Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	404636140
Hospital Revenue Code	481
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	5100500
Hospital Revenue Code	761
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INTRO CATH RETROG EXTR ARTERY

Facility

$331.55

Service Code	HCPCS 36140
Hospital Charge Code	74110053
Hospital Revenue Code	761
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$165.78
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) PPO	$84.55
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Oxford Commercial	$165.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$165.78

INTRODCER 9F PLVN903824VAD5CVI

Facility

$301.40

Hospital Charge Code	270632179
Hospital Revenue Code	272
Min. Negotiated Rate	$45.21
Max. Negotiated Rate	$45.21
Rate for Payer: Qualcare PPO/HMO/WC	$45.21

INTRODCER 9F PLVN903824VAD5CVI

Facility

$301.40

Hospital Charge Code	270632179
Hospital Revenue Code	272
Min. Negotiated Rate	$39.18
Max. Negotiated Rate	$150.70
Rate for Payer: Aetna Commercial	$90.42
Rate for Payer: Aetna Medicare Advantage	$90.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.86
Rate for Payer: Cigna Commercial	$150.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.18
Rate for Payer: Oxford Commercial	$150.70
Rate for Payer: Qualcare PPO/HMO/WC	$45.21
Rate for Payer: UnitedHealthcare Commercial	$150.70

INTRODCR ARROWFLEX 9x6 CL07965

Facility

$394.90

Hospital Charge Code	270634388
Hospital Revenue Code	272
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$59.23

INTRODCR ARROWFLEX 9x6 CL07965

Facility

$394.90

Hospital Charge Code	270634388
Hospital Revenue Code	272
Min. Negotiated Rate	$51.34
Max. Negotiated Rate	$197.45
Rate for Payer: Aetna Commercial	$118.47
Rate for Payer: Aetna Medicare Advantage	$118.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.70
Rate for Payer: Cigna Commercial	$197.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.34
Rate for Payer: Oxford Commercial	$197.45
Rate for Payer: Qualcare PPO/HMO/WC	$59.23
Rate for Payer: UnitedHealthcare Commercial	$197.45

INTRO DIALYSIS CIRCUIT

Facility

$2,873.16

Service Code	HCPCS 36901
Hospital Charge Code	16000484
Hospital Revenue Code	360
Min. Negotiated Rate	$373.51
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$861.95
Rate for Payer: Aetna Medicare Advantage	$861.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$732.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$732.66
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	$732.66
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.51
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$430.97
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INTRO DIALYSIS CIRCUIT

Facility

$2,873.16

Service Code	HCPCS 36901
Hospital Charge Code	16000484
Hospital Revenue Code	360
Min. Negotiated Rate	$430.97
Max. Negotiated Rate	$430.97
Rate for Payer: Qualcare PPO/HMO/WC	$430.97

INTRODR 8F VLESS PLESS 504608V

Facility

$44.85

Hospital Charge Code	270619639
Hospital Revenue Code	278
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

INTRODR 8F VLESS PLESS 504608V

Facility

$44.85

Hospital Charge Code	270619639
Hospital Revenue Code	278
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

INTROD RAABE 7FR 70CM G11635

Facility

$220.50

Service Code	HCPCS C1894
Hospital Charge Code	270636699C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$53.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.36
Rate for Payer: Qualcare PPO/HMO/WC	$33.08

INTROD RAABE 7FR 70CM G11635

Facility

$220.50

Service Code	HCPCS C1894
Hospital Charge Code	270636699C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$110.25
Rate for Payer: Aetna Commercial	$66.15
Rate for Payer: Aetna Medicare Advantage	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.23
Rate for Payer: Cigna Commercial	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.36
Rate for Payer: Qualcare PPO/HMO/WC	$33.08

INTRODR BRT TIP 5F 11c 401511M

Facility

$178.45

Hospital Charge Code	270624372
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

INTRODR BRT TIP 5F 11c 401511M

Facility

$178.45

Hospital Charge Code	270624372
Hospital Revenue Code	272
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$53.53
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.20
Rate for Payer: Oxford Commercial	$89.22
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$89.22

INTRODR GUIDE 8F 55c 4038553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374
Hospital Revenue Code	272
Min. Negotiated Rate	$80.60
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$186.00
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$310.00

INTRODR GUIDE 8F 55c 4038553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTRODUCER 10mm

Facility

$729.15

Hospital Charge Code	270679215
Hospital Revenue Code	272
Min. Negotiated Rate	$94.79
Max. Negotiated Rate	$364.57
Rate for Payer: Aetna Commercial	$218.75
Rate for Payer: Aetna Medicare Advantage	$218.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.93
Rate for Payer: Cigna Commercial	$364.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.79
Rate for Payer: Oxford Commercial	$364.57
Rate for Payer: Qualcare PPO/HMO/WC	$109.37
Rate for Payer: UnitedHealthcare Commercial	$364.57

INTRODUCER 10mm

Facility

$729.15

Hospital Charge Code	270679215
Hospital Revenue Code	272
Min. Negotiated Rate	$109.37
Max. Negotiated Rate	$109.37
Rate for Payer: Qualcare PPO/HMO/WC	$109.37

INTRODUCER 11 FR 10 CM CURVED

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270690726
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

INTRODUCER 11 FR 10 CM CURVED

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270690726
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

INTRODUCER 12FR X 30CM

Facility

$100.00

Hospital Charge Code	270683374
Hospital Revenue Code	272
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$50.00

INTRODUCER 12FR X 30CM

Facility

$100.00

Hospital Charge Code	270683374
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

INTRODUCER 3.6-11.5 BEVEL TIP

Facility

$972.33

Hospital Charge Code	270670666
Hospital Revenue Code	272
Min. Negotiated Rate	$145.85
Max. Negotiated Rate	$145.85
Rate for Payer: Qualcare PPO/HMO/WC	$145.85

INTRODUCER 3.6-11.5 BEVEL TIP

Facility

$972.33

Hospital Charge Code	270670666
Hospital Revenue Code	272
Min. Negotiated Rate	$126.40
Max. Negotiated Rate	$486.17
Rate for Payer: Aetna Commercial	$291.70
Rate for Payer: Aetna Medicare Advantage	$291.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.94
Rate for Payer: Cigna Commercial	$486.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.40
Rate for Payer: Oxford Commercial	$486.17
Rate for Payer: Qualcare PPO/HMO/WC	$145.85
Rate for Payer: UnitedHealthcare Commercial	$486.17

Know your out-of-pocket cost for care.

All Charges