Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR INS CATH REN ART 2ND UNILAT

Facility

$21,323.35

Service Code	HCPCS 36253
Hospital Charge Code	411036253
Hospital Revenue Code	361
Min. Negotiated Rate	$3,198.50
Max. Negotiated Rate	$3,198.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50

IR INS CATH REN ART 2ND UNILAT

Facility

$12,311.10

Service Code	HCPCS 36253
Hospital Charge Code	7411434
Hospital Revenue Code	361
Min. Negotiated Rate	$1,846.66
Max. Negotiated Rate	$1,846.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,846.66

IR INS ENDOVAS VENA CAVA FILTR

Facility

$25,628.45

Service Code	HCPCS 37191
Hospital Charge Code	5700251
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR INS ENDOVAS VENA CAVA FILTR

Facility

$25,628.45

Service Code	HCPCS 37191
Hospital Charge Code	321037191
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR INS ENDOVAS VENA CAVA FILTR

Facility

$25,628.45

Service Code	HCPCS 37191
Hospital Charge Code	321037191
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

IR INS ENDOVAS VENA CAVA FILTR

Facility

$25,628.45

Service Code	HCPCS 37191
Hospital Charge Code	5700251
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

IR-INSERT ARTERY CUTDOWN

Facility

$155.00

Service Code	HCPCS 36625
Hospital Charge Code	7411481
Hospital Revenue Code	361
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

IR-INSERT ARTERY CUTDOWN

Facility

$155.00

Service Code	HCPCS 36625
Hospital Charge Code	7411481
Hospital Revenue Code	361
Min. Negotiated Rate	$20.15
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.50
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
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	$39.52
Rate for Payer: Cigna Commercial	$103.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-INSERT ARTERY CUTDOWN

Facility

$155.00

Service Code	HCPCS 36625
Hospital Charge Code	2690065
Hospital Revenue Code	361
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

IR-INSERT ARTERY CUTDOWN

Facility

$155.00

Service Code	HCPCS 36625
Hospital Charge Code	2690065
Hospital Revenue Code	361
Min. Negotiated Rate	$20.15
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$46.50
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
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	$39.52
Rate for Payer: Cigna Commercial	$103.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-INSERT ARTERY NEWBORN

Facility

$589.00

Service Code	HCPCS 36660
Hospital Charge Code	2690070
Hospital Revenue Code	361
Min. Negotiated Rate	$61.99
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$176.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.19
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	$150.19
Rate for Payer: Cigna Commercial	$61.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.57
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.35
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT ARTERY NEWBORN

Facility

$589.00

Service Code	HCPCS 36660
Hospital Charge Code	2690070
Hospital Revenue Code	361
Min. Negotiated Rate	$88.35
Max. Negotiated Rate	$88.35
Rate for Payer: Qualcare PPO/HMO/WC	$88.35

IR-INSERT ARTERY NEWBORN

Facility

$589.00

Service Code	HCPCS 36660
Hospital Charge Code	7411482
Hospital Revenue Code	361
Min. Negotiated Rate	$88.35
Max. Negotiated Rate	$88.35
Rate for Payer: Qualcare PPO/HMO/WC	$88.35

IR-INSERT ARTERY NEWBORN

Facility

$589.00

Service Code	HCPCS 36660
Hospital Charge Code	7411482
Hospital Revenue Code	361
Min. Negotiated Rate	$61.99
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$176.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.19
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	$150.19
Rate for Payer: Cigna Commercial	$61.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.57
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.35
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT CANNU ART-CLOSE

Facility

$6,450.00

Service Code	HCPCS 36815
Hospital Charge Code	7411486
Hospital Revenue Code	361
Min. Negotiated Rate	$396.47
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Better Health Medicaid	$396.47
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
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	$1,644.75
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$9,851.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$404.40
Rate for Payer: Wellpoint Medicaid Managed Care	$396.47

IR-INSERT CANNU ART-CLOSE

Facility

$6,450.00

Service Code	HCPCS 36815
Hospital Charge Code	2690090
Hospital Revenue Code	361
Min. Negotiated Rate	$396.47
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Better Health Medicaid	$396.47
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
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	$1,644.75
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$9,851.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$404.40
Rate for Payer: Wellpoint Medicaid Managed Care	$396.47

IR-INSERT CANNU ART-CLOSE

Facility

$6,450.00

Service Code	HCPCS 36815
Hospital Charge Code	2690090
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

IR-INSERT CANNU ART-CLOSE

Facility

$6,450.00

Service Code	HCPCS 36815
Hospital Charge Code	7411486
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

IR-INSERT CANNULA ART-EXT

Facility

$6,450.00

Service Code	HCPCS 36810
Hospital Charge Code	7411485
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

IR-INSERT CANNULA ART-EXT

Facility

$6,450.00

Service Code	HCPCS 36810
Hospital Charge Code	2690085
Hospital Revenue Code	361
Min. Negotiated Rate	$838.50
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
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	$1,644.75
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT CANNULA ART-EXT

Facility

$6,450.00

Service Code	HCPCS 36810
Hospital Charge Code	7411485
Hospital Revenue Code	361
Min. Negotiated Rate	$838.50
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
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	$1,644.75
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT CANNULA ART-EXT

Facility

$6,450.00

Service Code	HCPCS 36810
Hospital Charge Code	2690085
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

IR-INSERT CANNU VEIN-VEIN

Facility

$6,450.00

Service Code	HCPCS 36800
Hospital Charge Code	2690080
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

IR-INSERT CANNU VEIN-VEIN

Facility

$6,450.00

Service Code	HCPCS 36800
Hospital Charge Code	7411484
Hospital Revenue Code	361
Min. Negotiated Rate	$838.50
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
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	$1,644.75
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR-INSERT CANNU VEIN-VEIN

Facility

$6,450.00

Service Code	HCPCS 36800
Hospital Charge Code	7411484
Hospital Revenue Code	361
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

Know your out-of-pocket cost for care.

All Charges