Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-EXT CANN DECLOTING/W @ CATH

Facility

$15,530.27

Service Code	HCPCS 36861
Hospital Charge Code	7411489
Hospital Revenue Code	361
Min. Negotiated Rate	$2,329.54
Max. Negotiated Rate	$2,329.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,329.54

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	2690425
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	7411789
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	2690425
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	321036005B
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	321036005B
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	7411789
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	411036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	7411895
Hospital Revenue Code	761
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	321036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	7411895
Hospital Revenue Code	761
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$261.50
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Oxford Commercial	$261.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Commercial	$261.50

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	366836500L
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	321036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	366836500L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	2691145
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	2691145
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	411036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36500RT
Hospital Charge Code	366836500R
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36500RT
Hospital Charge Code	411036005R
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36005RT
Hospital Charge Code	7411896
Hospital Revenue Code	761
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36500RT
Hospital Charge Code	366836500R
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36005RT
Hospital Charge Code	321036005R
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36005RT
Hospital Charge Code	2691150
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36005RT
Hospital Charge Code	7411896
Hospital Revenue Code	761
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$261.50
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Oxford Commercial	$261.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Commercial	$261.50

IR-EXT VENOGRAPHY INJ-RT

Facility

$523.00

Service Code	HCPCS 36005RT
Hospital Charge Code	321036005R
Hospital Revenue Code	361
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

Know your out-of-pocket cost for care.

All Charges