Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR CATH PLCMNT RENAL ARTRY BIL

Facility

$15,468.50

Service Code	HCPCS 36254
Hospital Charge Code	321036254
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
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	$1,864.00
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	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR CATH PLCMNT RENAL ARTRY BIL

Facility

$15,468.50

Service Code	HCPCS 36254
Hospital Charge Code	321036254
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR-CECO/COLONIC TUBE

Facility

$5,489.85

Service Code	HCPCS 49442
Hospital Charge Code	366849442
Hospital Revenue Code	361
Min. Negotiated Rate	$713.68
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,646.95
Rate for Payer: Aetna Medicare Advantage	$1,646.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,399.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,399.91
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	$1,399.91
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.68
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$823.48
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-CECO/COLONIC TUBE

Facility

$5,489.85

Service Code	HCPCS 49442
Hospital Charge Code	7411595
Hospital Revenue Code	361
Min. Negotiated Rate	$823.48
Max. Negotiated Rate	$823.48
Rate for Payer: Qualcare PPO/HMO/WC	$823.48

IR-CECO/COLONIC TUBE

Facility

$4,185.00

Service Code	HCPCS 49442
Hospital Charge Code	2690155
Hospital Revenue Code	361
Min. Negotiated Rate	$627.75
Max. Negotiated Rate	$627.75
Rate for Payer: Qualcare PPO/HMO/WC	$627.75

IR-CECO/COLONIC TUBE

Facility

$5,489.85

Service Code	HCPCS 49442
Hospital Charge Code	366849442
Hospital Revenue Code	361
Min. Negotiated Rate	$823.48
Max. Negotiated Rate	$823.48
Rate for Payer: Qualcare PPO/HMO/WC	$823.48

IR-CECO/COLONIC TUBE

Facility

$5,489.85

Service Code	HCPCS 49442
Hospital Charge Code	7411595
Hospital Revenue Code	361
Min. Negotiated Rate	$713.68
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,646.95
Rate for Payer: Aetna Medicare Advantage	$1,646.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,399.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,399.91
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	$1,399.91
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.68
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$823.48
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-CECO/COLONIC TUBE

Facility

$4,185.00

Service Code	HCPCS 49442
Hospital Charge Code	2690155
Hospital Revenue Code	361
Min. Negotiated Rate	$544.05
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,255.50
Rate for Payer: Aetna Medicare Advantage	$1,255.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,067.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,067.17
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	$1,067.17
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.05
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$627.75
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-CERV PUNCT FOR MYELOGRAM

Facility

$3,107.20

Service Code	HCPCS 61055
Hospital Charge Code	7411641
Hospital Revenue Code	361
Min. Negotiated Rate	$466.08
Max. Negotiated Rate	$466.08
Rate for Payer: Qualcare PPO/HMO/WC	$466.08

IR-CERV PUNCT FOR MYELOGRAM

Facility

$3,107.20

Service Code	HCPCS 61055
Hospital Charge Code	2680235
Hospital Revenue Code	361
Min. Negotiated Rate	$466.08
Max. Negotiated Rate	$466.08
Rate for Payer: Qualcare PPO/HMO/WC	$466.08

IR-CERV PUNCT FOR MYELOGRAM

Facility

$3,107.20

Service Code	HCPCS 61055
Hospital Charge Code	7411641
Hospital Revenue Code	361
Min. Negotiated Rate	$403.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$932.16
Rate for Payer: Aetna Medicare Advantage	$932.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$792.34
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	$792.34
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$466.08
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-CERV PUNCT FOR MYELOGRAM

Facility

$3,107.20

Service Code	HCPCS 61055
Hospital Charge Code	2680235
Hospital Revenue Code	361
Min. Negotiated Rate	$403.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$932.16
Rate for Payer: Aetna Medicare Advantage	$932.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$792.34
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	$792.34
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$466.08
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR CHANGE GASTROSTOMY TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	2101175
Hospital Revenue Code	361
Min. Negotiated Rate	$116.47
Max. Negotiated Rate	$116.47
Rate for Payer: Qualcare PPO/HMO/WC	$116.47

