Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	7411575
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	2004034
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	5600154
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

XR PATELLA/KNEE 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73562LT
Hospital Charge Code	2001535
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 PATELLA/KNEE 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73562LT
Hospital Charge Code	2001535
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR PATELLA/KNEE 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73562RT
Hospital Charge Code	2001536
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 PATELLA/KNEE 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73562RT
Hospital Charge Code	2001536
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR PELVIMETRY

Facility

$698.45

Service Code	HCPCS 74710
Hospital Charge Code	2000818
Hospital Revenue Code	320
Min. Negotiated Rate	$104.77
Max. Negotiated Rate	$104.77
Rate for Payer: Qualcare PPO/HMO/WC	$104.77

XR PELVIMETRY

Facility

$698.45

Service Code	HCPCS 74710
Hospital Charge Code	2000818
Hospital Revenue Code	320
Min. Negotiated Rate	$90.80
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$209.53
Rate for Payer: Aetna Medicare Advantage	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.10
Rate for Payer: Cigna Commercial	$349.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.80
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.77
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR PELVIS 1 VIEW

Facility

$6,601.19

Service Code	HCPCS 72170
Hospital Charge Code	2000685
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR PELVIS 1 VIEW

Facility

$6,601.19

Service Code	HCPCS 72170
Hospital Charge Code	2000685
Hospital Revenue Code	320
Min. Negotiated Rate	$30.86
Max. Negotiated Rate	$1,980.36
Rate for Payer: Aetna Better Health Medicaid	$399.88
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	$248.96
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	$407.88

XR PELVIS 2 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72170
Hospital Charge Code	2000701
Hospital Revenue Code	320
Min. Negotiated Rate	$30.86
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	$30.86
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 PELVIS 2 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72170
Hospital Charge Code	2000701
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR PELVIS 3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72190
Hospital Charge Code	2000702
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR PELVIS 3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72190
Hospital Charge Code	2000702
Hospital Revenue Code	320
Min. Negotiated Rate	$37.40
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	$37.40
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 PELVIS & HIPS INFANT/CHILD

Facility

$258.70

Hospital Charge Code	2011371
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 PELVIS & HIPS INFANT/CHILD

Facility

$258.70

Hospital Charge Code	2011371
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR PERC PLACE IVC FILTER

Facility

$1,807.55

Hospital Charge Code	5600019
Hospital Revenue Code	320
Min. Negotiated Rate	$271.13
Max. Negotiated Rate	$271.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.13

XR PERC PLACE IVC FILTER

Facility

$1,807.55

Hospital Charge Code	5600019
Hospital Revenue Code	320
Min. Negotiated Rate	$234.98
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$542.26
Rate for Payer: Aetna Medicare Advantage	$542.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$460.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$460.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$460.93
Rate for Payer: Cigna Commercial	$903.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.98
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR PERCUT ABLATE LIVER RF

Facility

$21,118.85

Service Code	HCPCS 47382
Hospital Charge Code	5600153
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,335.65
Rate for Payer: Aetna Medicare Advantage	$6,335.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.31
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	$5,385.31
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,745.45
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

XR PERCUT ABLATE LIVER RF

Facility

$21,118.85

Service Code	HCPCS 47382
Hospital Charge Code	5600153
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,157.80

Service Code	HCPCS 36481
Hospital Charge Code	5600018
Hospital Revenue Code	361
Min. Negotiated Rate	$473.67
Max. Negotiated Rate	$473.67
Rate for Payer: Qualcare PPO/HMO/WC	$473.67

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,179.25

Service Code	HCPCS 36481
Hospital Charge Code	7411445
Hospital Revenue Code	361
Min. Negotiated Rate	$476.89
Max. Negotiated Rate	$476.89
Rate for Payer: Qualcare PPO/HMO/WC	$476.89

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,179.25

Service Code	HCPCS 36481
Hospital Charge Code	7411445
Hospital Revenue Code	361
Min. Negotiated Rate	$302.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$953.77
Rate for Payer: Aetna Medicare Advantage	$953.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$810.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$810.71
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	$810.71
Rate for Payer: Cigna Commercial	$302.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.89
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,157.80

Service Code	HCPCS 36481
Hospital Charge Code	5600018
Hospital Revenue Code	361
Min. Negotiated Rate	$302.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$947.34
Rate for Payer: Aetna Medicare Advantage	$947.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.24
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	$805.24
Rate for Payer: Cigna Commercial	$302.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.51
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$473.67
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges