Heights University Hospital

All Charges

Charge

Type

Setting

Price

BIT ZIM DR QC 2.5MM 241025

Facility

$299.25

Hospital Charge Code	270601276
Hospital Revenue Code	272
Min. Negotiated Rate	$38.90
Max. Negotiated Rate	$149.62
Rate for Payer: Aetna Commercial	$89.78
Rate for Payer: Aetna Medicare Advantage	$89.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.31
Rate for Payer: Cigna Commercial	$149.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.90
Rate for Payer: Oxford Commercial	$149.62
Rate for Payer: Qualcare PPO/HMO/WC	$44.89
Rate for Payer: UnitedHealthcare Commercial	$149.62

BIT ZIM DR QC 2.5MM 241025

Facility

$299.25

Hospital Charge Code	270601276
Hospital Revenue Code	272
Min. Negotiated Rate	$44.89
Max. Negotiated Rate	$44.89
Rate for Payer: Qualcare PPO/HMO/WC	$44.89

BIT ZIM DR QC 3.5/195MM 241036

Facility

$224.00

Hospital Charge Code	270620811
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

BIT ZIM DR QC 3.5/195MM 241036

Facility

$224.00

Hospital Charge Code	270620811
Hospital Revenue Code	272
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$67.20
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$112.00

BIT ZIM DR QC 3.5MM 241035

Facility

$256.00

Hospital Charge Code	270601278
Hospital Revenue Code	272
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

BIT ZIM DR QC 3.5MM 241035

Facility

$256.00

Hospital Charge Code	270601278
Hospital Revenue Code	272
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$76.80
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$128.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$128.00

BIT ZIM DR QC 4.5/145MM 241045

Facility

$248.85

Hospital Charge Code	270605981
Hospital Revenue Code	272
Min. Negotiated Rate	$32.35
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$74.66
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.35
Rate for Payer: Oxford Commercial	$124.42
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Commercial	$124.42

BIT ZIM DR QC 4.5/145MM 241045

Facility

$248.85

Hospital Charge Code	270605981
Hospital Revenue Code	272
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

BK/JC VIRUS DNA,QL PCR I

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118A
Hospital Revenue Code	306
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

BK/JC VIRUS DNA,QL PCR I

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK/JC VIRUS DNA,QL PCR II

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK/JC VIRUS DNA,QL PCR II

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118B
Hospital Revenue Code	306
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

BK VIRUS DNA,QL RT-PCR,PL

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900404
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK VIRUS DNA,QL RT-PCR,PL

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900404
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

BK VIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900306
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK VIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900306
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$138.80
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.97
Rate for Payer: Cigna Commercial	$42.84
Rate for Payer: Cigna Medicare Advantage	$21.42
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

BLADDER INSTILLATION

Facility

$1,252.20

Service Code	HCPCS 51720
Hospital Charge Code	93500001
Hospital Revenue Code	761
Min. Negotiated Rate	$187.83
Max. Negotiated Rate	$187.83
Rate for Payer: Qualcare PPO/HMO/WC	$187.83

BLADDER INSTILLATION

Facility

$1,252.20

Service Code	HCPCS 51720
Hospital Charge Code	93500001
Hospital Revenue Code	761
Min. Negotiated Rate	$162.79
Max. Negotiated Rate	$1,660.53
Rate for Payer: Aetna Commercial	$375.66
Rate for Payer: Aetna Medicare Advantage	$375.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.31
Rate for Payer: Cigna Commercial	$1,660.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.79
Rate for Payer: Oxford Commercial	$626.10
Rate for Payer: Qualcare PPO/HMO/WC	$187.83
Rate for Payer: UnitedHealthcare Commercial	$626.10

BLADDER IRRIGATION

Facility

$1,253.65

Service Code	HCPCS 51700
Hospital Charge Code	93500183
Hospital Revenue Code	361
Min. Negotiated Rate	$162.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$376.10
Rate for Payer: Aetna Medicare Advantage	$376.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.68
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	$319.68
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.05
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

BLADDER IRRIGATION

Facility

$1,253.65

Service Code	HCPCS 51700
Hospital Charge Code	93500183
Hospital Revenue Code	361
Min. Negotiated Rate	$188.05
Max. Negotiated Rate	$188.05
Rate for Payer: Qualcare PPO/HMO/WC	$188.05

BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION

Facility

$1,864.00

Service Code	CPT 51700
Hospital Revenue Code	360
Min. Negotiated Rate	$594.98
Max. Negotiated Rate	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

BLADDER WASHING

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005346
Hospital Revenue Code	311
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$79.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.54
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

BLADDER WASHING

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005346
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

BLADE 18.6 X 5.5 MM

Facility

$32.85

Hospital Charge Code	270664985
Hospital Revenue Code	270
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$4.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.93

BLADE 18.6 X 5.5 MM

Facility

$32.85

Hospital Charge Code	270664985
Hospital Revenue Code	270
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$16.43
Rate for Payer: Aetna Commercial	$9.86
Rate for Payer: Aetna Medicare Advantage	$9.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.38
Rate for Payer: Cigna Commercial	$16.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.27
Rate for Payer: Oxford Commercial	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$4.93
Rate for Payer: UnitedHealthcare Commercial	$16.43

Know your out-of-pocket cost for care.

All Charges