Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ENDOCRINE SYSTEM UNLTED

Facility

$21,358.35

Service Code	HCPCS 60699
Hospital Charge Code	2680230
Hospital Revenue Code	361
Min. Negotiated Rate	$3,203.75
Max. Negotiated Rate	$3,203.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.75

IR ENDOCRINE SYSTEM UNLTED

Facility

$21,358.35

Service Code	HCPCS 60699
Hospital Charge Code	7411640
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

IR ENDOCRINE SYSTEM UNLTED

Facility

$21,358.35

Service Code	HCPCS 60699
Hospital Charge Code	7411640
Hospital Revenue Code	361
Min. Negotiated Rate	$3,203.75
Max. Negotiated Rate	$3,203.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.75

IR ENDOVAS AAA REPAIR

Facility

$13,750.00

Service Code	HCPCS 34802
Hospital Charge Code	7411393
Hospital Revenue Code	361
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

IR ENDOVAS AAA REPAIR

Facility

$13,750.00

Service Code	HCPCS 34802
Hospital Charge Code	2600141
Hospital Revenue Code	361
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

IR ENDOVAS AAA REPAIR

Facility

$13,750.00

Service Code	HCPCS 34802
Hospital Charge Code	7411393
Hospital Revenue Code	361
Min. Negotiated Rate	$1,787.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
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	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,787.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

IR ENDOVAS AAA REPAIR

Facility

$13,750.00

Service Code	HCPCS 34802
Hospital Charge Code	2600141
Hospital Revenue Code	361
Min. Negotiated Rate	$1,787.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
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	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,787.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

IR ENDOVAS AAA REPR W/3-P PART

Facility

$4,000.00

Service Code	HCPCS 34803
Hospital Charge Code	2011291
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS AAA REPR W/3-P PART

Facility

$4,000.00

Service Code	HCPCS 34803
Hospital Charge Code	7411394
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS AAA REPR W/3-P PART

Facility

$4,000.00

Service Code	HCPCS 34803
Hospital Charge Code	2011291
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS AAA REPR W/3-P PART

Facility

$4,000.00

Service Code	HCPCS 34803
Hospital Charge Code	7411394
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC ILIAC REFR W/GRAFT

Facility

$4,000.00

Service Code	HCPCS 34900
Hospital Charge Code	7411402
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC ILIAC REFR W/GRAFT

Facility

$4,000.00

Service Code	HCPCS 34900
Hospital Charge Code	7411402
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC ILIAC REFR W/GRAFT

Facility

$4,000.00

Service Code	HCPCS 34900
Hospital Charge Code	2011299
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC ILIAC REFR W/GRAFT

Facility

$4,000.00

Service Code	HCPCS 34900
Hospital Charge Code	2011299
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC REPAIR ABD AORTA

Facility

$4,000.00

Service Code	HCPCS 75952
Hospital Charge Code	2011287
Hospital Revenue Code	329
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ENDOVASC REPAIR ABD AORTA

Facility

$4,000.00

Service Code	HCPCS 75952
Hospital Charge Code	2011287
Hospital Revenue Code	329
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVASC REPAIR ABD AORTA

Facility

$4,000.00

Service Code	HCPCS 75952
Hospital Charge Code	7411732
Hospital Revenue Code	329
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ENDOVASC REPAIR ABD AORTA

Facility

$4,000.00

Service Code	HCPCS 75952
Hospital Charge Code	7411732
Hospital Revenue Code	329
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH ADD'L

Facility

$4,000.00

Service Code	HCPCS 34826
Hospital Charge Code	2011294
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH ADD'L

Facility

$4,000.00

Service Code	HCPCS 34826
Hospital Charge Code	7411401
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH ADD'L

Facility

$4,000.00

Service Code	HCPCS 34826
Hospital Charge Code	2011294
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH ADD'L

Facility

$4,000.00

Service Code	HCPCS 34826
Hospital Charge Code	7411401
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH INIT

Facility

$4,000.00

Service Code	HCPCS 34825
Hospital Charge Code	2011296
Hospital Revenue Code	361
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
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	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ENDOVAS EXTEND PROSTH INIT

Facility

$4,000.00

Service Code	HCPCS 34825
Hospital Charge Code	2011296
Hospital Revenue Code	361
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Know your out-of-pocket cost for care.

All Charges