Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	366849450
Hospital Revenue Code	361
Min. Negotiated Rate	$483.24
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,115.16
Rate for Payer: Aetna Medicare Advantage	$1,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.89
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	$947.89
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR/GASTRO/CECO/COLON TUBE

Facility

$1,891.00

Service Code	HCPCS 49450
Hospital Charge Code	7411597
Hospital Revenue Code	361
Min. Negotiated Rate	$283.65
Max. Negotiated Rate	$283.65
Rate for Payer: Qualcare PPO/HMO/WC	$283.65

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	366849450
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	411049450
Hospital Revenue Code	361
Min. Negotiated Rate	$483.24
Max. Negotiated Rate	$3,687.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Aetna Commercial	$1,115.16
Rate for Payer: Aetna Medicare Advantage	$1,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.89
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	$947.89
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.24
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	321049450
Hospital Revenue Code	361
Min. Negotiated Rate	$579.74
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,337.87
Rate for Payer: Aetna Medicare Advantage	$1,337.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.19
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	$1,137.19
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.74
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	411049450
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	2690165
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	7411672
Hospital Revenue Code	320
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2600088
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$380.40
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2600088
Hospital Revenue Code	320
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	7411672
Hospital Revenue Code	320
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$380.40
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	366876937
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	2100239
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	7411752
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	321076937
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	2100239
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	366876937
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	7411752
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	321076937
Hospital Revenue Code	402
Min. Negotiated Rate	$45.82
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$45.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

IR HEPATIC VENOGRAPHY

Facility

$13,436.40

Service Code	HCPCS 75889
Hospital Charge Code	2001629
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR HEPATIC VENOGRAPHY

Facility

$13,436.40

Service Code	HCPCS 75889
Hospital Charge Code	2001629
Hospital Revenue Code	320
Min. Negotiated Rate	$353.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2680285
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	321073525
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	321073525
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2680285
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

Know your out-of-pocket cost for care.

All Charges