Heights University Hospital

All Charges

Charge

Type

Setting

Price

CTA HEAD W & W/O CONT

Facility

$9,500.00

Service Code	HCPCS 70496
Hospital Charge Code	2200001
Hospital Revenue Code	351
Min. Negotiated Rate	$345.95
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	$345.95
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

CTA HEAD W & W/O CONT

Facility

$9,500.00

Service Code	HCPCS 70496
Hospital Charge Code	2200001
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CTA LOW EXT WO/W CONT BILAT

Facility

$3,541.80

Service Code	HCPCS 7370650
Hospital Charge Code	2205314
Hospital Revenue Code	352
Min. Negotiated Rate	$460.43
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$1,062.54
Rate for Payer: Aetna Medicare Advantage	$1,062.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$903.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$903.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$903.16
Rate for Payer: Cigna Commercial	$1,770.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.43
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$531.27
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CTA LOW EXT WO/W CONT BILAT

Facility

$3,541.80

Service Code	HCPCS 7370650
Hospital Charge Code	2205314
Hospital Revenue Code	352
Min. Negotiated Rate	$531.27
Max. Negotiated Rate	$531.27
Rate for Payer: Qualcare PPO/HMO/WC	$531.27

CTA NECK W & W/O CONT

Facility

$9,500.00

Service Code	HCPCS 70498
Hospital Charge Code	2200002
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CTA NECK W & W/O CONT

Facility

$9,500.00

Service Code	HCPCS 70498
Hospital Charge Code	2200002
Hospital Revenue Code	351
Min. Negotiated Rate	$345.95
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	$345.95
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

CT ANGIO ABD AORTA&ILIOFEMORAL

Facility

$1,770.90

Service Code	HCPCS 75635
Hospital Charge Code	2205449
Hospital Revenue Code	352
Min. Negotiated Rate	$230.22
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$531.27
Rate for Payer: Aetna Medicare Advantage	$531.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.58
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.22
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.63
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT ANGIO ABD AORTA&ILIOFEMORAL

Facility

$1,770.90

Service Code	HCPCS 75635
Hospital Charge Code	2205449
Hospital Revenue Code	352
Min. Negotiated Rate	$265.63
Max. Negotiated Rate	$265.63
Rate for Payer: Qualcare PPO/HMO/WC	$265.63

CT ANGIO ABDMNL AORTA&BIL IFLE

Facility

$9,500.00

Service Code	HCPCS 75635
Hospital Charge Code	2207001
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

CT ANGIO ABDMNL AORTA&BIL IFLE

Facility

$9,500.00

Service Code	HCPCS 75635
Hospital Charge Code	2207001
Hospital Revenue Code	352
Min. Negotiated Rate	$344.08
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	$344.08
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

CT ANGIO ABDOM W/WO DYE

Facility

$9,500.00

Service Code	HCPCS 74175
Hospital Charge Code	2200065
Hospital Revenue Code	352
Min. Negotiated Rate	$317.90
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	$317.90
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

CT ANGIO ABDOM W/WO DYE

Facility

$9,500.00

Service Code	HCPCS 74175
Hospital Charge Code	2200065
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

CT ANGIO ABD W/ CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74175
Hospital Charge Code	2250407
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

CT ANGIO ABD W/ CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74175
Hospital Charge Code	2250407
Hospital Revenue Code	352
Min. Negotiated Rate	$317.90
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	$317.90
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

CT ANGIOGRAPH PELV W/WO DYE

Facility

$9,500.00

Service Code	HCPCS 72191
Hospital Charge Code	2200150
Hospital Revenue Code	352
Min. Negotiated Rate	$349.69
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	$349.69
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

CT ANGIOGRAPH PELV W/WO DYE

Facility

$9,500.00

Service Code	HCPCS 72191
Hospital Charge Code	2200150
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

CT ANGIOGRAPHY, CHEST

Facility

$9,500.00

Service Code	HCPCS 71275
Hospital Charge Code	2200003
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

CT ANGIOGRAPHY, CHEST

Facility

$9,500.00

Service Code	HCPCS 71275
Hospital Charge Code	2200003
Hospital Revenue Code	352
Min. Negotiated Rate	$327.12
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	$327.12
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

CT ANGIOGRAPHY HEAD (DUAL SIN)

Facility

$1,770.90

Service Code	HCPCS 70496
Hospital Charge Code	2205476
Hospital Revenue Code	351
Min. Negotiated Rate	$230.22
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$531.27
Rate for Payer: Aetna Medicare Advantage	$531.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.58
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.22
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.63
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT ANGIOGRAPHY HEAD (DUAL SIN)

Facility

$1,770.90

Service Code	HCPCS 70496
Hospital Charge Code	2205476
Hospital Revenue Code	351
Min. Negotiated Rate	$265.63
Max. Negotiated Rate	$265.63
Rate for Payer: Qualcare PPO/HMO/WC	$265.63

CT ANGIO LOWER EXT LT W/WO DYE

Facility

$1,770.90

Service Code	HCPCS 73706LT
Hospital Charge Code	2205309
Hospital Revenue Code	352
Min. Negotiated Rate	$230.22
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$531.27
Rate for Payer: Aetna Medicare Advantage	$531.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.58
Rate for Payer: Cigna Commercial	$885.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.22
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.63
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT ANGIO LOWER EXT LT W/WO DYE

Facility

$1,770.90

Service Code	HCPCS 73706LT
Hospital Charge Code	2205309
Hospital Revenue Code	352
Min. Negotiated Rate	$265.63
Max. Negotiated Rate	$265.63
Rate for Payer: Qualcare PPO/HMO/WC	$265.63

CT ANGIO LOWER EXT RT W/WO DYE

Facility

$1,770.90

Service Code	HCPCS 73706RT
Hospital Charge Code	2205311
Hospital Revenue Code	352
Min. Negotiated Rate	$230.22
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$531.27
Rate for Payer: Aetna Medicare Advantage	$531.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.58
Rate for Payer: Cigna Commercial	$885.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.22
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.63
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CT ANGIO LOWER EXT RT W/WO DYE

Facility

$1,770.90

Service Code	HCPCS 73706RT
Hospital Charge Code	2205311
Hospital Revenue Code	352
Min. Negotiated Rate	$265.63
Max. Negotiated Rate	$265.63
Rate for Payer: Qualcare PPO/HMO/WC	$265.63

CT ANGIO LOW EXT W/WO CON

Facility

$9,500.00

Service Code	HCPCS 73706
Hospital Charge Code	2209001
Hospital Revenue Code	352
Min. Negotiated Rate	$349.69
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Better Health Medicaid	$940.08
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	$349.69
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88

Know your out-of-pocket cost for care.

All Charges