Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR MASTOIDS < 3 VIEWS RIGHT

Facility

$258.70

Service Code	HCPCS 70120RT
Hospital Charge Code	2011361
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR MASTOIDS < 3 VIEWS RIGHT

Facility

$258.70

Service Code	HCPCS 70120RT
Hospital Charge Code	2011361
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
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) PPO	$65.97
Rate for Payer: Cigna Commercial	$129.35
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

XR MASTOIDS COMPLETE BILETERAL

Facility

$1,398.50

Service Code	HCPCS 7013050
Hospital Charge Code	2011362
Hospital Revenue Code	320
Min. Negotiated Rate	$181.81
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$419.55
Rate for Payer: Aetna Medicare Advantage	$419.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$356.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$356.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$356.62
Rate for Payer: Cigna Commercial	$699.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.81
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$209.78
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR MASTOIDS COMPLETE BILETERAL

Facility

$1,398.50

Service Code	HCPCS 7013050
Hospital Charge Code	2011362
Hospital Revenue Code	320
Min. Negotiated Rate	$209.78
Max. Negotiated Rate	$209.78
Rate for Payer: Qualcare PPO/HMO/WC	$209.78

XR MASTOIDS COMPLETE LEFT

Facility

$699.25

Service Code	HCPCS 70130LT
Hospital Charge Code	2011363
Hospital Revenue Code	320
Min. Negotiated Rate	$90.90
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$209.78
Rate for Payer: Aetna Medicare Advantage	$209.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.31
Rate for Payer: Cigna Commercial	$349.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR MASTOIDS COMPLETE LEFT

Facility

$699.25

Service Code	HCPCS 70130LT
Hospital Charge Code	2011363
Hospital Revenue Code	320
Min. Negotiated Rate	$104.89
Max. Negotiated Rate	$104.89
Rate for Payer: Qualcare PPO/HMO/WC	$104.89

XR MASTOIDS COMPLETE RIGHT

Facility

$699.25

Service Code	HCPCS 70130RT
Hospital Charge Code	2011364
Hospital Revenue Code	320
Min. Negotiated Rate	$90.90
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$209.78
Rate for Payer: Aetna Medicare Advantage	$209.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.31
Rate for Payer: Cigna Commercial	$349.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR MASTOIDS COMPLETE RIGHT

Facility

$699.25

Service Code	HCPCS 70130RT
Hospital Charge Code	2011364
Hospital Revenue Code	320
Min. Negotiated Rate	$104.89
Max. Negotiated Rate	$104.89
Rate for Payer: Qualcare PPO/HMO/WC	$104.89

XR MASTOIDS COMP STUDY

Facility

$699.25

Service Code	HCPCS 70130
Hospital Charge Code	2000438
Hospital Revenue Code	320
Min. Negotiated Rate	$45.95
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$209.78
Rate for Payer: Aetna Medicare Advantage	$209.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.31
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR MASTOIDS COMP STUDY

Facility

$699.25

Service Code	HCPCS 70130
Hospital Charge Code	2000438
Hospital Revenue Code	320
Min. Negotiated Rate	$104.89
Max. Negotiated Rate	$104.89
Rate for Payer: Qualcare PPO/HMO/WC	$104.89

XR MECH REMOV TUNN CV CATH

Facility

$11,315.45

Service Code	HCPCS 36595
Hospital Charge Code	7411475
Hospital Revenue Code	361
Min. Negotiated Rate	$1,471.01
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,394.64
Rate for Payer: Aetna Medicare Advantage	$3,394.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,885.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,885.44
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	$2,885.44
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.01
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.32
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR MECH REMOV TUNN CV CATH

Facility

$15,468.50

Service Code	HCPCS 36595
Hospital Charge Code	5600138
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR MECH REMOV TUNN CV CATH

Facility

$15,468.50

Service Code	HCPCS 36595
Hospital Charge Code	5600138
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

XR MECH REMOV TUNN CV CATH

Facility

$15,468.50

Service Code	HCPCS 36595
Hospital Charge Code	321036595
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

XR MECH REMOV TUNN CV CATH

Facility

$11,315.45

Service Code	HCPCS 36595
Hospital Charge Code	7411475
Hospital Revenue Code	361
Min. Negotiated Rate	$1,697.32
Max. Negotiated Rate	$1,697.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.32

XR MECH REMOV TUNN CV CATH

Facility

$15,468.50

Service Code	HCPCS 36595
Hospital Charge Code	321036595
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$6,404.20

Service Code	HCPCS 36596
Hospital Charge Code	5600139
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

XR MEC REMOV TUN CV CATH LUMEN

Facility

$6,404.20

Service Code	HCPCS 36596
Hospital Charge Code	321036596
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$6,404.20

Service Code	HCPCS 36596
Hospital Charge Code	5600139
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$4,914.50

Service Code	HCPCS 36596
Hospital Charge Code	366836596
Hospital Revenue Code	361
Min. Negotiated Rate	$638.88
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,474.35
Rate for Payer: Aetna Medicare Advantage	$1,474.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,253.20
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	$1,253.20
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$5,025.35

Service Code	HCPCS 36596
Hospital Charge Code	7411476
Hospital Revenue Code	361
Min. Negotiated Rate	$753.80
Max. Negotiated Rate	$753.80
Rate for Payer: Qualcare PPO/HMO/WC	$753.80

XR MEC REMOV TUN CV CATH LUMEN

Facility

$5,025.35

Service Code	HCPCS 36596
Hospital Charge Code	7411476
Hospital Revenue Code	361
Min. Negotiated Rate	$653.30
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,507.61
Rate for Payer: Aetna Medicare Advantage	$1,507.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.46
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	$1,281.46
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.30
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$753.80
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$4,914.50

Service Code	HCPCS 36596
Hospital Charge Code	411036596
Hospital Revenue Code	361
Min. Negotiated Rate	$638.88
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,474.35
Rate for Payer: Aetna Medicare Advantage	$1,474.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,253.20
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	$1,253.20
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

XR MEC REMOV TUN CV CATH LUMEN

Facility

$4,914.50

Service Code	HCPCS 36596
Hospital Charge Code	411036596
Hospital Revenue Code	361
Min. Negotiated Rate	$737.17
Max. Negotiated Rate	$737.17
Rate for Payer: Qualcare PPO/HMO/WC	$737.17

XR MEC REMOV TUN CV CATH LUMEN

Facility

$6,404.20

Service Code	HCPCS 36596
Hospital Charge Code	321036596
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

Know your out-of-pocket cost for care.

All Charges