Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	7411658
Hospital Revenue Code	361
Min. Negotiated Rate	$5,834.25
Max. Negotiated Rate	$5,834.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	7411658
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,668.50
Rate for Payer: Aetna Commercial	$11,668.50
Rate for Payer: Aetna Medicare Advantage	$11,668.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,918.23
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	$9,918.23
Rate for Payer: Cigna Commercial	$3,171.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,056.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	5700252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,668.50
Rate for Payer: Aetna Commercial	$11,668.50
Rate for Payer: Aetna Medicare Advantage	$11,668.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,918.23
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	$9,918.23
Rate for Payer: Cigna Commercial	$3,171.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,056.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IRBESARTAN 150 MG TAB

Facility

$7.90

Hospital Charge Code	60629280
Hospital Revenue Code	250
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

IRBESARTAN 150 MG TAB

Facility

$7.90

Hospital Charge Code	60629280
Hospital Revenue Code	250
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.95
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.95

IR BILE STONE REMOVAL

Facility

$819.70

Hospital Charge Code	2101149
Hospital Revenue Code	320
Min. Negotiated Rate	$106.56
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$245.91
Rate for Payer: Aetna Medicare Advantage	$245.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.02
Rate for Payer: Cigna Commercial	$409.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.56
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.95
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR BILE STONE REMOVAL

Facility

$819.70

Hospital Charge Code	2101149
Hospital Revenue Code	320
Min. Negotiated Rate	$122.95
Max. Negotiated Rate	$122.95
Rate for Payer: Qualcare PPO/HMO/WC	$122.95

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	7411572
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	7411572
Hospital Revenue Code	361
Min. Negotiated Rate	$548.89
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$1,266.67
Rate for Payer: Aetna Medicare Advantage	$1,266.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.67
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	$1,076.67
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.89
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	2011295
Hospital Revenue Code	361
Min. Negotiated Rate	$548.89
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$1,266.67
Rate for Payer: Aetna Medicare Advantage	$1,266.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.67
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	$1,076.67
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.89
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	2011295
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	2600050
Hospital Revenue Code	320
Min. Negotiated Rate	$313.20
Max. Negotiated Rate	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$313.20

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411675
Hospital Revenue Code	320
Min. Negotiated Rate	$271.44
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$626.40
Rate for Payer: Aetna Medicare Advantage	$626.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.44
Rate for Payer: Cigna Commercial	$1,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	2600050
Hospital Revenue Code	320
Min. Negotiated Rate	$271.44
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$626.40
Rate for Payer: Aetna Medicare Advantage	$626.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.44
Rate for Payer: Cigna Commercial	$1,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411675
Hospital Revenue Code	320
Min. Negotiated Rate	$313.20
Max. Negotiated Rate	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$313.20

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	7411777
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	2690345
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	2690345
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	7411777
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	7411873
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	2690970
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	7411873
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	2690970
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	7411874
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	2690975
Hospital Revenue Code	361
Min. Negotiated Rate	$249.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$574.80
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.08
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

Know your out-of-pocket cost for care.

All Charges