Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR TRANSCATH STENT CCA W/EPS

Facility

IP

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	2600147
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/EPS

Facility

IP

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	7411508
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

IR TRANSCATH STENT CCA W/EPS

Facility

OP

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	321037215
Hospital Revenue Code	361
Min. Negotiated Rate	$371.98
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,865.30
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,630.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$371.98
Rate for Payer: Wellpoint Medicaid Managed Care	$409.03

IR TRANSCATH STENT CCA W/EPS

Facility

IP

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	2600146
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

IR TRANSCATH STENT CCA W/O EPS

Facility

IP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	7411509
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/O EPS

Facility

OP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	411037216
Hospital Revenue Code	361
Min. Negotiated Rate	$371.98
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,865.30
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,630.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$371.98
Rate for Payer: Wellpoint Medicaid Managed Care	$409.03

IR TRANSCATH STENT CCA W/O EPS

Facility

OP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	7411509
Hospital Revenue Code	361
Min. Negotiated Rate	$371.98
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,865.30
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,630.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$371.98
Rate for Payer: Wellpoint Medicaid Managed Care	$409.03

IR TRANSCATH STENT CCA W/O EPS

Facility

IP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	411037216
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/O EPS

Facility

IP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	2600152
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/O EPS

Facility

OP

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	2600152
Hospital Revenue Code	361
Min. Negotiated Rate	$371.98
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,865.30
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,630.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$371.98
Rate for Payer: Wellpoint Medicaid Managed Care	$409.03

IR TRANSCATH THERAPY

Facility

IP

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2101169
Hospital Revenue Code	320
Min. Negotiated Rate	$499.12
Max. Negotiated Rate	$499.12
Rate for Payer: Qualcare PPO/HMO/WC	$499.12

IR TRANSCATH THERAPY

Facility

OP

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2101169
Hospital Revenue Code	320
Min. Negotiated Rate	$80.19
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,264.45
Rate for Payer: Aetna Medicare Advantage	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$487.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.51
Rate for Payer: Cigna Commercial	$1,663.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$499.12
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$80.19
Rate for Payer: Wellpoint Medicaid Managed Care	$88.18

IR-TRANSCATH THERAPY

Facility

IP

$4,119.00

Hospital Charge Code	2690100
Hospital Revenue Code	761
Min. Negotiated Rate	$617.85
Max. Negotiated Rate	$617.85
Rate for Payer: Qualcare PPO/HMO/WC	$617.85

IR-TRANSCATH THERAPY

Facility

OP

$4,119.00

Hospital Charge Code	2690100
Hospital Revenue Code	761
Min. Negotiated Rate	$99.27
Max. Negotiated Rate	$2,059.50
Rate for Payer: Aetna Commercial	$1,565.22
Rate for Payer: Aetna Medicare Advantage	$1,235.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,050.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,050.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,050.35
Rate for Payer: Cigna Commercial	$2,059.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.70
Rate for Payer: Oxford Commercial	$823.80
Rate for Payer: Qualcare PPO/HMO/WC	$617.85
Rate for Payer: UnitedHealthcare Commercial	$823.80
Rate for Payer: UnitedHealthcare Community & State	$99.27
Rate for Payer: Wellpoint Medicaid Managed Care	$109.15

IR TRANSCATH THERAPY INFUSION

Facility

OP

$2,998.75

Service Code	HCPCS 75896
Hospital Charge Code	2011169
Hospital Revenue Code	320
Min. Negotiated Rate	$72.27
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,139.53
Rate for Payer: Aetna Medicare Advantage	$899.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.68
Rate for Payer: Cigna Commercial	$1,499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$899.62
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$449.81
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$72.27
Rate for Payer: Wellpoint Medicaid Managed Care	$79.47

IR TRANSCATH THERAPY INFUSION

Facility

IP

$2,998.75

Service Code	HCPCS 75896
Hospital Charge Code	2011169
Hospital Revenue Code	320
Min. Negotiated Rate	$449.81
Max. Negotiated Rate	$449.81
Rate for Payer: Qualcare PPO/HMO/WC	$449.81

IR TRANSCATH THER RAD SUP EM

Facility

IP

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2011172
Hospital Revenue Code	320
Min. Negotiated Rate	$499.12
Max. Negotiated Rate	$499.12
Rate for Payer: Qualcare PPO/HMO/WC	$499.12

IR TRANSCATH THER RAD SUP EM

Facility

OP

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2011172
Hospital Revenue Code	320
Min. Negotiated Rate	$80.19
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,264.45
Rate for Payer: Aetna Medicare Advantage	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$487.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.51
Rate for Payer: Cigna Commercial	$1,663.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$499.12
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$80.19
Rate for Payer: Wellpoint Medicaid Managed Care	$88.18

IR TRANSCERVICAL CATH FALLOPTU

Facility

OP

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	2680315
Hospital Revenue Code	320
Min. Negotiated Rate	$19.47
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$307.04
Rate for Payer: Aetna Medicare Advantage	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.04
Rate for Payer: Cigna Commercial	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$19.47
Rate for Payer: Wellpoint Medicaid Managed Care	$21.41

IR TRANSCERVICAL CATH FALLOPTU

Facility

OP

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$19.47
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$307.04
Rate for Payer: Aetna Medicare Advantage	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.04
Rate for Payer: Cigna Commercial	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$19.47
Rate for Payer: Wellpoint Medicaid Managed Care	$21.41

IR TRANSCERVICAL CATH FALLOPTU

Facility

IP

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSCERVICAL CATH FALLOPTU

Facility

IP

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	2680315
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSHEPATIC CHOLANGIO

Facility

IP

$1,631.25

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$244.69
Max. Negotiated Rate	$244.69
Rate for Payer: Qualcare PPO/HMO/WC	$244.69

IR TRANSHEPATIC CHOLANGIO

Facility

OP

$1,631.25

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$39.31
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$619.88
Rate for Payer: Aetna Medicare Advantage	$489.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.97
Rate for Payer: Cigna Commercial	$815.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.38
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.69
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$39.31
Rate for Payer: Wellpoint Medicaid Managed Care	$43.23

IR TRANSL PERI ATHERECT PER TI

Facility

IP

$13,876.00

Service Code	HCPCS 35495
Hospital Charge Code	2680165
Hospital Revenue Code	361
Min. Negotiated Rate	$2,081.40
Max. Negotiated Rate	$2,081.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.40