Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	321075630
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	2004851
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	321075630
Hospital Revenue Code	323
Min. Negotiated Rate	$163.62
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO AORTA-THORACIC

Facility

$13,436.40

Service Code	HCPCS 75605
Hospital Charge Code	2001337
Hospital Revenue Code	323
Min. Negotiated Rate	$268.03
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO AORTA-THORACIC

Facility

$13,436.40

Service Code	HCPCS 75605
Hospital Charge Code	2001337
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR ANGIO BALLON PERPHRAL ARTRY

Facility

$21,962.30

Service Code	HCPCS 75962
Hospital Charge Code	2600002
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLON PERPHRAL ARTRY

Facility

$21,962.30

Service Code	HCPCS 75962
Hospital Charge Code	2600002
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	7411738
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600003
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600003
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	7411738
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO BALLOON RENAL LEFT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600004
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO BALLOON RENAL LEFT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600004
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLOON RENAL RIGHT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600005
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLOON RENAL RIGHT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600005
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL BI

Facility

$20,317.50

Hospital Charge Code	2000842
Hospital Revenue Code	323
Min. Negotiated Rate	$3,047.62
Max. Negotiated Rate	$3,047.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62

IR ANGIO CAROTID CEREBRAL BI

Facility

$20,317.50

Hospital Charge Code	2000842
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,158.75
Rate for Payer: Aetna Commercial	$6,095.25
Rate for Payer: Aetna Medicare Advantage	$6,095.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,180.96
Rate for Payer: Cigna Commercial	$10,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,641.28
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL BLTL

Facility

$20,317.50

Service Code	HCPCS 75671
Hospital Charge Code	2600014
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,158.75
Rate for Payer: Aetna Commercial	$6,095.25
Rate for Payer: Aetna Medicare Advantage	$6,095.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,180.96
Rate for Payer: Cigna Commercial	$10,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,641.28
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL BLTL

Facility

$20,317.50

Service Code	HCPCS 75671
Hospital Charge Code	2600014
Hospital Revenue Code	323
Min. Negotiated Rate	$3,047.62
Max. Negotiated Rate	$3,047.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62

IR ANGIO CAROTID CEREBRAL LEFT

Facility

$13,436.40

Service Code	HCPCS 75665
Hospital Charge Code	2600015
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR ANGIO CAROTID CEREBRAL LEFT

Facility

$13,436.40

Service Code	HCPCS 75665
Hospital Charge Code	2600015
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$6,718.20
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$6,718.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL RGHT

Facility

$13,436.40

Service Code	HCPCS 75665
Hospital Charge Code	2600016
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR ANGIO CAROTID CEREBRAL RGHT

Facility

$13,436.40

Service Code	HCPCS 75665
Hospital Charge Code	2600016
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$6,718.20
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$6,718.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL UNI

Facility

$13,436.40

Hospital Charge Code	2000834
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$6,718.20
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$6,718.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO CAROTID CEREBRAL UNI

Facility

$13,436.40

Hospital Charge Code	2000834
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

Know your out-of-pocket cost for care.

All Charges