Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR ILIAC ANEURISM ENDOVAS RPR

Facility

$4,000.00

Service Code	HCPCS 75954
Hospital Charge Code	7411734
Hospital Revenue Code	320
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ILIAC ANEURISM ENDOVAS RPR

Facility

$4,000.00

Service Code	HCPCS 75954
Hospital Charge Code	2011300
Hospital Revenue Code	320
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IR ILIAC ANGIO W/CARD CATH

Facility

$6,837.15

Hospital Charge Code	2101166
Hospital Revenue Code	320
Min. Negotiated Rate	$1,025.57
Max. Negotiated Rate	$1,025.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.57

IR ILIAC ANGIO W/CARD CATH

Facility

$6,837.15

Hospital Charge Code	2101166
Hospital Revenue Code	320
Min. Negotiated Rate	$888.83
Max. Negotiated Rate	$3,418.57
Rate for Payer: Aetna Commercial	$2,051.14
Rate for Payer: Aetna Medicare Advantage	$2,051.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.47
Rate for Payer: Cigna Commercial	$3,418.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.83
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.57
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37220
Hospital Charge Code	366837220
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37220
Hospital Charge Code	366837220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,711.65
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
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	$6,482.94
Rate for Payer: Cigna Commercial	$12,711.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	321037220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37254
Hospital Charge Code	411037220
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	5600201
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	5600201
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC

Facility

$22,441.40

Service Code	HCPCS 37220
Hospital Charge Code	7411510
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	321037220
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR ILIAC REVASC

Facility

$22,441.40

Service Code	HCPCS 37220
Hospital Charge Code	7411510
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC

Facility

$22,441.40

Service Code	HCPCS 37220
Hospital Charge Code	5700301
Hospital Revenue Code	360
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37254
Hospital Charge Code	411037220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
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	$6,482.94
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR ILIAC REVASC

Facility

$22,441.40

Service Code	HCPCS 37220
Hospital Charge Code	5700301
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5700303
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5700303
Hospital Revenue Code	360
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5600203
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5600203
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37255
Hospital Charge Code	411037222
Hospital Revenue Code	361
Min. Negotiated Rate	$145.79
Max. Negotiated Rate	$6,732.42
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$145.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	321037222
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	7411512
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	7411512
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	321037222
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Know your out-of-pocket cost for care.

All Charges