Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ANGIOGRAPHY THRU X CATH F/U

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	2001250
Hospital Revenue Code	323
Min. Negotiated Rate	$131.04
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$302.40
Rate for Payer: Aetna Medicare Advantage	$302.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.04
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIOGRAPHY THRU X CATH F/U

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	2001250
Hospital Revenue Code	323
Min. Negotiated Rate	$151.20
Max. Negotiated Rate	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$151.20

IR ANGIO HEPATIC SELECTIVE

Facility

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	2001246
Hospital Revenue Code	323
Min. Negotiated Rate	$458.10
Max. Negotiated Rate	$458.10
Rate for Payer: Qualcare PPO/HMO/WC	$458.10

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	366875774
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411702
Hospital Revenue Code	323
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$1,187.44
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.56
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO HEPATIC SELECTIVE

Facility

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	2001246
Hospital Revenue Code	323
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$916.20
Rate for Payer: Aetna Medicare Advantage	$916.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$778.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$778.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$778.77
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.02
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.10
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	411075774
Hospital Revenue Code	323
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$1,187.44
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.56
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411702
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	411075774
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	366875774
Hospital Revenue Code	323
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$1,187.44
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.56
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411691
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411691
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
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	$266.51
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	2001279
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
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	$266.51
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	2001279
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 MESENTERIC SUP

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	2001261
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,535.25
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO MESENTERIC SUP

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	2001261
Hospital Revenue Code	323
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

IR ANGIO MESENTERIC SUP

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411692
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 MESENTERIC SUP

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411692
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
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	$266.51
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 PULMONARY BILAT SEL

Facility

$15,468.50

Service Code	HCPCS 75743
Hospital Charge Code	2004786
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 PULMONARY BILAT SEL

Facility

$7,240.05

Service Code	HCPCS 75743
Hospital Charge Code	7411699
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 ANGIO PULMONARY BILAT SEL

Facility

$15,468.50

Service Code	HCPCS 75743
Hospital Charge Code	321075743
Hospital Revenue Code	323
Min. Negotiated Rate	$327.23
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	$327.23
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 PULMONARY BILAT SEL

Facility

$7,240.05

Service Code	HCPCS 75743
Hospital Charge Code	7411699
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 ANGIO PULMONARY BILAT SEL

Facility

$15,468.50

Service Code	HCPCS 75743
Hospital Charge Code	2004786
Hospital Revenue Code	323
Min. Negotiated Rate	$327.23
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	$327.23
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 PULMONARY BILAT SEL

Facility

$15,468.50

Service Code	HCPCS 75743
Hospital Charge Code	321075743
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 PULMONARY UNI SEL

Facility

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2001220
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

Know your out-of-pocket cost for care.

All Charges