Heights University Hospital

All Charges

Charge

Type

Setting

Price

INS CATH REN ART 1ST UNILAT

Facility

$12,462.85

Service Code	HCPCS 36251
Hospital Charge Code	411036251
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 UNILAT

Facility

$12,462.85

Service Code	HCPCS 36251
Hospital Charge Code	411036251
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 DRL SLV3.5/2.5m4808-035-02

Facility

$344.00

Hospital Charge Code	270634936
Hospital Revenue Code	272
Min. Negotiated Rate	$44.72
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$103.20
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.60
Rate for Payer: UnitedHealthcare Commercial	$172.00

INS DRL SLV3.5/2.5m4808-035-02

Facility

$344.00

Hospital Charge Code	270634936
Hospital Revenue Code	272
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

INSECT VEN, PAPER WASP

Facility

$46.25

Hospital Charge Code	3035148
Hospital Revenue Code	301
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

INSECT VEN, PAPER WASP

Facility

$46.25

Hospital Charge Code	3035148
Hospital Revenue Code	301
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.88
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$114.00

INSER PERIPH STENT S&I NON-COR

Facility

$1,648.00

Hospital Charge Code	5100340
Hospital Revenue Code	320
Min. Negotiated Rate	$247.20
Max. Negotiated Rate	$247.20
Rate for Payer: Qualcare PPO/HMO/WC	$247.20

INSER PERIPH STENT S&I NON-COR

Facility

$1,648.00

Hospital Charge Code	5100340
Hospital Revenue Code	320
Min. Negotiated Rate	$214.24
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$494.40
Rate for Payer: Aetna Medicare Advantage	$494.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.24
Rate for Payer: Cigna Commercial	$824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.24
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INSER PIC LINE FLURO/ULTRA S&I

Facility

$608.00

Service Code	HCPCS 36489
Hospital Charge Code	5100575
Hospital Revenue Code	320
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INSER PIC LINE FLURO/ULTRA S&I

Facility

$608.00

Service Code	HCPCS 36489
Hospital Charge Code	5100575
Hospital Revenue Code	320
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

INSERT 12X63/62 183622

Facility

$4,975.00

Hospital Charge Code	270639115
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

INSERT 12X63/62 183622

Facility

$4,975.00

Hospital Charge Code	270639115
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

INSERT 12x63/67 183722

Facility

$5,370.00

Hospital Charge Code	270639168
Hospital Revenue Code	272
Min. Negotiated Rate	$698.10
Max. Negotiated Rate	$2,685.00
Rate for Payer: Aetna Commercial	$1,611.00
Rate for Payer: Aetna Medicare Advantage	$1,611.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,369.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,369.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,369.35
Rate for Payer: Cigna Commercial	$2,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.10
Rate for Payer: Oxford Commercial	$2,685.00
Rate for Payer: Qualcare PPO/HMO/WC	$805.50
Rate for Payer: UnitedHealthcare Commercial	$2,685.00

INSERT 12x63/67 183722

Facility

$5,370.00

Hospital Charge Code	270639168
Hospital Revenue Code	272
Min. Negotiated Rate	$805.50
Max. Negotiated Rate	$805.50
Rate for Payer: Qualcare PPO/HMO/WC	$805.50

INSERT 12 X 67 11146532

Facility

$4,459.10

Hospital Charge Code	270633958
Hospital Revenue Code	272
Min. Negotiated Rate	$668.87
Max. Negotiated Rate	$668.87
Rate for Payer: Qualcare PPO/HMO/WC	$668.87

INSERT 12 X 67 11146532

Facility

$4,459.10

Hospital Charge Code	270633958
Hospital Revenue Code	272
Min. Negotiated Rate	$579.68
Max. Negotiated Rate	$2,229.55
Rate for Payer: Aetna Commercial	$1,337.73
Rate for Payer: Aetna Medicare Advantage	$1,337.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.07
Rate for Payer: Cigna Commercial	$2,229.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.68
Rate for Payer: Oxford Commercial	$2,229.55
Rate for Payer: Qualcare PPO/HMO/WC	$668.87
Rate for Payer: UnitedHealthcare Commercial	$2,229.55

INSERT 12x71/75 183742

Facility

$3,750.00

Hospital Charge Code	270638692
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

INSERT 12x71/75 183742

Facility

$3,750.00

Hospital Charge Code	270638692
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$1,875.00

INSERT 14 X 63

Facility

$4,720.00

Hospital Charge Code	270637515
Hospital Revenue Code	272
Min. Negotiated Rate	$708.00
Max. Negotiated Rate	$708.00
Rate for Payer: Qualcare PPO/HMO/WC	$708.00

INSERT 14 X 63

Facility

$4,720.00

Hospital Charge Code	270637515
Hospital Revenue Code	272
Min. Negotiated Rate	$613.60
Max. Negotiated Rate	$2,360.00
Rate for Payer: Aetna Commercial	$1,416.00
Rate for Payer: Aetna Medicare Advantage	$1,416.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,203.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,203.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,203.60
Rate for Payer: Cigna Commercial	$2,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.60
Rate for Payer: Oxford Commercial	$2,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$708.00
Rate for Payer: UnitedHealthcare Commercial	$2,360.00

INSERT 1 ELECT PM-DEFIB REPEAT

Facility

$27,329.78

Service Code	HCPCS 3321678
Hospital Charge Code	5100820
Hospital Revenue Code	480
Min. Negotiated Rate	$4,099.47
Max. Negotiated Rate	$4,099.47
Rate for Payer: Qualcare PPO/HMO/WC	$4,099.47

INSERT 1 ELECT PM-DEFIB REPEAT

Facility

$27,329.78

Service Code	HCPCS 3321678
Hospital Charge Code	5100820
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$13,664.89
Rate for Payer: Aetna Commercial	$8,198.93
Rate for Payer: Aetna Medicare Advantage	$8,198.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,969.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,969.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,969.09
Rate for Payer: Cigna Commercial	$13,664.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,552.87
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,099.47
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

INSERT 1 ELECTRODE PM-DEFIB

Facility

$27,329.78

Service Code	HCPCS 33216
Hospital Charge Code	5100819
Hospital Revenue Code	480
Min. Negotiated Rate	$282.90
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Better Health Medicaid	$961.87
Rate for Payer: Aetna Commercial	$8,198.93
Rate for Payer: Aetna Medicare Advantage	$8,198.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,969.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,969.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,969.09
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,552.87
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,099.47
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$981.11

INSERT 1 ELECTRODE PM-DEFIB

Facility

$27,329.78

Service Code	HCPCS 33216
Hospital Charge Code	5100819
Hospital Revenue Code	480
Min. Negotiated Rate	$4,099.47
Max. Negotiated Rate	$4,099.47
Rate for Payer: Qualcare PPO/HMO/WC	$4,099.47

INSERT AND REMOVE BONE PIN

Facility

$15,297.50

Service Code	HCPCS 20650
Hospital Charge Code	5701010
Hospital Revenue Code	450
Min. Negotiated Rate	$94.42
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,589.25
Rate for Payer: Aetna Medicare Advantage	$4,589.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,900.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,900.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,900.86
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,988.67
Rate for Payer: Qualcare PPO/HMO/WC	$2,294.62

Know your out-of-pocket cost for care.

All Charges