00

Service Code	HCPCS 70150
Hospital Charge Code	2000362
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FACIAL BONES MIN 3 VWS

Facility

$5,100.00

Service Code	HCPCS 70150
Hospital Charge Code	2000362
Hospital Revenue Code	320
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$309.88
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	$37.40
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08

XR FALLOPIAN TUBE CATHERZATION

Facility

$1,224.75

Service Code	HCPCS 74742
Hospital Charge Code	2011336
Hospital Revenue Code	320
Min. Negotiated Rate	$128.97
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$367.43
Rate for Payer: Aetna Medicare Advantage	$367.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.31
Rate for Payer: Cigna Commercial	$612.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.22
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.71
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FALLOPIAN TUBE CATHERZATION

Facility

$1,224.75

Service Code	HCPCS 74742
Hospital Charge Code	2011336
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR FEMUR BILATERAL

Facility

$590.50

Hospital Charge Code	2011337
Hospital Revenue Code	320
Min. Negotiated Rate	$88.58
Max. Negotiated Rate	$88.58
Rate for Payer: Qualcare PPO/HMO/WC	$88.58

Know your out-of-pocket cost for care.

All Charges