Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-INTRO CTH-EXT ARTERY

Facility

$1,443.00

Service Code	HCPCS 3614050
Hospital Charge Code	3668361405
Hospital Revenue Code	361
Min. Negotiated Rate	$187.59
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$432.90
Rate for Payer: Aetna Medicare Advantage	$432.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.96
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	$367.96
Rate for Payer: Cigna Commercial	$721.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.59
Rate for Payer: Qualcare PPO/HMO/WC	$216.45

IR-INTRO GASTRO TUBE

Facility

$576.00

Service Code	HCPCS 44500
Hospital Charge Code	2690120
Hospital Revenue Code	361
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
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	$146.88
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.88
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-INTRO GASTRO TUBE

Facility

$576.00

Service Code	HCPCS 44500
Hospital Charge Code	2690120
Hospital Revenue Code	361
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

IR-INTRO GASTRO TUBE

Facility

$576.00

Service Code	HCPCS 44500
Hospital Charge Code	7411550
Hospital Revenue Code	361
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

IR-INTRO GASTRO TUBE

Facility

$576.00

Service Code	HCPCS 44500
Hospital Charge Code	7411550
Hospital Revenue Code	361
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
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	$146.88
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.88
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-INTRO GUIDE REN PEL-LT

Facility

$5,397.00

Service Code	HCPCS 50395LT
Hospital Charge Code	7411968
Hospital Revenue Code	761
Min. Negotiated Rate	$701.61
Max. Negotiated Rate	$2,698.50
Rate for Payer: Aetna Commercial	$1,619.10
Rate for Payer: Aetna Medicare Advantage	$1,619.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.23
Rate for Payer: Cigna Commercial	$2,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.61
Rate for Payer: Oxford Commercial	$2,698.50
Rate for Payer: Qualcare PPO/HMO/WC	$809.55
Rate for Payer: UnitedHealthcare Commercial	$2,698.50

IR-INTRO GUIDE REN PEL-LT

Facility

$5,397.00

Service Code	HCPCS 50395LT
Hospital Charge Code	2691630
Hospital Revenue Code	761
Min. Negotiated Rate	$809.55
Max. Negotiated Rate	$809.55
Rate for Payer: Qualcare PPO/HMO/WC	$809.55

IR-INTRO GUIDE REN PEL-LT

Facility

$5,397.00

Service Code	HCPCS 50395LT
Hospital Charge Code	7411968
Hospital Revenue Code	761
Min. Negotiated Rate	$809.55
Max. Negotiated Rate	$809.55
Rate for Payer: Qualcare PPO/HMO/WC	$809.55

IR-INTRO GUIDE REN PEL-LT

Facility

$5,397.00

Service Code	HCPCS 50395LT
Hospital Charge Code	2691630
Hospital Revenue Code	761
Min. Negotiated Rate	$701.61
Max. Negotiated Rate	$2,698.50
Rate for Payer: Aetna Commercial	$1,619.10
Rate for Payer: Aetna Medicare Advantage	$1,619.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.23
Rate for Payer: Cigna Commercial	$2,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.61
Rate for Payer: Oxford Commercial	$2,698.50
Rate for Payer: Qualcare PPO/HMO/WC	$809.55
Rate for Payer: UnitedHealthcare Commercial	$2,698.50

IR-INTRO GUIDE REN PEL-RT

Facility

$5,397.00

Service Code	HCPCS 50395RT
Hospital Charge Code	7411969
Hospital Revenue Code	761
Min. Negotiated Rate	$809.55
Max. Negotiated Rate	$809.55
Rate for Payer: Qualcare PPO/HMO/WC	$809.55

IR-INTRO GUIDE REN PEL-RT

Facility

$5,397.00

Service Code	HCPCS 50395RT
Hospital Charge Code	2691635
Hospital Revenue Code	761
Min. Negotiated Rate	$809.55
Max. Negotiated Rate	$809.55
Rate for Payer: Qualcare PPO/HMO/WC	$809.55

IR-INTRO GUIDE REN PEL-RT

Facility

$5,397.00

Service Code	HCPCS 50395RT
Hospital Charge Code	2691635
Hospital Revenue Code	761
Min. Negotiated Rate	$701.61
Max. Negotiated Rate	$2,698.50
Rate for Payer: Aetna Commercial	$1,619.10
Rate for Payer: Aetna Medicare Advantage	$1,619.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.23
Rate for Payer: Cigna Commercial	$2,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.61
Rate for Payer: Oxford Commercial	$2,698.50
Rate for Payer: Qualcare PPO/HMO/WC	$809.55
Rate for Payer: UnitedHealthcare Commercial	$2,698.50

IR-INTRO GUIDE REN PEL-RT

Facility

$5,397.00

Service Code	HCPCS 50395RT
Hospital Charge Code	7411969
Hospital Revenue Code	761
Min. Negotiated Rate	$701.61
Max. Negotiated Rate	$2,698.50
Rate for Payer: Aetna Commercial	$1,619.10
Rate for Payer: Aetna Medicare Advantage	$1,619.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.23
Rate for Payer: Cigna Commercial	$2,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.61
Rate for Payer: Oxford Commercial	$2,698.50
Rate for Payer: Qualcare PPO/HMO/WC	$809.55
Rate for Payer: UnitedHealthcare Commercial	$2,698.50

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2004190
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	321036140
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	411036140
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	366836140
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	7411422
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	2004190
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	411036140
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	321036140
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	366836140
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INTRO NDL/CATH EXTR ART

Facility

$414.45

Service Code	HCPCS 36140
Hospital Charge Code	7411422
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR INTRO NDLE/CATH AV SHUNT

Facility

$414.45

Hospital Charge Code	2004745
Hospital Revenue Code	761
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$207.22
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$207.22

IR INTRO NDLE/CATH AV SHUNT

Facility

$414.45

Hospital Charge Code	2004745
Hospital Revenue Code	761
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

Know your out-of-pocket cost for care.

All Charges