Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR PERCUT KYPHOPLASTY LUMBAR

Facility

$15,443.85

Service Code	HCPCS 22525
Hospital Charge Code	2600200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$4,633.15
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
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	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,007.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

XR PERCUT KYPHOPLASTY LUMBAR

Facility

$15,443.85

Service Code	HCPCS 22525
Hospital Charge Code	2600200
Hospital Revenue Code	361
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

XR PERICARDIOCENTESIS INITI

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	2004075
Hospital Revenue Code	361
Min. Negotiated Rate	$394.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$911.05
Rate for Payer: Aetna Medicare Advantage	$911.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.40
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	$774.40
Rate for Payer: Cigna Commercial	$1,518.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.79
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

XR PERICARDIOCENTESIS INITI

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	2004075
Hospital Revenue Code	361
Min. Negotiated Rate	$455.53
Max. Negotiated Rate	$455.53
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

XR PERICARDIOCENTESIS SUBSEQ**

Facility

$162.00

Service Code	HCPCS 33011
Hospital Charge Code	2004083
Hospital Revenue Code	361
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$1,864.00
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	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.06
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

XR PERICARDIOCENTESIS SUBSEQ**

Facility

$162.00

Service Code	HCPCS 33011
Hospital Charge Code	2004083
Hospital Revenue Code	361
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

XR PERINEORAM

Facility

$906.25

Service Code	HCPCS 74775
Hospital Charge Code	2011372
Hospital Revenue Code	320
Min. Negotiated Rate	$135.94
Max. Negotiated Rate	$135.94
Rate for Payer: Qualcare PPO/HMO/WC	$135.94

XR PERINEORAM

Facility

$906.25

Service Code	HCPCS 74775
Hospital Charge Code	2011372
Hospital Revenue Code	320
Min. Negotiated Rate	$78.54
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$271.88
Rate for Payer: Aetna Medicare Advantage	$271.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.09
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.81
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.94
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR PERITONEOGRAM

Facility

$1,224.75

Service Code	HCPCS 74190
Hospital Charge Code	2011373
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR PERITONEOGRAM

Facility

$1,224.75

Service Code	HCPCS 74190
Hospital Charge Code	2011373
Hospital Revenue Code	320
Min. Negotiated Rate	$99.11
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) NJ Health	$99.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.31
Rate for Payer: Cigna Commercial	$1,301.24
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 PERQ RF ABLATE TX PUL TUMOR

Facility

$21,118.75

Service Code	HCPCS 32998
Hospital Charge Code	5600108
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,335.62
Rate for Payer: Aetna Medicare Advantage	$6,335.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.28
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	$5,385.28
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,745.44
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

XR PERQ RF ABLATE TX PUL TUMOR

Facility

$21,118.75

Service Code	HCPCS 32998
Hospital Charge Code	5600108
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.81
Max. Negotiated Rate	$3,167.81
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81

XR PHARX/LARX W/ FLO

Facility

$491.25

Service Code	HCPCS 70370
Hospital Charge Code	2000495
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$147.38
Rate for Payer: Aetna Medicare Advantage	$147.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.27
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.69
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR PHARX/LARX W/ FLO

Facility

$491.25

Service Code	HCPCS 70370
Hospital Charge Code	2000495
Hospital Revenue Code	320
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$73.69
Rate for Payer: Qualcare PPO/HMO/WC	$73.69

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	5600148
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	5600148
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	7411539
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	7411539
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	7411540
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	7411540
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	5600149
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	5600149
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR PHRYNX OR CERVICAL ESOPHAGS

Facility

$1,224.75

Service Code	HCPCS 74210
Hospital Charge Code	2011374
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR PHRYNX OR CERVICAL ESOPHAGS

Facility

$1,224.75

Service Code	HCPCS 74210
Hospital Charge Code	2011374
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
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) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.31
Rate for Payer: Cigna Commercial	$417.70
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 PLACE CECOSTOMY TUBE PERC

Facility

$5,547.05

Service Code	HCPCS 49442
Hospital Charge Code	5600161
Hospital Revenue Code	361
Min. Negotiated Rate	$721.12
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,664.12
Rate for Payer: Aetna Medicare Advantage	$1,664.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,414.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,414.50
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	$1,414.50
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$832.06
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Know your out-of-pocket cost for care.

All Charges