Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCTION NEEDLE AV SHUNT

Facility

$331.55

Service Code	HCPCS 36145
Hospital Charge Code	5100339
Hospital Revenue Code	761
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

INTRODUCTION NEEDLE AV SHUNT

Facility

$331.55

Service Code	HCPCS 36145
Hospital Charge Code	5100339
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	$165.78
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

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	366836200
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$131.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	74110036
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$131.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	366836200
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	5100310
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$131.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	5100310
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	74110036
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTRODUCTION OF NEEDLE/INTCATH

Facility

$300.00

Service Code	HCPCS 36000
Hospital Charge Code	5300140
Hospital Revenue Code	636
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

INTRODUCTION OF NEEDLE/INTCATH

Facility

$300.00

Service Code	HCPCS 36000
Hospital Charge Code	5300140
Hospital Revenue Code	636
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

INTROD VISBRIT 8F 55C 4038553H

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624373N
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
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) NJ Health	$124.00
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	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTROD VISBRIT 8F 55C 4038553H

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624373
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTROD VISBRIT 8F 55C 4038553H

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624373N
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$150.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTROD VISBRIT 8F 55C 4038553H

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624373
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$84.56
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTROD VISTA BRITE 7F 4037553A

Facility

$470.45

Hospital Charge Code	270624008
Hospital Revenue Code	272
Min. Negotiated Rate	$70.57
Max. Negotiated Rate	$70.57
Rate for Payer: Qualcare PPO/HMO/WC	$70.57

INTROD VISTA BRITE 7F 4037553A

Facility

$470.45

Hospital Charge Code	270624008
Hospital Revenue Code	272
Min. Negotiated Rate	$61.16
Max. Negotiated Rate	$235.22
Rate for Payer: Aetna Commercial	$141.13
Rate for Payer: Aetna Medicare Advantage	$141.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.96
Rate for Payer: Cigna Commercial	$235.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.16
Rate for Payer: Oxford Commercial	$235.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.57
Rate for Payer: UnitedHealthcare Commercial	$235.22

INTRO GUIDEESHEATH 6FX10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658268
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

INTRO GUIDEESHEATH 6FX10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658268
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$74.25
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

Intro Guidesheath 5fx10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658270
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

Intro Guidesheath 5fx10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658270
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$74.25
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	278686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$26.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	278686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$54.60
Rate for Payer: Aetna Commercial	$32.76
Rate for Payer: Aetna Medicare Advantage	$32.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.85
Rate for Payer: Cigna Commercial	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	270686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$26.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	270686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$54.60
Rate for Payer: Aetna Commercial	$32.76
Rate for Payer: Aetna Medicare Advantage	$32.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.85
Rate for Payer: Cigna Commercial	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT PERCUTANEOUS SHEATH

Facility

$157.49

Hospital Charge Code	270649534
Hospital Revenue Code	272
Min. Negotiated Rate	$20.47
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$47.25
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.47
Rate for Payer: Oxford Commercial	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Commercial	$78.75

Know your out-of-pocket cost for care.

All Charges