Heights University Hospital

All Charges

Charge

Type

Setting

Price

ABDOMEN WITH CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74160
Hospital Charge Code	2200046
Hospital Revenue Code	352
Min. Negotiated Rate	$312.87
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

ABDOMEN WITH CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74160
Hospital Charge Code	2200046
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMEN W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74150
Hospital Charge Code	2200053
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMEN W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74150
Hospital Charge Code	2200053
Hospital Revenue Code	352
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

ABDOMEN W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74170
Hospital Charge Code	2200061
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMEN W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74170
Hospital Charge Code	2200061
Hospital Revenue Code	352
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

ABDOMINAL AORTA

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	94061165
Hospital Revenue Code	402
Min. Negotiated Rate	$82.28
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

ABDOMINAL AORTA

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	94061165
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

ABDOMINAL AORTOGRAM

Facility

$13,077.65

Service Code	HCPCS 76525
Hospital Charge Code	1600000660
Hospital Revenue Code	360
Min. Negotiated Rate	$1,961.65
Max. Negotiated Rate	$1,961.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.65

ABDOMINAL AORTOGRAM

Facility

$21,359.77

Hospital Charge Code	2009045
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

ABDOMINAL AORTOGRAM

Facility

$13,077.65

Service Code	HCPCS 76525
Hospital Charge Code	1600000660
Hospital Revenue Code	360
Min. Negotiated Rate	$1,700.09
Max. Negotiated Rate	$6,538.82
Rate for Payer: Aetna Commercial	$3,923.30
Rate for Payer: Aetna Medicare Advantage	$3,923.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,334.80
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	$3,334.80
Rate for Payer: Cigna Commercial	$6,538.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,700.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.65

ABDOMINAL AORTOGRAM

Facility

$21,359.77

Hospital Charge Code	2009045
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,679.89
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$10,679.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ABDOMINAL BINDER 3PANEL 30-45

Facility

$38.55

Hospital Charge Code	270649881
Hospital Revenue Code	270
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$19.27
Rate for Payer: Aetna Commercial	$11.56
Rate for Payer: Aetna Medicare Advantage	$11.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.83
Rate for Payer: Cigna Commercial	$19.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.01
Rate for Payer: Oxford Commercial	$19.27
Rate for Payer: Qualcare PPO/HMO/WC	$5.78
Rate for Payer: UnitedHealthcare Commercial	$19.27

ABDOMINAL BINDER 3PANEL 30-45

Facility

$38.55

Hospital Charge Code	270649881
Hospital Revenue Code	270
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$5.78

ABDOMINAL BINDER 3PANEL 46-64

Facility

$38.95

Hospital Charge Code	270649882
Hospital Revenue Code	270
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.84

ABDOMINAL BINDER 3PANEL 46-64

Facility

$38.95

Hospital Charge Code	270649882
Hospital Revenue Code	270
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$19.48
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna Medicare Advantage	$11.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.93
Rate for Payer: Cigna Commercial	$19.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.06
Rate for Payer: Oxford Commercial	$19.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.84
Rate for Payer: UnitedHealthcare Commercial	$19.48

ABDOMINAL BINDER 3 PANEL 74-84

Facility

$51.55

Hospital Charge Code	270649883
Hospital Revenue Code	270
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$25.77
Rate for Payer: Aetna Commercial	$15.46
Rate for Payer: Aetna Medicare Advantage	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.15
Rate for Payer: Cigna Commercial	$25.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.70
Rate for Payer: Oxford Commercial	$25.77
Rate for Payer: Qualcare PPO/HMO/WC	$7.73
Rate for Payer: UnitedHealthcare Commercial	$25.77

ABDOMINAL BINDER 3 PANEL 74-84

Facility

$51.55

Hospital Charge Code	270649883
Hospital Revenue Code	270
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$7.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.73

ABDOMINAL MASS

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3000501
Hospital Revenue Code	310
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$207.63
Rate for Payer: Aetna Commercial	$207.63
Rate for Payer: Aetna Medicare Advantage	$207.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.49
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$39.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

ABDOMINAL MASS

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3000501
Hospital Revenue Code	310
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

ABDOMINAL PAIN

Facility

$6,454.53

Service Code	APR-DRG 2511
Min. Negotiated Rate	$4,721.10
Max. Negotiated Rate	$6,454.53
Rate for Payer: Aetna Better Health Medicaid	$6,327.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,454.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4,721.10

ABDOMINAL PAIN

Facility

$17,029.54

Service Code	APR-DRG 2514
Min. Negotiated Rate	$15,148.51
Max. Negotiated Rate	$17,029.54
Rate for Payer: Aetna Better Health Medicaid	$16,695.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,029.54
Rate for Payer: Wellpoint Medicaid Managed Care	$15,148.51

ABDOMINAL PAIN

Facility

$10,945.76

Service Code	APR-DRG 2513
Min. Negotiated Rate	$7,908.93
Max. Negotiated Rate	$10,945.76
Rate for Payer: Aetna Better Health Medicaid	$10,731.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,945.76
Rate for Payer: Wellpoint Medicaid Managed Care	$7,908.93

ABDOMINAL PAIN

Facility

$8,281.65

Service Code	APR-DRG 2512
Min. Negotiated Rate	$5,852.96
Max. Negotiated Rate	$8,281.65
Rate for Payer: Aetna Better Health Medicaid	$8,119.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,281.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5,852.96

ABDOMNAL AORTA W/ RUN-OFF

Facility

$6,122.00

Hospital Charge Code	2009050
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

Know your out-of-pocket cost for care.

All Charges