IR CHANGE GASTROSTOMY TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	7411547
Hospital Revenue Code	361
Min. Negotiated Rate	$116.47
Max. Negotiated Rate	$116.47
Rate for Payer: Qualcare PPO/HMO/WC	$116.47

IR CHANGE GASTROSTOMY TUBE

Facility

$1,147.55

Service Code	HCPCS 43760
Hospital Charge Code	411043760
Hospital Revenue Code	361
Min. Negotiated Rate	$172.13
Max. Negotiated Rate	$172.13
Rate for Payer: Qualcare PPO/HMO/WC	$172.13

IR CHANGE GASTROSTOMY TUBE

Facility

$1,147.55

Service Code	HCPCS 43760
Hospital Charge Code	411043760
Hospital Revenue Code	361
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$766.34
Rate for Payer: Aetna Commercial	$344.26
Rate for Payer: Aetna Medicare Advantage	$344.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.63
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	$292.63
Rate for Payer: Cigna Commercial	$573.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.18
Rate for Payer: Qualcare PPO/HMO/WC	$172.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$766.34

IR CHANGE GASTROSTOMY TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	2101175
Hospital Revenue Code	361
Min. Negotiated Rate	$100.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$766.34
Rate for Payer: Aetna Commercial	$232.94
Rate for Payer: Aetna Medicare Advantage	$232.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.99
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	$197.99
Rate for Payer: Cigna Commercial	$388.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.94
Rate for Payer: Qualcare PPO/HMO/WC	$116.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$766.34

IR CHANGE GASTROSTOMY TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	7411547
Hospital Revenue Code	361
Min. Negotiated Rate	$100.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$766.34
Rate for Payer: Aetna Commercial	$232.94
Rate for Payer: Aetna Medicare Advantage	$232.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.99
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	$197.99
Rate for Payer: Cigna Commercial	$388.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.94
Rate for Payer: Qualcare PPO/HMO/WC	$116.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$766.34

IR-CHANGE NEPHROST TBE-BI

Facility

$2,840.00

Hospital Charge Code	2690660
Hospital Revenue Code	761
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$1,420.00
Rate for Payer: Aetna Commercial	$852.00
Rate for Payer: Aetna Medicare Advantage	$852.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$724.20
Rate for Payer: Cigna Commercial	$1,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.20
Rate for Payer: Oxford Commercial	$1,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00
Rate for Payer: UnitedHealthcare Commercial	$1,420.00

IR-CHANGE NEPHROST TBE-BI

Facility

$2,840.00

Hospital Charge Code	2690660
Hospital Revenue Code	761
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$426.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00

IR-CHANGE NEPHROST TBE-LT

Facility

$2,840.00

Hospital Charge Code	2691650
Hospital Revenue Code	761
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$1,420.00
Rate for Payer: Aetna Commercial	$852.00
Rate for Payer: Aetna Medicare Advantage	$852.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$724.20
Rate for Payer: Cigna Commercial	$1,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.20
Rate for Payer: Oxford Commercial	$1,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00
Rate for Payer: UnitedHealthcare Commercial	$1,420.00

IR-CHANGE NEPHROST TBE-LT

Facility

$2,840.00

Hospital Charge Code	2691650
Hospital Revenue Code	761
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$426.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00

IR-CHANGE NEPHROST TBE-RT

Facility

$2,840.00

Hospital Charge Code	2691655
Hospital Revenue Code	761
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$1,420.00
Rate for Payer: Aetna Commercial	$852.00
Rate for Payer: Aetna Medicare Advantage	$852.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$724.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$724.20
Rate for Payer: Cigna Commercial	$1,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.20
Rate for Payer: Oxford Commercial	$1,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00
Rate for Payer: UnitedHealthcare Commercial	$1,420.00

IR-CHANGE NEPHROST TBE-RT

Facility

$2,840.00

Hospital Charge Code	2691655
Hospital Revenue Code	761
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$426.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.00

IR CHANGE PERC BIL DRAIN CATH

Facility

$2,682.45

Hospital Charge Code	2004739
Hospital Revenue Code	361
Min. Negotiated Rate	$402.37
Max. Negotiated Rate	$402.37
Rate for Payer: Qualcare PPO/HMO/WC	$402.37

Know your out-of-pocket cost for care.

All Charges