Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2670020
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	411077002
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$138.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ECHO GUIDANCE RADIOTHERAPY

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2101158
Hospital Revenue Code	402
Min. Negotiated Rate	$112.88
Max. Negotiated Rate	$112.88
Rate for Payer: Qualcare PPO/HMO/WC	$112.88

IR ECHO GUIDANCE RADIOTHERAPY

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2101158
Hospital Revenue Code	402
Min. Negotiated Rate	$97.83
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$225.75
Rate for Payer: Aetna Medicare Advantage	$225.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.89
Rate for Payer: Cigna Commercial	$107.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.83
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.88
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	2680270
Hospital Revenue Code	322
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$595.10
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	7411665
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	7411665
Hospital Revenue Code	322
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$595.10
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	2680270
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	7411391
Hospital Revenue Code	361
Min. Negotiated Rate	$3,355.69
Max. Negotiated Rate	$3,355.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	5600195
Hospital Revenue Code	361
Min. Negotiated Rate	$3,355.69
Max. Negotiated Rate	$3,355.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	5600195
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$6,711.38
Rate for Payer: Aetna Medicare Advantage	$6,711.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,704.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,704.67
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	$5,704.67
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,908.26
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	7411391
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$6,711.38
Rate for Payer: Aetna Medicare Advantage	$6,711.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,704.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,704.67
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	$5,704.67
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,908.26
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	321075894
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	2600072
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	7411728
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	366875894
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	366875894
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	7411728
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	321075894
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	2600072
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR EMBOLIZATION UTERINE FIBROI

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	2600149
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

IR EMBOLIZATION UTERINE FIBROI

Facility

$15,863.35

Service Code	HCPCS 37243
Hospital Charge Code	7411531
Hospital Revenue Code	361
Min. Negotiated Rate	$2,379.50
Max. Negotiated Rate	$2,379.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,379.50

IR EMBOLIZATION UTERINE FIBROI

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	2600149
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR EMBOLIZATION UTERINE FIBROI

Facility

$15,863.35

Service Code	HCPCS 37243
Hospital Charge Code	7411531
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$4,759.01
Rate for Payer: Aetna Medicare Advantage	$4,759.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,045.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,045.15
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	$4,045.15
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,062.24
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,379.50
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

IR ENDOCRINE SYSTEM UNLTED

Facility

$21,358.35

Service Code	HCPCS 60699
Hospital Charge Code	2680230
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$6,407.51
Rate for Payer: Aetna Medicare Advantage	$6,407.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.38
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	$5,446.38
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.59
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.75
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Know your out-of-pocket cost for care.

All Charges