Heights University Hospital

All Charges

Charge

Type

Setting

Price

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	7411930
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	366837226L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	7411930
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	321037226L
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	2691390
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	321037226L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	2691390
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-LT

Facility

$75,737.34

Service Code	HCPCS 37226LT
Hospital Charge Code	366837226L
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	366837226R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	2691395
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	7411931
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	321037226R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	7411931
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	2691395
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	321037226R
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM-POP STENT W/PTA-RT

Facility

$75,737.34

Service Code	HCPCS 37226RT
Hospital Charge Code	366837226R
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

FEM POR CR 72.5M LT 183073

Facility

$17,420.00

Hospital Charge Code	270640763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$4,215.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEM POR CR 72.5M LT 183073

Facility

$17,420.00

Hospital Charge Code	270640763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$8,710.00
Rate for Payer: Aetna Commercial	$5,226.00
Rate for Payer: Aetna Medicare Advantage	$5,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,442.10
Rate for Payer: Cigna Commercial	$8,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEM POROUS CR 75MM RT 183054

Facility

$17,420.00

Hospital Charge Code	270640761
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$8,710.00
Rate for Payer: Aetna Commercial	$5,226.00
Rate for Payer: Aetna Medicare Advantage	$5,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,442.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,442.10
Rate for Payer: Cigna Commercial	$8,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEM POROUS CR 75MM RT 183054

Facility

$17,420.00

Hospital Charge Code	270640761
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.00
Max. Negotiated Rate	$4,215.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,215.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.00

FEM PS INTERLOK 75MM LT 183134

Facility

$15,770.00

Hospital Charge Code	270640577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,365.50
Max. Negotiated Rate	$7,885.00
Rate for Payer: Aetna Commercial	$4,731.00
Rate for Payer: Aetna Medicare Advantage	$4,731.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,021.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,021.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,021.35
Rate for Payer: Cigna Commercial	$7,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,816.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,365.50

FEM PS INTERLOK 75MM LT 183134

Facility

$15,770.00

Hospital Charge Code	270640577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,365.50
Max. Negotiated Rate	$3,816.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,816.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,365.50

FEM PSN PS CMT CCR STD SZ 10L

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698387
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEM PSN PS CMT CCR STD SZ 10L

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698387
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEMRL FPP NC ECHO POR 12X 40MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691841
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

Know your out-of-pocket cost for care.

All Charges