Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR INSERT TIPS W/ IMAGE GUIDE

Facility

$1,600.00

Service Code	HCPCS 37182
Hospital Charge Code	2011099
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

$1,600.00

Service Code	HCPCS 37182
Hospital Charge Code	2011099
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	411037182
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 INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	411036556
Hospital Revenue Code	361
Min. Negotiated Rate	$793.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,832.25
Rate for Payer: Aetna Medicare Advantage	$1,832.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,557.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,557.41
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	$1,557.41
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.98
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	7411448
Hospital Revenue Code	361
Min. Negotiated Rate	$793.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,832.25
Rate for Payer: Aetna Medicare Advantage	$1,832.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,557.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,557.41
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	$1,557.41
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.98
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	411036556
Hospital Revenue Code	361
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

IR INS NON-TUNNEL CV CATH >5

Facility

$6,402.70

Service Code	HCPCS 36556
Hospital Charge Code	321036556
Hospital Revenue Code	361
Min. Negotiated Rate	$960.40
Max. Negotiated Rate	$960.40
Rate for Payer: Qualcare PPO/HMO/WC	$960.40

IR INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	366836556
Hospital Revenue Code	361
Min. Negotiated Rate	$793.98
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,832.25
Rate for Payer: Aetna Medicare Advantage	$1,832.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,557.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,557.41
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	$1,557.41
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.98
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	7411448
Hospital Revenue Code	361
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

IR INS NON-TUNNEL CV CATH >5

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	366836556
Hospital Revenue Code	361
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

IR INS NON-TUNNEL CV CATH >5

Facility

$6,402.70

Service Code	HCPCS 36556
Hospital Charge Code	321036556
Hospital Revenue Code	361
Min. Negotiated Rate	$832.35
Max. Negotiated Rate	$7,519.21
Rate for Payer: Qualcare PPO/HMO/WC	$960.40
Rate for Payer: Aetna Commercial	$1,920.81
Rate for Payer: Aetna Medicare Advantage	$1,920.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.69
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	$1,632.69
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.35
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR INS NON-TUNNEL CV CATH >5

Facility

$6,402.70

Service Code	HCPCS 36556
Hospital Charge Code	2011275
Hospital Revenue Code	361
Min. Negotiated Rate	$832.35
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,920.81
Rate for Payer: Aetna Medicare Advantage	$1,920.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.69
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	$1,632.69
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.35
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.40
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR INS NON-TUNNEL CV CATH >5

Facility

$6,402.70

Service Code	HCPCS 36556
Hospital Charge Code	2011275
Hospital Revenue Code	361
Min. Negotiated Rate	$960.40
Max. Negotiated Rate	$960.40
Rate for Payer: Qualcare PPO/HMO/WC	$960.40

IR INS PEG TUBE

Facility

$8,368.50

Service Code	HCPCS 49441
Hospital Charge Code	7411594
Hospital Revenue Code	361
Min. Negotiated Rate	$1,255.28
Max. Negotiated Rate	$1,255.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.28

IR INS PEG TUBE

Facility

$7,136.45

Service Code	HCPCS 49441
Hospital Charge Code	411049441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,070.47
Max. Negotiated Rate	$1,070.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.47

IR INS PEG TUBE

Facility

$8,368.50

Service Code	HCPCS 49441
Hospital Charge Code	366849441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,087.90
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$2,510.55
Rate for Payer: Aetna Medicare Advantage	$2,510.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,133.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,133.97
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	$2,133.97
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.90
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.28
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR INS PEG TUBE

Facility

$8,686.35

Service Code	HCPCS 49441
Hospital Charge Code	2670040
Hospital Revenue Code	361
Min. Negotiated Rate	$1,129.23
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$2,605.91
Rate for Payer: Aetna Medicare Advantage	$2,605.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,215.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,215.02
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	$2,215.02
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.23
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR INS PEG TUBE

Facility

$8,686.35

Service Code	HCPCS 49441
Hospital Charge Code	321049441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,129.23
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$2,605.91
Rate for Payer: Aetna Medicare Advantage	$2,605.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,215.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,215.02
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	$2,215.02
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.23
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR INS PEG TUBE

Facility

$8,686.35

Service Code	HCPCS 49441
Hospital Charge Code	2670040
Hospital Revenue Code	361
Min. Negotiated Rate	$1,302.95
Max. Negotiated Rate	$1,302.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95

IR INS PEG TUBE

Facility

$8,686.35

Service Code	HCPCS 49441
Hospital Charge Code	321049441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,302.95
Max. Negotiated Rate	$1,302.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95

IR INS PEG TUBE

Facility

$8,368.50

Service Code	HCPCS 49441
Hospital Charge Code	366849441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,255.28
Max. Negotiated Rate	$1,255.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.28

IR INS PEG TUBE

Facility

$7,136.45

Service Code	HCPCS 49441
Hospital Charge Code	411049441
Hospital Revenue Code	361
Min. Negotiated Rate	$927.74
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$2,140.93
Rate for Payer: Aetna Medicare Advantage	$2,140.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,819.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,819.79
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	$1,819.79
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.74
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.47
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR INS PEG TUBE

Facility

$8,368.50

Service Code	HCPCS 49441
Hospital Charge Code	7411594
Hospital Revenue Code	361
Min. Negotiated Rate	$1,087.90
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$2,510.55
Rate for Payer: Aetna Medicare Advantage	$2,510.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,133.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,133.97
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	$2,133.97
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.90
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.28
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR INS TEMP BLADDER CATH (FOLE

Facility

$623.55

Service Code	HCPCS 51702
Hospital Charge Code	321051702
Hospital Revenue Code	361
Min. Negotiated Rate	$81.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$187.06
Rate for Payer: Aetna Medicare Advantage	$187.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.01
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	$159.01
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INS TEMP BLADDER CATH (FOLE

Facility

$274.00

Service Code	HCPCS 51702
Hospital Charge Code	2680215
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$82.20
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
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	$69.87
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges