Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ANGIOGRAM PULMNRY NONSLCTVE

Facility

$4,747.25

Service Code	HCPCS 75746
Hospital Charge Code	2600033
Hospital Revenue Code	323
Min. Negotiated Rate	$712.09
Max. Negotiated Rate	$712.09
Rate for Payer: Qualcare PPO/HMO/WC	$712.09

IR ANGIOGRAM PULMONARY BILTRAL

Facility

$7,240.05

Service Code	HCPCS 75743
Hospital Charge Code	2600031
Hospital Revenue Code	323
Min. Negotiated Rate	$327.23
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,172.01
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$941.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAM PULMONARY BILTRAL

Facility

$7,240.05

Service Code	HCPCS 75743
Hospital Charge Code	2600031
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM PULMONARY LEFT

Facility

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2600032
Hospital Revenue Code	323
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$7,519.21
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	$261.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
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 ANGIOGRAM PULMONARY LEFT

Facility

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2600032
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 ANGIOGRAM PULMONARY RIGHT

Facility

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2600034
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 ANGIOGRAM PULMONARY RIGHT

Facility

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2600034
Hospital Revenue Code	323
Min. Negotiated Rate	$261.80
Max. Negotiated Rate	$7,519.21
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	$261.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
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 ANGIOGRAM RENAL BILATERAL

Facility

$7,240.05

Hospital Charge Code	2600035
Hospital Revenue Code	323
Min. Negotiated Rate	$941.21
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,172.01
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$941.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAM RENAL BILATERAL

Facility

$7,240.05

Hospital Charge Code	2600035
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM RENAL LEFT

Facility

$13,436.40

Hospital Charge Code	2600036
Hospital Revenue Code	320
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 ANGIOGRAM RENAL LEFT

Facility

$13,436.40

Hospital Charge Code	2600036
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR ANGIOGRAM RENAL RIGHT

Facility

$13,436.40

Hospital Charge Code	2600037
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 ANGIOGRAM RENAL RIGHT

Facility

$13,436.40

Hospital Charge Code	2600037
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 ANGIOGRAM SPINE SELECTIVE

Facility

$13,436.40

Service Code	HCPCS 75705
Hospital Charge Code	7411689
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 ANGIOGRAM SPINE SELECTIVE

Facility

$13,436.40

Service Code	HCPCS 75705
Hospital Charge Code	2600038
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 ANGIOGRAM SPINE SELECTIVE

Facility

$13,436.40

Service Code	HCPCS 75705
Hospital Charge Code	2600038
Hospital Revenue Code	323
Min. Negotiated Rate	$333.05
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	$333.05
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 ANGIOGRAM SPINE SELECTIVE

Facility

$13,436.40

Service Code	HCPCS 75705
Hospital Charge Code	7411689
Hospital Revenue Code	323
Min. Negotiated Rate	$333.05
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	$333.05
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 ANGIOGRAM VERTEBRAL

Facility

$7,240.05

Hospital Charge Code	2600039
Hospital Revenue Code	323
Min. Negotiated Rate	$941.21
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,172.01
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$941.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAM VERTEBRAL

Facility

$7,240.05

Hospital Charge Code	2600039
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAPHY AORTIC ARCH

Facility

$20,317.50

Hospital Charge Code	2001113
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 ANGIOGRAPHY AORTIC ARCH

Facility

$20,317.50

Hospital Charge Code	2001113
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 ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	7411688
Hospital Revenue Code	323
Min. Negotiated Rate	$598.73
Max. Negotiated Rate	$2,302.82
Rate for Payer: Aetna Commercial	$1,381.69
Rate for Payer: Aetna Medicare Advantage	$1,381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.44
Rate for Payer: Cigna Commercial	$2,302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2000719
Hospital Revenue Code	323
Min. Negotiated Rate	$598.73
Max. Negotiated Rate	$2,302.82
Rate for Payer: Aetna Commercial	$1,381.69
Rate for Payer: Aetna Medicare Advantage	$1,381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.44
Rate for Payer: Cigna Commercial	$2,302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2000719
Hospital Revenue Code	323
Min. Negotiated Rate	$690.85
Max. Negotiated Rate	$690.85
Rate for Payer: Qualcare PPO/HMO/WC	$690.85

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	7411688
Hospital Revenue Code	323
Min. Negotiated Rate	$690.85
Max. Negotiated Rate	$690.85
Rate for Payer: Qualcare PPO/HMO/WC	$690.85

Know your out-of-pocket cost for care.

All Charges