Heights University Hospital

All Charges

Charge

Type

Setting

Price

ENDOVENOUS RF 1ST VEIN

Facility

$17,623.95

Service Code	HCPCS 36475
Hospital Charge Code	421036475
Hospital Revenue Code	761
Min. Negotiated Rate	$2,643.59
Max. Negotiated Rate	$2,643.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	5600119
Hospital Revenue Code	361
Min. Negotiated Rate	$3,811.02
Max. Negotiated Rate	$3,811.02
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	1600000571
Hospital Revenue Code	360
Min. Negotiated Rate	$3,811.02
Max. Negotiated Rate	$3,811.02
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02

ENDOVENOUS RF 1ST VEIN

Facility

$17,623.95

Service Code	HCPCS 36475
Hospital Charge Code	421036475
Hospital Revenue Code	761
Min. Negotiated Rate	$1,408.17
Max. Negotiated Rate	$8,811.98
Rate for Payer: Aetna Commercial	$5,287.19
Rate for Payer: Aetna Medicare Advantage	$5,287.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,408.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,494.11
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,291.11
Rate for Payer: Oxford Commercial	$8,811.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59
Rate for Payer: UnitedHealthcare Commercial	$8,811.98

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	1600000571
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,622.04
Rate for Payer: Aetna Commercial	$7,622.04
Rate for Payer: Aetna Medicare Advantage	$7,622.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,478.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,478.73
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	$6,478.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,302.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	5600120
Hospital Revenue Code	361
Min. Negotiated Rate	$126.27
Max. Negotiated Rate	$2,991.29
Rate for Payer: Aetna Commercial	$2,991.29
Rate for Payer: Aetna Medicare Advantage	$2,991.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.59
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	$2,542.59
Rate for Payer: Cigna Commercial	$126.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,296.22
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	1600000573
Hospital Revenue Code	360
Min. Negotiated Rate	$1,495.64
Max. Negotiated Rate	$1,495.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	1600000573
Hospital Revenue Code	360
Min. Negotiated Rate	$126.27
Max. Negotiated Rate	$2,991.29
Rate for Payer: Aetna Commercial	$2,991.29
Rate for Payer: Aetna Medicare Advantage	$2,991.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.59
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	$2,542.59
Rate for Payer: Cigna Commercial	$126.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,296.22
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	5600120
Hospital Revenue Code	361
Min. Negotiated Rate	$1,495.64
Max. Negotiated Rate	$1,495.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64

ENDOVENOUS RF VEIN ADD-ON

Facility

$17,623.95

Service Code	HCPCS 36476
Hospital Charge Code	421036476
Hospital Revenue Code	761
Min. Negotiated Rate	$2,643.59
Max. Negotiated Rate	$2,643.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59

ENDOVENOUS RF VEIN ADD-ON

Facility

$17,623.95

Service Code	HCPCS 36476
Hospital Charge Code	421036476
Hospital Revenue Code	761
Min. Negotiated Rate	$126.27
Max. Negotiated Rate	$8,811.98
Rate for Payer: Aetna Commercial	$5,287.19
Rate for Payer: Aetna Medicare Advantage	$5,287.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,494.11
Rate for Payer: Cigna Commercial	$126.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,291.11
Rate for Payer: Oxford Commercial	$8,811.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59
Rate for Payer: UnitedHealthcare Commercial	$8,811.98

ENDOVEN THER CHEM ADHES 1ST

Facility

$29,358.35

Service Code	HCPCS 36482
Hospital Charge Code	421036482
Hospital Revenue Code	761
Min. Negotiated Rate	$4,403.75
Max. Negotiated Rate	$4,403.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75

ENDOVEN THER CHEM ADHES 1ST

Facility

$29,358.35

Service Code	HCPCS 36482
Hospital Charge Code	421036482
Hospital Revenue Code	761
Min. Negotiated Rate	$1,281.15
Max. Negotiated Rate	$14,679.17
Rate for Payer: Aetna Commercial	$8,807.50
Rate for Payer: Aetna Medicare Advantage	$8,807.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,281.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,486.38
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,816.59
Rate for Payer: Oxford Commercial	$14,679.17
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75
Rate for Payer: UnitedHealthcare Commercial	$14,679.17

ENDOVEN THER CHEM ADHES SBSQ

Facility

$29,358.35

Service Code	HCPCS 36483
Hospital Charge Code	421036483
Hospital Revenue Code	761
Min. Negotiated Rate	$4,403.75
Max. Negotiated Rate	$4,403.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75

ENDOVEN THER CHEM ADHES SBSQ

Facility

$29,358.35

Service Code	HCPCS 36483
Hospital Charge Code	421036483
Hospital Revenue Code	761
Min. Negotiated Rate	$85.44
Max. Negotiated Rate	$14,679.17
Rate for Payer: Aetna Commercial	$8,807.50
Rate for Payer: Aetna Medicare Advantage	$8,807.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,486.38
Rate for Payer: Cigna Commercial	$85.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,816.59
Rate for Payer: Oxford Commercial	$14,679.17
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75
Rate for Payer: UnitedHealthcare Commercial	$14,679.17

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$40.95
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.75
Rate for Payer: Oxford Commercial	$68.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$68.25

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$40.95
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.75
Rate for Payer: Oxford Commercial	$68.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$68.25

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$40.95
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.75
Rate for Payer: Oxford Commercial	$68.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$68.25

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOWRISTONE SUCTION IRRIGATOR

Facility

$6,600.00

Hospital Charge Code	270664010
Hospital Revenue Code	270
Min. Negotiated Rate	$858.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$1,980.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.00
Rate for Payer: Oxford Commercial	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Commercial	$3,300.00

ENDOWRISTONE SUCTION IRRIGATOR

Facility

$6,600.00

Hospital Charge Code	270664010
Hospital Revenue Code	270
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$118.08
Max. Negotiated Rate	$454.15
Rate for Payer: Aetna Commercial	$272.49
Rate for Payer: Aetna Medicare Advantage	$272.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.62
Rate for Payer: Cigna Commercial	$454.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.08
Rate for Payer: Oxford Commercial	$454.15
Rate for Payer: Qualcare PPO/HMO/WC	$136.25
Rate for Payer: UnitedHealthcare Commercial	$454.15

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$136.25
Max. Negotiated Rate	$136.25
Rate for Payer: Qualcare PPO/HMO/WC	$136.25

Know your out-of-pocket cost for care.

All Charges