Heights University Hospital

All Charges

Charge

Type

Setting

Price

IN.PACT Admiral 6x200

Facility

$10,725.00

Service Code	HCPCS C2623
Hospital Charge Code	270684957
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$2,595.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

IN.PACT ADMIRAL 6X200

Facility

$10,725.00

Service Code	HCPCS C2623
Hospital Charge Code	270684957S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$5,362.50
Rate for Payer: Aetna Commercial	$3,217.50
Rate for Payer: Aetna Medicare Advantage	$3,217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,734.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,734.88
Rate for Payer: Cigna Commercial	$5,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

IN.PACT ADMIRAL 6X200

Facility

$10,725.00

Service Code	HCPCS C2623
Hospital Charge Code	270684957S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.75
Max. Negotiated Rate	$2,595.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,595.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.75

IN.PACT Admiral 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$2,855.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT Admiral 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$5,900.00
Rate for Payer: Aetna Commercial	$3,540.00
Rate for Payer: Aetna Medicare Advantage	$3,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,009.00
Rate for Payer: Cigna Commercial	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT Admiral 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$2,855.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT Admiral 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$5,900.00
Rate for Payer: Aetna Commercial	$3,540.00
Rate for Payer: Aetna Medicare Advantage	$3,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,009.00
Rate for Payer: Cigna Commercial	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT ADMIRAL 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$5,900.00
Rate for Payer: Aetna Commercial	$3,540.00
Rate for Payer: Aetna Medicare Advantage	$3,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,009.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,009.00
Rate for Payer: Cigna Commercial	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT ADMIRAL 6x250

Facility

$11,800.00

Service Code	HCPCS C2623
Hospital Charge Code	270684958S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,770.00
Max. Negotiated Rate	$2,855.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,770.00

IN.PACT Admiral DCB 40mm

Facility

$7,050.00

Service Code	HCPCS C2623
Hospital Charge Code	270686203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

IN.PACT Admiral DCB 40mm

Facility

$7,050.00

Service Code	HCPCS C2623
Hospital Charge Code	270686203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

INR STRIP

Facility

$390.00

Service Code	HCPCS 85610
Hospital Charge Code	87502750
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INR STRIP

Facility

$390.00

Service Code	HCPCS 85610
Hospital Charge Code	87502750
Hospital Revenue Code	305
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.90
Rate for Payer: Aetna Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.55
Rate for Payer: Wellcare Medicare Advantage	$4.29

INS CATH ABD/L-EXT ART 1ST

Facility

$3,632.92

Service Code	HCPCS 36245
Hospital Charge Code	16000580
Hospital Revenue Code	360
Min. Negotiated Rate	$544.94
Max. Negotiated Rate	$544.94
Rate for Payer: Qualcare PPO/HMO/WC	$544.94

INS CATH ABD/L-EXT ART 1ST

Facility

$3,632.92

Service Code	HCPCS 36245
Hospital Charge Code	16000580
Hospital Revenue Code	360
Min. Negotiated Rate	$222.90
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,089.88
Rate for Payer: Aetna Medicare Advantage	$1,089.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$926.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$926.39
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	$926.39
Rate for Payer: Cigna Commercial	$222.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$472.28
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.94
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INS CATH ABD/L-EXT ART 1ST

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	366836245
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$222.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INS CATH ABD/L-EXT ART 1ST

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	366836245
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

INS CATH ABD/L-EXT ART ADDL

Facility

$484.00

Service Code	HCPCS 36248
Hospital Charge Code	366836248
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

INS CATH ABD/L-EXT ART ADDL

Facility

$2,620.78

Service Code	HCPCS 36248
Hospital Charge Code	16000733
Hospital Revenue Code	360
Min. Negotiated Rate	$393.12
Max. Negotiated Rate	$393.12
Rate for Payer: Qualcare PPO/HMO/WC	$393.12

INS CATH ABD/L-EXT ART ADDL

Facility

$484.00

Service Code	HCPCS 36248
Hospital Charge Code	366836248
Hospital Revenue Code	361
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INS CATH ABD/L-EXT ART ADDL

Facility

$2,620.78

Service Code	HCPCS 36248
Hospital Charge Code	16000733
Hospital Revenue Code	360
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$786.23
Rate for Payer: Aetna Medicare Advantage	$786.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$668.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$668.30
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	$668.30
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.12
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	411036252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Better Health Medicaid	$7,075.29
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	411036252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	366836252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	366836252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Better Health Medicaid	$7,075.29
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

Know your out-of-pocket cost for care.

All Charges