Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANGIO AV SHUNT COMPLETE

Facility

$1,310.20

Service Code	HCPCS 75791
Hospital Charge Code	5100652
Hospital Revenue Code	350
Min. Negotiated Rate	$196.53
Max. Negotiated Rate	$196.53
Rate for Payer: Qualcare PPO/HMO/WC	$196.53

ANGIO AV SHUNT COMPLETE

Facility

$1,310.20

Service Code	HCPCS 75791
Hospital Charge Code	5100652
Hospital Revenue Code	350
Min. Negotiated Rate	$170.33
Max. Negotiated Rate	$2,773.00
Rate for Payer: Aetna Commercial	$393.06
Rate for Payer: Aetna Medicare Advantage	$393.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.10
Rate for Payer: Cigna Commercial	$655.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.33
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.53
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

ANGIO AV SHUNT S&I

Facility

$1,268.00

Hospital Charge Code	5100346
Hospital Revenue Code	323
Min. Negotiated Rate	$164.84
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$380.40
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ANGIO AV SHUNT S&I

Facility

$1,268.00

Hospital Charge Code	5100346
Hospital Revenue Code	323
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

ANGIO CAROTID/CERVICAL UNI S&I

Facility

$1,453.45

Service Code	HCPCS 75676
Hospital Charge Code	5100343
Hospital Revenue Code	323
Min. Negotiated Rate	$188.95
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$436.04
Rate for Payer: Aetna Medicare Advantage	$436.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.63
Rate for Payer: Cigna Commercial	$726.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.95
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.02
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ANGIO CAROTID/CERVICAL UNI S&I

Facility

$1,453.45

Service Code	HCPCS 75676
Hospital Charge Code	5100343
Hospital Revenue Code	323
Min. Negotiated Rate	$218.02
Max. Negotiated Rate	$218.02
Rate for Payer: Qualcare PPO/HMO/WC	$218.02

ANGIOCATH 14G *******

Facility

$10.00

Hospital Charge Code	7000565
Hospital Revenue Code	279
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

ANGIOCATH 14G *******

Facility

$10.00

Hospital Charge Code	7000565
Hospital Revenue Code	279
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

ANGIOCATH 14GAX2 381167

Facility

$16.85

Hospital Charge Code	270620471
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

ANGIOCATH 14GAX2 381167

Facility

$16.85

Hospital Charge Code	270620471
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

ANGIOCATH 14GX1-1/4

Facility

$2.15

Hospital Charge Code	270651391
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.32

ANGIOCATH 14GX1-1/4

Facility

$2.15

Hospital Charge Code	270651391
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$1.07
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.55
Rate for Payer: Cigna Commercial	$1.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.28
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.32
Rate for Payer: UnitedHealthcare Commercial	$1.07

ANGIOCATH 16G - 24G****

Facility

$11.00

Hospital Charge Code	7000557
Hospital Revenue Code	279
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

ANGIOCATH 16G - 24G****

Facility

$11.00

Hospital Charge Code	7000557
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

ANGIOCATH 16G 2 IN

Facility

$11.25

Hospital Charge Code	270041005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

ANGIOCATH 16G 2 IN

Facility

$11.25

Hospital Charge Code	270041005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

ANGIOCATH 16G 5-1/4 YELLOW

Facility

$66.00

Hospital Charge Code	270311614
Hospital Revenue Code	272
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

ANGIOCATH 16G 5-1/4 YELLOW

Facility

$66.00

Hospital Charge Code	270311614
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

ANGIOCATH 16G 5-1/4YELLOW

Facility

$66.00

Hospital Charge Code	270331614
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

ANGIOCATH 16G 5-1/4YELLOW

Facility

$66.00

Hospital Charge Code	270331614
Hospital Revenue Code	272
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

ANGIOCATH 16GAX2 381157

Facility

$16.85

Hospital Charge Code	270620472
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

ANGIOCATH 16GAX2 381157

Facility

$16.85

Hospital Charge Code	270620472
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

ANGIOCATH 16G INSYTE AUTOGUARD

Facility

$8.71

Hospital Charge Code	270645440
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

ANGIOCATH 16G INSYTE AUTOGUARD

Facility

$8.71

Hospital Charge Code	270645440
Hospital Revenue Code	270
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$4.36

ANGIOCATH 18G 1 1/4 IN

Facility

$24.21

Hospital Charge Code	270041004
Hospital Revenue Code	272
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$3.63

Know your out-of-pocket cost for care.

All Charges