Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR NEEDLE BIOPSY RENAL PERC

Facility

$7,071.40

Service Code	HCPCS 50200
Hospital Charge Code	2004547
Hospital Revenue Code	361
Min. Negotiated Rate	$919.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.42
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR NEEDLE BIOPSY RENAL PERC

Facility

$7,071.40

Service Code	HCPCS 50200
Hospital Charge Code	2004547
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

XR NEEDLE BX LIVER ADD ON

Facility

$2,500.00

Service Code	HCPCS 47001
Hospital Charge Code	7411554
Hospital Revenue Code	361
Min. Negotiated Rate	$99.89
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
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	$637.50
Rate for Payer: Cigna Commercial	$99.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR NEEDLE BX LIVER ADD ON

Facility

$2,500.00

Service Code	HCPCS 47001
Hospital Charge Code	7411554
Hospital Revenue Code	361
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

XR NEEDLE BX LIVER ADD ON

Facility

$2,500.00

Service Code	HCPCS 47001
Hospital Charge Code	5600152
Hospital Revenue Code	361
Min. Negotiated Rate	$99.89
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
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	$637.50
Rate for Payer: Cigna Commercial	$99.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR NEEDLE BX LIVER ADD ON

Facility

$2,500.00

Service Code	HCPCS 47001
Hospital Charge Code	5600152
Hospital Revenue Code	361
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

XR NEEDLE BX LYMPH NODES

Facility

$8,054.80

Service Code	HCPCS 38505
Hospital Charge Code	5700150
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR NEEDLE BX LYMPH NODES

Facility

$8,054.80

Service Code	HCPCS 38505
Hospital Charge Code	5700150
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

XR NEEDLE BX LYMPH NODES

Facility

$8,054.80

Service Code	HCPCS 38505
Hospital Charge Code	321038505
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

XR NEEDLE BX LYMPH NODES

Facility

$6,202.00

Service Code	HCPCS 38505
Hospital Charge Code	7411544
Hospital Revenue Code	361
Min. Negotiated Rate	$806.26
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,860.60
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.26
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.30
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR NEEDLE BX LYMPH NODES

Facility

$8,054.80

Service Code	HCPCS 38505
Hospital Charge Code	321038505
Hospital Revenue Code	361
Min. Negotiated Rate	$1,047.12
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,416.44
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR NEEDLE BX LYMPH NODES

Facility

$6,202.00

Service Code	HCPCS 38505
Hospital Charge Code	7411544
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

XR OPTIC FORAMINA RIGHT

Facility

$376.85

Service Code	HCPCS 70190RT
Hospital Charge Code	2011367
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 OPTIC FORAMINA RIGHT

Facility

$376.85

Service Code	HCPCS 70190RT
Hospital Charge Code	2011367
Hospital Revenue Code	320
Min. Negotiated Rate	$56.53
Max. Negotiated Rate	$56.53
Rate for Payer: Qualcare PPO/HMO/WC	$56.53

XR OPTIC FORAMINE

Facility

$376.85

Service Code	HCPCS 70190
Hospital Charge Code	2000446
Hospital Revenue Code	320
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$242.34
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) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.10
Rate for Payer: Cigna Commercial	$207.24
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$247.19

XR OPTIC FORAMINE

Facility

$376.85

Service Code	HCPCS 70190
Hospital Charge Code	2000446
Hospital Revenue Code	320
Min. Negotiated Rate	$56.53
Max. Negotiated Rate	$56.53
Rate for Payer: Qualcare PPO/HMO/WC	$56.53

XR ORBITS COMPLETE BILATERAL

Facility

$258.70

Service Code	HCPCS 70200
Hospital Charge Code	2011368
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$248.96
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR ORBITS COMPLETE BILATERAL

Facility

$258.70

Service Code	HCPCS 70200
Hospital Charge Code	2011368
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR ORBITS COMPLETE RIGHT

Facility

$258.70

Service Code	HCPCS 70200
Hospital Charge Code	2011369
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR ORBITS COMPLETE RIGHT

Facility

$258.70

Service Code	HCPCS 70200
Hospital Charge Code	2011369
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$248.96
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR ORBITS COMPL MIN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70200
Hospital Charge Code	2000453
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ORBITS COMPL MIN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70200
Hospital Charge Code	2000453
Hospital Revenue Code	320
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
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	$46.75
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	$407.88

XR PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	5600154
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
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	$617.78
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

XR PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	2004034
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

XR PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	7411575
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
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	$617.78
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Know your out-of-pocket cost for care.

All Charges