Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR ANGIO PULMONARY UNI SEL

Facility

OP

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	7411698
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 ANGIO PULMONARY UNI SEL

Facility

IP

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	7411698
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 PULMONARY UNI SEL

Facility

IP

$13,436.40

Service Code	HCPCS 75741
Hospital Charge Code	2001220
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 PULMONARY VEN NON/SEL

Facility

OP

$4,914.50

Service Code	HCPCS 75746
Hospital Charge Code	411075746
Hospital Revenue Code	323
Min. Negotiated Rate	$100.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,474.35
Rate for Payer: Aetna Medicare Advantage	$1,474.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,253.20
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO PULMONARY VEN NON/SEL

Facility

IP

$4,747.25

Service Code	HCPCS 75746
Hospital Charge Code	7411700
Hospital Revenue Code	323
Min. Negotiated Rate	$712.09
Max. Negotiated Rate	$712.09
Rate for Payer: Qualcare PPO/HMO/WC	$712.09

IR ANGIO PULMONARY VEN NON/SEL

Facility

IP

$4,914.50

Service Code	HCPCS 75746
Hospital Charge Code	366875746
Hospital Revenue Code	323
Min. Negotiated Rate	$737.17
Max. Negotiated Rate	$737.17
Rate for Payer: Qualcare PPO/HMO/WC	$737.17

IR ANGIO PULMONARY VEN NON/SEL

Facility

IP

$6,404.20

Service Code	HCPCS 75746
Hospital Charge Code	2004794
Hospital Revenue Code	323
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR ANGIO PULMONARY VEN NON/SEL

Facility

IP

$4,914.50

Service Code	HCPCS 75746
Hospital Charge Code	411075746
Hospital Revenue Code	323
Min. Negotiated Rate	$737.17
Max. Negotiated Rate	$737.17
Rate for Payer: Qualcare PPO/HMO/WC	$737.17

IR ANGIO PULMONARY VEN NON/SEL

Facility

OP

$4,747.25

Service Code	HCPCS 75746
Hospital Charge Code	7411700
Hospital Revenue Code	323
Min. Negotiated Rate	$100.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,424.17
Rate for Payer: Aetna Medicare Advantage	$1,424.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,210.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,210.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,210.55
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.09
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO PULMONARY VEN NON/SEL

Facility

OP

$4,914.50

Service Code	HCPCS 75746
Hospital Charge Code	366875746
Hospital Revenue Code	323
Min. Negotiated Rate	$100.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,474.35
Rate for Payer: Aetna Medicare Advantage	$1,474.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,253.20
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO PULMONARY VEN NON/SEL

Facility

OP

$6,404.20

Service Code	HCPCS 75746
Hospital Charge Code	321075746
Hospital Revenue Code	323
Min. Negotiated Rate	$100.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO PULMONARY VEN NON/SEL

Facility

IP

$6,404.20

Service Code	HCPCS 75746
Hospital Charge Code	321075746
Hospital Revenue Code	323
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR ANGIO PULMONARY VEN NON/SEL

Facility

OP

$6,404.20

Service Code	HCPCS 75746
Hospital Charge Code	2004794
Hospital Revenue Code	323
Min. Negotiated Rate	$100.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ANGIO RENAL BILAT SEL

Facility

OP

$7,240.05

Hospital Charge Code	2004802
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 ANGIO RENAL BILAT SEL

Facility

IP

$7,240.05

Hospital Charge Code	2004802
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 RENAL UNILAT SEL

Facility

IP

$13,436.40

Hospital Charge Code	2000891
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 RENAL UNILAT SEL

Facility

OP

$13,436.40

Hospital Charge Code	2000891
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 SEL EA ADD

Facility

IP

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	321075774
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 SEL EA ADD

Facility

OP

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	5100450
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 SEL EA ADD

Facility

IP

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	5100450
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 SEL EA ADD

Facility

IP

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411703
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 SEL EA ADD

Facility

OP

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411703
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 SEL EA ADD

Facility

OP

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	321075774
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 SEL PELV S&I

Facility

IP

$7,240.05

Service Code	HCPCS 75736
Hospital Charge Code	5100345
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 SEL PELV S&I

Facility

OP

$7,240.05

Service Code	HCPCS 75736
Hospital Charge Code	5100345
Hospital Revenue Code	323
Min. Negotiated Rate	$282.74
Max. Negotiated Rate	$13,251.23
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	$282.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$13,251.23
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