Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-INSERT KIDNEY DRAIN-BI

Facility

$4,495.00

Hospital Charge Code	2690635
Hospital Revenue Code	361
Min. Negotiated Rate	$674.25
Max. Negotiated Rate	$674.25
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT KIDNEY DRAIN-BI

Facility

$4,495.00

Hospital Charge Code	2690635
Hospital Revenue Code	361
Min. Negotiated Rate	$584.35
Max. Negotiated Rate	$2,247.50
Rate for Payer: Aetna Commercial	$1,348.50
Rate for Payer: Aetna Medicare Advantage	$1,348.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,146.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,146.22
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	$1,146.22
Rate for Payer: Cigna Commercial	$2,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.35
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT KIDNEY DRAIN-LT

Facility

$4,495.00

Hospital Charge Code	2691600
Hospital Revenue Code	361
Min. Negotiated Rate	$584.35
Max. Negotiated Rate	$2,247.50
Rate for Payer: Aetna Commercial	$1,348.50
Rate for Payer: Aetna Medicare Advantage	$1,348.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,146.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,146.22
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	$1,146.22
Rate for Payer: Cigna Commercial	$2,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.35
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT KIDNEY DRAIN-LT

Facility

$4,495.00

Hospital Charge Code	2691600
Hospital Revenue Code	361
Min. Negotiated Rate	$674.25
Max. Negotiated Rate	$674.25
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT KIDNEY DRAIN-RT

Facility

$4,495.00

Hospital Charge Code	2691605
Hospital Revenue Code	361
Min. Negotiated Rate	$674.25
Max. Negotiated Rate	$674.25
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT KIDNEY DRAIN-RT

Facility

$4,495.00

Hospital Charge Code	2691605
Hospital Revenue Code	361
Min. Negotiated Rate	$584.35
Max. Negotiated Rate	$2,247.50
Rate for Payer: Aetna Commercial	$1,348.50
Rate for Payer: Aetna Medicare Advantage	$1,348.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,146.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,146.22
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	$1,146.22
Rate for Payer: Cigna Commercial	$2,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.35
Rate for Payer: Qualcare PPO/HMO/WC	$674.25

IR-INSERT NDL CATH BOWEL

Facility

$1,155.00

Service Code	HCPCS 44015
Hospital Charge Code	7411549
Hospital Revenue Code	361
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

IR-INSERT NDL CATH BOWEL

Facility

$1,155.00

Service Code	HCPCS 44015
Hospital Charge Code	7411549
Hospital Revenue Code	361
Min. Negotiated Rate	$136.68
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
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	$294.52
Rate for Payer: Cigna Commercial	$136.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.15
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$173.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT NDL CATH BOWEL

Facility

$1,155.00

Service Code	HCPCS 44015
Hospital Charge Code	2690115
Hospital Revenue Code	361
Min. Negotiated Rate	$136.68
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
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	$294.52
Rate for Payer: Cigna Commercial	$136.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.15
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$173.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-INSERT NDL CATH BOWEL

Facility

$1,155.00

Service Code	HCPCS 44015
Hospital Charge Code	2690115
Hospital Revenue Code	361
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

IR-INSERT NDLE BONE CAVTY

Facility

$240.00

Service Code	HCPCS 36680
Hospital Charge Code	7411483
Hospital Revenue Code	361
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

IR-INSERT NDLE BONE CAVTY

Facility

$240.00

Service Code	HCPCS 36680
Hospital Charge Code	2690075
Hospital Revenue Code	361
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

IR-INSERT NDLE BONE CAVTY

Facility

$240.00

Service Code	HCPCS 36680
Hospital Charge Code	2690075
Hospital Revenue Code	361
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
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	$61.20
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-INSERT NDLE BONE CAVTY

Facility

$240.00

Service Code	HCPCS 36680
Hospital Charge Code	7411483
Hospital Revenue Code	361
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
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	$61.20
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INSERT OF IMPLANT VEN DEV

Facility

$5,224.75

Service Code	HCPCS 36557
Hospital Charge Code	7411450
Hospital Revenue Code	361
Min. Negotiated Rate	$783.71
Max. Negotiated Rate	$783.71
Rate for Payer: Qualcare PPO/HMO/WC	$783.71

IR INSERT OF IMPLANT VEN DEV

Facility

$5,224.75

Service Code	HCPCS 36557
Hospital Charge Code	2101150
Hospital Revenue Code	361
Min. Negotiated Rate	$783.71
Max. Negotiated Rate	$783.71
Rate for Payer: Qualcare PPO/HMO/WC	$783.71

IR INSERT OF IMPLANT VEN DEV

Facility

$5,224.75

Service Code	HCPCS 36557
Hospital Charge Code	2101150
Hospital Revenue Code	361
Min. Negotiated Rate	$679.22
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$1,567.42
Rate for Payer: Aetna Medicare Advantage	$1,567.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.31
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	$1,332.31
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.22
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$783.71
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR INSERT OF IMPLANT VEN DEV

Facility

$5,224.75

Service Code	HCPCS 36557
Hospital Charge Code	7411450
Hospital Revenue Code	361
Min. Negotiated Rate	$679.22
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$1,567.42
Rate for Payer: Aetna Medicare Advantage	$1,567.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.31
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	$1,332.31
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.22
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$783.71
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR INSERT OF TUBE THORACOSTOMY

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	5600185
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

IR INSERT OF TUBE THORACOSTOMY

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	5600185
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Better Health Medicaid	$2,426.75
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
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	$617.78
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,475.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,426.75

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$1,600.00

Service Code	HCPCS 37182
Hospital Charge Code	7411492
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$18,561.00

Service Code	HCPCS 37182
Hospital Charge Code	366837182
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$5,568.30
Rate for Payer: Aetna Medicare Advantage	$5,568.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,733.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,733.06
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	$4,733.06
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.93
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,784.15
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$1,600.00

Service Code	HCPCS 37182
Hospital Charge Code	7411492
Hospital Revenue Code	361
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$18,561.00

Service Code	HCPCS 37182
Hospital Charge Code	366837182
Hospital Revenue Code	361
Min. Negotiated Rate	$2,784.15
Max. Negotiated Rate	$2,784.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,784.15

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$18,561.00

Service Code	HCPCS 37182
Hospital Charge Code	411037182
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$5,568.30
Rate for Payer: Aetna Medicare Advantage	$5,568.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,733.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,733.06
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	$4,733.06
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.93
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,784.15
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

Know your out-of-pocket cost for care.

All Charges