Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	411051102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,102.12
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$2,543.36
Rate for Payer: Aetna Medicare Advantage	$2,543.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.85
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	$2,161.85
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.12
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,499.52

Service Code	HCPCS 51102
Hospital Charge Code	7411622
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.93
Max. Negotiated Rate	$1,274.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.93

IR ASPIRATION BLADDER W CATH

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,423.85
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$3,285.81
Rate for Payer: Aetna Medicare Advantage	$3,285.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,792.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,792.94
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	$2,792.94
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,423.85
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR ASPIRATION BLADDER W CATH

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,642.90
Max. Negotiated Rate	$1,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90

IR ATHERECTMY PERPHERAL ARTERY

Facility

$4,665.90

Hospital Charge Code	2600045
Hospital Revenue Code	320
Min. Negotiated Rate	$699.88
Max. Negotiated Rate	$699.88
Rate for Payer: Qualcare PPO/HMO/WC	$699.88

IR ATHERECTMY PERPHERAL ARTERY

Facility

$4,665.90

Hospital Charge Code	2600045
Hospital Revenue Code	320
Min. Negotiated Rate	$606.57
Max. Negotiated Rate	$2,332.95
Rate for Payer: Aetna Commercial	$1,399.77
Rate for Payer: Aetna Medicare Advantage	$1,399.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,189.80
Rate for Payer: Cigna Commercial	$2,332.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$699.88
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$25,808.44
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,183.66
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$25,808.44
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,183.66
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$25,808.44
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,183.66
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$25,808.44
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,183.66
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	321037225L
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	2691370
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412042
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	366837225L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	366837225L
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	321037225L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	2691370
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412042
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$14,313.52
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,202.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	7411926
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

Know your out-of-pocket cost for care.

All Charges