Heights University Hospital

All Charges

Charge

Type

Setting

Price

EVASC RPR A-AO NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34702
Hospital Charge Code	2004952
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	321034706
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$2,202.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	2004956
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$2,202.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	321034706
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	2004956
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	2004953
Hospital Revenue Code	361
Min. Negotiated Rate	$1,332.16
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,332.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	321034703
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	2004953
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	321034703
Hospital Revenue Code	361
Min. Negotiated Rate	$1,332.16
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,332.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	2004954
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	321034704
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$2,165.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	321034704
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	2004954
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$2,165.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	321034707
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	2004957
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	321034707
Hospital Revenue Code	361
Min. Negotiated Rate	$1,131.86
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,131.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	2004957
Hospital Revenue Code	361
Min. Negotiated Rate	$1,131.86
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,131.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	2004958
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,769.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	321034708
Hospital Revenue Code	361
Min. Negotiated Rate	$1,764.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,071.00
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
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	$3,460.35
Rate for Payer: Cigna Commercial	$1,769.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	2004958
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	321034708
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC VEN ARTLZ TIBL/PRNL VN

Facility

$98,874.75

Service Code	HCPCS 0620T
Hospital Charge Code	41100620T
Hospital Revenue Code	360
Min. Negotiated Rate	$14,831.21
Max. Negotiated Rate	$14,831.21
Rate for Payer: Qualcare PPO/HMO/WC	$14,831.21

EVASC VEN ARTLZ TIBL/PRNL VN

Facility

$98,874.75

Service Code	HCPCS 0620T
Hospital Charge Code	41100620T
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$29,662.42
Rate for Payer: Aetna Commercial	$29,662.42
Rate for Payer: Aetna Medicare Advantage	$29,662.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,213.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,213.06
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	$25,213.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,853.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,831.21
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

EVENT MONITORING

Facility

$2,613.70

Service Code	HCPCS 93228
Hospital Charge Code	74116014
Hospital Revenue Code	731
Min. Negotiated Rate	$392.06
Max. Negotiated Rate	$392.06
Rate for Payer: Qualcare PPO/HMO/WC	$392.06

EVENT MONITORING

Facility

$2,613.70

Service Code	HCPCS 93228
Hospital Charge Code	74116014
Hospital Revenue Code	731
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$784.11
Rate for Payer: Aetna Medicare Advantage	$784.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$666.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$666.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$666.49
Rate for Payer: Cigna Commercial	$27.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.78
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$392.06
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

Know your out-of-pocket cost for care.

All Charges