Heights University Hospital

All Charges

Charge

Type

Setting

Price

CADASIL

Facility

$121.00

Hospital Charge Code	3035094T
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AA
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CADASIL

Facility

$128.00

Hospital Charge Code	3035094M
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$121.00

Hospital Charge Code	3035094S
Hospital Revenue Code	301
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$111.00

Hospital Charge Code	3035094AI
Hospital Revenue Code	301
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.30
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$111.00

Hospital Charge Code	3035094A
Hospital Revenue Code	301
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.30
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AG
Hospital Revenue Code	301
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$121.00

Hospital Charge Code	3035094T
Hospital Revenue Code	301
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$128.00

Hospital Charge Code	3035094H
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AF
Hospital Revenue Code	301
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$128.00

Hospital Charge Code	3035094K
Hospital Revenue Code	301
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$128.00

Hospital Charge Code	3035094M
Hospital Revenue Code	301
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AA
Hospital Revenue Code	301
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$155.70
Rate for Payer: Qualcare PPO/HMO/WC	$155.70

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$134.94
Max. Negotiated Rate	$3,989.00
Rate for Payer: Aetna Commercial	$311.40
Rate for Payer: Aetna Medicare Advantage	$311.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.69
Rate for Payer: Cigna Commercial	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.94
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.70
Rate for Payer: UnitedHealthcare Commercial	$3,989.00

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

CADEXOMER IODINE 0.9% GEL

Facility

$918.30

Service Code	NDC 40565012249
Hospital Charge Code	60630080
Hospital Revenue Code	250
Min. Negotiated Rate	$137.75
Max. Negotiated Rate	$137.75
Rate for Payer: Qualcare PPO/HMO/WC	$137.75

CADEXOMER IODINE 0.9% GEL

Facility

$918.30

Service Code	NDC 40565012249
Hospital Charge Code	60630080
Hospital Revenue Code	250
Min. Negotiated Rate	$119.38
Max. Negotiated Rate	$459.15
Rate for Payer: Aetna Commercial	$275.49
Rate for Payer: Aetna Medicare Advantage	$275.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.17
Rate for Payer: Cigna Commercial	$459.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.38
Rate for Payer: Oxford Commercial	$459.15
Rate for Payer: Qualcare PPO/HMO/WC	$137.75
Rate for Payer: UnitedHealthcare Commercial	$459.15

CADEXOMER IODINE 40 GM GEL

Facility

$95.75

Hospital Charge Code	60630016
Hospital Revenue Code	250
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$47.88
Rate for Payer: Aetna Commercial	$28.73
Rate for Payer: Aetna Medicare Advantage	$28.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.42
Rate for Payer: Cigna Commercial	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.45
Rate for Payer: Oxford Commercial	$47.88
Rate for Payer: Qualcare PPO/HMO/WC	$14.36
Rate for Payer: UnitedHealthcare Commercial	$47.88

CADEXOMER IODINE 40 GM GEL

Facility

$95.75

Hospital Charge Code	60630016
Hospital Revenue Code	250
Min. Negotiated Rate	$14.36
Max. Negotiated Rate	$14.36
Rate for Payer: Qualcare PPO/HMO/WC	$14.36

CAD FOR DIAG MAMMO

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	94061443
Hospital Revenue Code	401
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

CAD FOR DIAG MAMMO

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	94061443
Hospital Revenue Code	401
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

CADIUM (URINE)

Facility

$200.85

Service Code	HCPCS 82300
Hospital Charge Code	3031069
Hospital Revenue Code	301
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

CADIUM (URINE)

Facility

$200.85

Service Code	HCPCS 82300
Hospital Charge Code	3031069
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

Know your out-of-pocket cost for care.

All Charges