Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$737.17
Max. Negotiated Rate	$737.17
Rate for Payer: Qualcare PPO/HMO/WC	$737.17

XR MYELOGRAM CERVICAL

Facility

$3,577.65

Service Code	HCPCS 72240
Hospital Charge Code	2004372
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,866.82
Rate for Payer: Aetna Commercial	$1,073.30
Rate for Payer: Aetna Medicare Advantage	$1,073.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.30
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	$912.30
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.09
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$536.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR MYELOGRAM CERVICAL

Facility

$3,577.65

Service Code	HCPCS 72240
Hospital Charge Code	2004372
Hospital Revenue Code	320
Min. Negotiated Rate	$536.65
Max. Negotiated Rate	$536.65
Rate for Payer: Qualcare PPO/HMO/WC	$536.65

XR MYELOGRAM ENTIRE

Facility

$3,672.00

Service Code	HCPCS 72270
Hospital Charge Code	2002095
Hospital Revenue Code	320
Min. Negotiated Rate	$157.08
Max. Negotiated Rate	$1,866.82
Rate for Payer: Aetna Better Health Medicaid	$595.10
Rate for Payer: Aetna Commercial	$1,101.60
Rate for Payer: Aetna Medicare Advantage	$1,101.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$936.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$936.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$936.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$550.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00

XR MYELOGRAM ENTIRE

Facility

$3,672.00

Service Code	HCPCS 72270
Hospital Charge Code	2002095
Hospital Revenue Code	320
Min. Negotiated Rate	$550.80
Max. Negotiated Rate	$550.80
Rate for Payer: Qualcare PPO/HMO/WC	$550.80

XR MYELOGRAM LUMBOSACRAL

Facility

$5,100.00

Service Code	HCPCS 72265
Hospital Charge Code	2000735
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR MYELOGRAM LUMBOSACRAL

Facility

$5,100.00

Service Code	HCPCS 72265
Hospital Charge Code	2000735
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,866.82
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	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,866.82
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 MYELOGRAM THORACIC

Facility

$2,839.25

Service Code	HCPCS 72255
Hospital Charge Code	2004364
Hospital Revenue Code	320
Min. Negotiated Rate	$425.89
Max. Negotiated Rate	$425.89
Rate for Payer: Qualcare PPO/HMO/WC	$425.89

XR MYELOGRAM THORACIC

Facility

$2,839.25

Service Code	HCPCS 72255
Hospital Charge Code	2004364
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,866.82
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
Rate for Payer: Aetna Commercial	$851.77
Rate for Payer: Aetna Medicare Advantage	$851.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$724.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$724.01
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	$724.01
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$425.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

XR MYELOGRAPHY LUMBOSACRAL

Facility

$1,033.95

Service Code	HCPCS 72265
Hospital Charge Code	2011365
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,866.82
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) NJ Health	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.66
Rate for Payer: Cigna Commercial	$1,866.82
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 MYELOGRAPHY LUMBOSACRAL

Facility

$1,033.95

Service Code	HCPCS 72265
Hospital Charge Code	2011365
Hospital Revenue Code	320
Min. Negotiated Rate	$155.09
Max. Negotiated Rate	$155.09
Rate for Payer: Qualcare PPO/HMO/WC	$155.09

XR MYELOGRAPHY POSTERIOR FOSSA

Facility

$1,033.95

Service Code	HCPCS 70010
Hospital Charge Code	2011366
Hospital Revenue Code	320
Min. Negotiated Rate	$155.09
Max. Negotiated Rate	$155.09
Rate for Payer: Qualcare PPO/HMO/WC	$155.09

XR MYELOGRAPHY POSTERIOR FOSSA

Facility

$1,033.95

Service Code	HCPCS 70010
Hospital Charge Code	2011366
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) NJ Health	$167.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.66
Rate for Payer: Cigna Commercial	$830.80
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 NASAL BONES MIN 3 VWS

Facility

$6,601.19

Service Code	HCPCS 70160
Hospital Charge Code	2000370
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR NASAL BONES MIN 3 VWS

Facility

$6,601.19

Service Code	HCPCS 70160
Hospital Charge Code	2000370
Hospital Revenue Code	320
Min. Negotiated Rate	$30.86
Max. Negotiated Rate	$1,980.36
Rate for Payer: Aetna Better Health Medicaid	$212.34
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	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$207.24
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

XR NASAL/ORGASTRIC W/STENT

Facility

$572.10

Service Code	HCPCS 43752
Hospital Charge Code	5600150
Hospital Revenue Code	361
Min. Negotiated Rate	$85.81
Max. Negotiated Rate	$85.81
Rate for Payer: Qualcare PPO/HMO/WC	$85.81

XR NASAL/ORGASTRIC W/STENT

Facility

$572.10

Service Code	HCPCS 43752
Hospital Charge Code	7411546
Hospital Revenue Code	361
Min. Negotiated Rate	$74.37
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$171.63
Rate for Payer: Aetna Medicare Advantage	$171.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.89
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	$145.89
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.37
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.81
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR NASAL/ORGASTRIC W/STENT

Facility

$572.10

Service Code	HCPCS 43752
Hospital Charge Code	7411546
Hospital Revenue Code	361
Min. Negotiated Rate	$85.81
Max. Negotiated Rate	$85.81
Rate for Payer: Qualcare PPO/HMO/WC	$85.81

XR NASAL/ORGASTRIC W/STENT

Facility

$572.10

Service Code	HCPCS 43752
Hospital Charge Code	5600150
Hospital Revenue Code	361
Min. Negotiated Rate	$74.37
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$171.63
Rate for Payer: Aetna Medicare Advantage	$171.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.89
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	$145.89
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.37
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.81
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR NECK SOFT TISSUE

Facility

$6,601.19

Service Code	HCPCS 70360
Hospital Charge Code	2000487
Hospital Revenue Code	320
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$1,980.36
Rate for Payer: Aetna Better Health Medicaid	$212.34
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	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$207.24
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

XR NECK SOFT TISSUE

Facility

$6,601.19

Service Code	HCPCS 70360
Hospital Charge Code	2000487
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR NEEDLE BIOPSY PLEURA

Facility

$4,350.20

Service Code	HCPCS 32400
Hospital Charge Code	5600103
Hospital Revenue Code	361
Min. Negotiated Rate	$565.53
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,305.06
Rate for Payer: Aetna Medicare Advantage	$1,305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.30
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	$1,109.30
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.53
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.53
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR NEEDLE BIOPSY PLEURA

Facility

$4,350.20

Service Code	HCPCS 32400
Hospital Charge Code	5600103
Hospital Revenue Code	361
Min. Negotiated Rate	$652.53
Max. Negotiated Rate	$652.53
Rate for Payer: Qualcare PPO/HMO/WC	$652.53

XR NEEDLE BIOPSY PLEURA PER***

Facility

$162.00

Service Code	HCPCS 32400
Hospital Charge Code	2004133
Hospital Revenue Code	361
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

XR NEEDLE BIOPSY PLEURA PER***

Facility

$162.00

Service Code	HCPCS 32400
Hospital Charge Code	2004133
Hospital Revenue Code	361
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
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	$41.31
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.06
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Know your out-of-pocket cost for care.

All Charges