Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR FEMUR BILATERAL

Facility

$590.50

Hospital Charge Code	2011337
Hospital Revenue Code	320
Min. Negotiated Rate	$76.77
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$177.15
Rate for Payer: Aetna Medicare Advantage	$177.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.58
Rate for Payer: Cigna Commercial	$295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.58
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FEMUR LT

Facility

$307.00

Hospital Charge Code	2000131
Hospital Revenue Code	320
Min. Negotiated Rate	$39.91
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$92.10
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.91
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FEMUR LT

Facility

$307.00

Hospital Charge Code	2000131
Hospital Revenue Code	320
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

XR FEMUR RT

Facility

$295.25

Hospital Charge Code	2000132
Hospital Revenue Code	320
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

XR FEMUR RT

Facility

$295.25

Hospital Charge Code	2000132
Hospital Revenue Code	320
Min. Negotiated Rate	$38.38
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$88.58
Rate for Payer: Aetna Medicare Advantage	$88.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.29
Rate for Payer: Cigna Commercial	$147.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.38
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FILM SCREEN DIAG BI CONVERT

Facility

$1,058.75

Service Code	HCPCS 77056
Hospital Charge Code	2002566
Hospital Revenue Code	401
Min. Negotiated Rate	$137.64
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$317.62
Rate for Payer: Aetna Medicare Advantage	$317.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.98
Rate for Payer: Cigna Commercial	$529.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.64
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.81
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

XR FILM SCREEN DIAG BI CONVERT

Facility

$1,058.75

Service Code	HCPCS 77056
Hospital Charge Code	2002566
Hospital Revenue Code	401
Min. Negotiated Rate	$158.81
Max. Negotiated Rate	$158.81
Rate for Payer: Qualcare PPO/HMO/WC	$158.81

XR FILM SCREEN DIAG UNI CONV

Facility

$777.50

Service Code	HCPCS 77055
Hospital Charge Code	2002582
Hospital Revenue Code	401
Min. Negotiated Rate	$116.62
Max. Negotiated Rate	$116.62
Rate for Payer: Qualcare PPO/HMO/WC	$116.62

XR FILM SCREEN DIAG UNI CONV

Facility

$777.50

Service Code	HCPCS 77055
Hospital Charge Code	2002582
Hospital Revenue Code	401
Min. Negotiated Rate	$101.08
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$233.25
Rate for Payer: Aetna Medicare Advantage	$233.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.26
Rate for Payer: Cigna Commercial	$388.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.08
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.62
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

XR FINE NDL ASPIR W/IMAGE GUID

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2001635
Hospital Revenue Code	361
Min. Negotiated Rate	$312.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$720.96
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.42
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

XR FINE NDL ASPIR W/IMAGE GUID

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2001635
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

XR FISTULOGRAM

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2000321
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FISTULOGRAM

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2000321
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
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	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,301.24
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 FLUORO BRONCH BX*****

Facility

$210.00

Service Code	HCPCS 71038
Hospital Charge Code	2004463
Hospital Revenue Code	329
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

XR FLUORO BRONCH BX*****

Facility

$210.00

Service Code	HCPCS 71038
Hospital Charge Code	2004463
Hospital Revenue Code	329
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FLUORO EXAM OF G/COLON TUBE

Facility

$604.00

Service Code	HCPCS 49465
Hospital Charge Code	5600166
Hospital Revenue Code	361
Min. Negotiated Rate	$78.52
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$181.20
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
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	$154.02
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.52
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR FLUORO EXAM OF G/COLON TUBE

Facility

$604.00

Service Code	HCPCS 49465
Hospital Charge Code	5600166
Hospital Revenue Code	361
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

XR FLUORO GUIDE CV ACCESS DEV

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004405
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$2,607.78
Rate for Payer: Aetna Commercial	$2,607.78
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,130.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FLUORO GUIDE CV ACCESS DEV

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004405
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

XR FLUORO LOC INTRATHOR LESION

Facility

$1,065.00

Service Code	HCPCS 77002
Hospital Charge Code	2004885
Hospital Revenue Code	320
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$159.75
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

XR FLUORO LOC INTRATHOR LESION

Facility

$1,065.00

Service Code	HCPCS 77002
Hospital Charge Code	2004885
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$319.50
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$138.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.45
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR FLUORO LOC NDL/CATH SPINE

Facility

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	2004888
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FLUORO LOC NDL/CATH SPINE

Facility

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	2004888
Hospital Revenue Code	320
Min. Negotiated Rate	$37.81
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	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$119.21
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 FLUORO LUMBA PUNC SPIN TAP

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004406
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
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	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$138.80
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 FLUORO LUMBA PUNC SPIN TAP

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004406
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

Know your out-of-pocket cost for care.

All Charges