Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR INTRNL AUDIO MEATI CMP BILA

Facility

$2,449.50

Service Code	HCPCS 7013450
Hospital Charge Code	2011349
Hospital Revenue Code	320
Min. Negotiated Rate	$318.44
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$734.85
Rate for Payer: Aetna Medicare Advantage	$734.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.62
Rate for Payer: Cigna Commercial	$1,224.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.43
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR INTRNL AUDIO MEATI CMP LEFT

Facility

$1,224.75

Service Code	HCPCS 70134LT
Hospital Charge Code	2011350
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR INTRNL AUDIO MEATI CMP LEFT

Facility

$1,224.75

Service Code	HCPCS 70134LT
Hospital Charge Code	2011350
Hospital Revenue Code	320
Min. Negotiated Rate	$159.22
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) 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 INTRNL AUDIO MEATI CMP RGHT

Facility

$1,224.75

Service Code	HCPCS 70134RT
Hospital Charge Code	2011351
Hospital Revenue Code	320
Min. Negotiated Rate	$159.22
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) 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 INTRNL AUDIO MEATI CMP RGHT

Facility

$1,224.75

Service Code	HCPCS 70134RT
Hospital Charge Code	2011351
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR INTRODUCING TUBE

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2011130
Hospital Revenue Code	320
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

XR INTRODUCING TUBE

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2011130
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$380.40
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR INTRO-GUIDE DILATE NEPH TRT

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	2004927
Hospital Revenue Code	361
Min. Negotiated Rate	$1,280.25
Max. Negotiated Rate	$1,280.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25

XR INTRO-GUIDE DILATE NEPH TRT

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	2004927
Hospital Revenue Code	361
Min. Negotiated Rate	$1,109.55
Max. Negotiated Rate	$4,267.50
Rate for Payer: Aetna Commercial	$2,560.50
Rate for Payer: Aetna Medicare Advantage	$2,560.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,176.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,176.43
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	$2,176.43
Rate for Payer: Cigna Commercial	$4,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25

XR INTRO NDL/CATH EXT ART ADDL

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2011178
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

XR INTRO NDL/CATH EXT ART ADDL

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2011178
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR INTRO NDL/CATH EXTREM ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2011177
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR INTRO NDL/CATH EXTREM ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2011177
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

XR INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	5700195
Hospital Revenue Code	361
Min. Negotiated Rate	$135.49
Max. Negotiated Rate	$135.49
Rate for Payer: Qualcare PPO/HMO/WC	$135.49

XR INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	5700195
Hospital Revenue Code	361
Min. Negotiated Rate	$117.42
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$270.98
Rate for Payer: Aetna Medicare Advantage	$270.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.33
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	$230.33
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.42
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.49
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

XR IVP NEPHROTOMOGRAPHY

Facility

$1,198.45

Service Code	HCPCS 74415
Hospital Charge Code	2000792
Hospital Revenue Code	320
Min. Negotiated Rate	$179.77
Max. Negotiated Rate	$179.77
Rate for Payer: Qualcare PPO/HMO/WC	$179.77

XR IVP NEPHROTOMOGRAPHY

Facility

$1,198.45

Service Code	HCPCS 74415
Hospital Charge Code	2000792
Hospital Revenue Code	320
Min. Negotiated Rate	$154.28
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$359.54
Rate for Payer: Aetna Medicare Advantage	$359.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.60
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.80
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$179.77
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR KNEE 3 VIEWS BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356250
Hospital Charge Code	2011353
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
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) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
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 KNEE 3 VIEWS BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356250
Hospital Charge Code	2011353
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR KNEE BOTH STANDING AP

Facility

$5,100.00

Service Code	HCPCS 73565
Hospital Charge Code	2011120
Hospital Revenue Code	320
Min. Negotiated Rate	$48.23
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	$48.23
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 KNEE BOTH STANDING AP

Facility

$5,100.00

Service Code	HCPCS 73565
Hospital Charge Code	2011120
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR KNEE COMPLETE BILATERAL

Facility

$5,100.00

Service Code	HCPCS 7356450
Hospital Charge Code	2011354
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR KNEE COMPLETE BILATERAL

Facility

$5,100.00

Service Code	HCPCS 7356450
Hospital Charge Code	2011354
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 KNEE COMPLETE LEFT

Facility

$5,100.00

Service Code	HCPCS 73564LT
Hospital Charge Code	2011355
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 KNEE COMPLETE LEFT

Facility

$5,100.00

Service Code	HCPCS 73564LT
Hospital Charge Code	2011355
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