Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSERT FOR MDM LINER 22.2MM 38

Facility

$4,055.65

Service Code	HCPCS C1776
Hospital Charge Code	270681379
Hospital Revenue Code	278
Min. Negotiated Rate	$608.35
Max. Negotiated Rate	$981.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$811.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$981.47
Rate for Payer: Qualcare PPO/HMO/WC	$608.35

INSERT HEPATIC SHUNT (TIPS)

Facility

$48,530.72

Service Code	HCPCS 37182
Hospital Charge Code	16000430
Hospital Revenue Code	360
Min. Negotiated Rate	$7,279.61
Max. Negotiated Rate	$7,279.61
Rate for Payer: Qualcare PPO/HMO/WC	$7,279.61

INSERT HEPATIC SHUNT (TIPS)

Facility

$48,530.72

Service Code	HCPCS 37182
Hospital Charge Code	16000430
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$14,559.22
Rate for Payer: Aetna Medicare Advantage	$14,559.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,375.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,375.33
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	$12,375.33
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,308.99
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,279.61
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

INSERT HUMERAL FLEX SYS 36MM

Facility

$6,787.50

Service Code	HCPCS C1776
Hospital Charge Code	270698765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,018.12
Max. Negotiated Rate	$1,642.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,642.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,018.12

INSERT HUMERAL FLEX SYS 36MM

Facility

$6,787.50

Service Code	HCPCS C1776
Hospital Charge Code	270698765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,018.12
Max. Negotiated Rate	$3,393.75
Rate for Payer: Aetna Commercial	$2,036.25
Rate for Payer: Aetna Medicare Advantage	$2,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,730.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,730.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,357.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,730.81
Rate for Payer: Cigna Commercial	$3,393.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,642.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,018.12

INSERT HUNT BIPOLAR LONG *****

Facility

$224.00

Hospital Charge Code	1605658
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

INSERT HUNT BIPOLAR LONG *****

Facility

$224.00

Hospital Charge Code	1605658
Hospital Revenue Code	272
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$67.20
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$112.00

INSERT HUNT MACRO BIPOLAR ****

Facility

$224.00

Hospital Charge Code	1605633
Hospital Revenue Code	272
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$67.20
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$112.00

INSERT HUNT MACRO BIPOLAR ****

Facility

$224.00

Hospital Charge Code	1605633
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

INSERT INTRA AORTIC BALLN PERC

Facility

$6,070.00

Service Code	HCPCS 33967
Hospital Charge Code	5100313
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

INSERT INTRA AORTIC BALLN PERC

Facility

$3,932.20

Service Code	HCPCS 33967
Hospital Charge Code	74110037
Hospital Revenue Code	480
Min. Negotiated Rate	$589.83
Max. Negotiated Rate	$589.83
Rate for Payer: Qualcare PPO/HMO/WC	$589.83

INSERT INTRA AORTIC BALLN PERC

Facility

$6,070.00

Service Code	HCPCS 33967
Hospital Charge Code	5100313
Hospital Revenue Code	480
Min. Negotiated Rate	$142.60
Max. Negotiated Rate	$1,821.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$242.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

INSERT INTRA AORTIC BALLN PERC

Facility

$3,932.20

Service Code	HCPCS 33967
Hospital Charge Code	74110037
Hospital Revenue Code	480
Min. Negotiated Rate	$142.60
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$1,179.66
Rate for Payer: Aetna Medicare Advantage	$1,179.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,002.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,002.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,002.71
Rate for Payer: Cigna Commercial	$242.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.19
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$589.83
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

INSERT INTRACRANIAL PRESSURE M

Facility

$9,489.90

Service Code	HCPCS 61107
Hospital Charge Code	83120005
Hospital Revenue Code	361
Min. Negotiated Rate	$1,423.48
Max. Negotiated Rate	$1,423.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,423.48

INSERT INTRACRANIAL PRESSURE M

Facility

$9,489.90

Service Code	HCPCS 61107
Hospital Charge Code	83120005
Hospital Revenue Code	361
Min. Negotiated Rate	$311.55
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,846.97
Rate for Payer: Aetna Medicare Advantage	$2,846.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,419.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,419.92
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	$2,419.92
Rate for Payer: Cigna Commercial	$311.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,423.48
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INSERTION BILIARY DRAIN

Facility

$331.55

Service Code	HCPCS 47510
Hospital Charge Code	5100505
Hospital Revenue Code	361
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INSERTION BILIARY DRAIN

Facility

$331.55

Service Code	HCPCS 47510
Hospital Charge Code	5100505
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INSERTION BILIARY DR TUBE S&I

Facility

$2,149.80

Service Code	HCPCS 75982
Hospital Charge Code	5100506
Hospital Revenue Code	320
Min. Negotiated Rate	$322.47
Max. Negotiated Rate	$322.47
Rate for Payer: Qualcare PPO/HMO/WC	$322.47

INSERTION BILIARY DR TUBE S&I

Facility

$2,149.80

Service Code	HCPCS 75982
Hospital Charge Code	5100506
Hospital Revenue Code	320
Min. Negotiated Rate	$279.47
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$644.94
Rate for Payer: Aetna Medicare Advantage	$644.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$548.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$548.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$548.20
Rate for Payer: Cigna Commercial	$1,074.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.47
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$322.47
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

INSERTION BILIARY STENT S&I

Facility

$1,670.40

Service Code	HCPCS 74363
Hospital Charge Code	5100507
Hospital Revenue Code	278
Min. Negotiated Rate	$250.56
Max. Negotiated Rate	$404.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.24
Rate for Payer: Qualcare PPO/HMO/WC	$250.56

INSERTION BILIARY STENT S&I

Facility

$1,670.40

Service Code	HCPCS 74363
Hospital Charge Code	5100507
Hospital Revenue Code	278
Min. Negotiated Rate	$250.56
Max. Negotiated Rate	$835.20
Rate for Payer: Aetna Commercial	$501.12
Rate for Payer: Aetna Medicare Advantage	$501.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.95
Rate for Payer: Cigna Commercial	$835.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.24
Rate for Payer: Qualcare PPO/HMO/WC	$250.56

INSERTION CATHETER ARTERY

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	1600000759
Hospital Revenue Code	360
Min. Negotiated Rate	$43.85
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$287.94
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$43.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.77
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSERTION CATHETER ARTERY

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	1600000759
Hospital Revenue Code	360
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

INSERTION CERVICAL DILATOR

Facility

$169.00

Service Code	HCPCS 59200
Hospital Charge Code	1800155
Hospital Revenue Code	361
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

INSERTION CERVICAL DILATOR

Facility

$169.00

Service Code	HCPCS 59200
Hospital Charge Code	1800155
Hospital Revenue Code	361
Min. Negotiated Rate	$21.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$50.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.09
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	$43.09
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges