Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXTRCTR PRO RPD 15-18M00547020

Facility

$742.00

Hospital Charge Code	270646921
Hospital Revenue Code	272
Min. Negotiated Rate	$96.46
Max. Negotiated Rate	$371.00
Rate for Payer: Aetna Commercial	$222.60
Rate for Payer: Aetna Medicare Advantage	$222.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.21
Rate for Payer: Cigna Commercial	$371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.46
Rate for Payer: Oxford Commercial	$371.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.30
Rate for Payer: UnitedHealthcare Commercial	$371.00

EXTREM ANGIO-BILAT

Facility

$21,359.77

Hospital Charge Code	2009065
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

EXTREM ANGIO-BILAT

Facility

$21,359.77

Hospital Charge Code	2009065
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,679.89
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$10,679.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREM ARTERIO-UNILAT

Facility

$6,122.00

Hospital Charge Code	2009055
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

EXTREM ARTERIO-UNILAT

Facility

$6,122.00

Hospital Charge Code	2009055
Hospital Revenue Code	323
Min. Negotiated Rate	$795.86
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$1,836.60
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$795.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE

Facility

$200,414.12

Service Code	MSDRG 790
Min. Negotiated Rate	$4,037.00
Max. Negotiated Rate	$200,414.12
Rate for Payer: Aetna Commercial	$200,414.12
Rate for Payer: Aetna Medicare Advantage	$64,858.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165,402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165,402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61,445.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165,402.00
Rate for Payer: Cigna Commercial	$127,910.06
Rate for Payer: Cigna Medicare Advantage	$61,445.57
Rate for Payer: Clover Medicare Advantage	$58,373.29
Rate for Payer: EmblemHealth Commercial	$184,336.71
Rate for Payer: Humana Medicare Advantage	$63,288.94
Rate for Payer: Oxford Commercial	$4,037.00
Rate for Payer: UnitedHealthcare Commercial	$4,582.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$61,445.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$65,132.30
Rate for Payer: Wellcare Medicare Advantage	$61,445.57

EXTREMITY ANGIOGRAM-BILAT

Facility

$21,359.77

Service Code	HCPCS 75716
Hospital Charge Code	7411149
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

EXTREMITY ANGIOGRAM-BILAT

Facility

$21,359.77

Service Code	HCPCS 75716
Hospital Charge Code	7411149
Hospital Revenue Code	323
Min. Negotiated Rate	$235.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$6,407.93
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	321075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	366875710L
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	366875710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$6,122.00

Service Code	HCPCS 75710LT
Hospital Charge Code	7412002
Hospital Revenue Code	323
Min. Negotiated Rate	$795.86
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$1,836.60
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$795.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-LT

Facility

$6,122.00

Service Code	HCPCS 75710LT
Hospital Charge Code	7412002
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	2691865
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	321075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	411075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	411075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	2691865
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-RT

Facility

$6,122.00

Service Code	HCPCS 75710RT
Hospital Charge Code	7412003
Hospital Revenue Code	323
Min. Negotiated Rate	$795.86
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$1,836.60
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$795.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	411075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	2691870
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	321075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	411075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	321075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	366875710R
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

Know your out-of-pocket cost for care.

All Charges