Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR INTRO OF PERC TRANS CATH

Facility

$13,811.90

Hospital Charge Code	2000937
Hospital Revenue Code	361
Min. Negotiated Rate	$2,071.78
Max. Negotiated Rate	$2,071.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,071.78

IR-INTRO URET CATH URE-BI

Facility

$5,397.00

Hospital Charge Code	2690640
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 URET CATH URE-BI

Facility

$5,397.00

Hospital Charge Code	2690640
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 URET CATH URE-LT

Facility

$5,397.00

Hospital Charge Code	2691610
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 URET CATH URE-LT

Facility

$5,397.00

Hospital Charge Code	2691610
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 URET CATH URE-RT

Facility

$5,397.00

Hospital Charge Code	2691615
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 URET CATH URE-RT

Facility

$5,397.00

Hospital Charge Code	2691615
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 URETERAL CATH/STENT

Facility

$7,084.55

Hospital Charge Code	5600017
Hospital Revenue Code	361
Min. Negotiated Rate	$920.99
Max. Negotiated Rate	$3,542.28
Rate for Payer: Aetna Commercial	$2,125.36
Rate for Payer: Aetna Medicare Advantage	$2,125.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,806.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,806.56
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	$1,806.56
Rate for Payer: Cigna Commercial	$3,542.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.68

IR INTRO URETERAL CATH/STENT

Facility

$7,084.55

Hospital Charge Code	5600017
Hospital Revenue Code	361
Min. Negotiated Rate	$1,062.68
Max. Negotiated Rate	$1,062.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.68

IR INT URET CTH OR STNT TO URE

Facility

$2,621.25

Hospital Charge Code	2004522
Hospital Revenue Code	361
Min. Negotiated Rate	$393.19
Max. Negotiated Rate	$393.19
Rate for Payer: Qualcare PPO/HMO/WC	$393.19

IR INT URET CTH OR STNT TO URE

Facility

$2,621.25

Hospital Charge Code	2004522
Hospital Revenue Code	361
Min. Negotiated Rate	$340.76
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$786.38
Rate for Payer: Aetna Medicare Advantage	$786.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$668.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$668.42
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	$668.42
Rate for Payer: Cigna Commercial	$1,310.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.76
Rate for Payer: Qualcare PPO/HMO/WC	$393.19

IRIS HOOK AND LENS MANIPULATOR

Facility

$771.90

Hospital Charge Code	270678625
Hospital Revenue Code	272
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$385.95
Rate for Payer: Aetna Commercial	$231.57
Rate for Payer: Aetna Medicare Advantage	$231.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.83
Rate for Payer: Cigna Commercial	$385.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.35
Rate for Payer: Oxford Commercial	$385.95
Rate for Payer: Qualcare PPO/HMO/WC	$115.78
Rate for Payer: UnitedHealthcare Commercial	$385.95

IRIS HOOK AND LENS MANIPULATOR

Facility

$771.90

Hospital Charge Code	270678625
Hospital Revenue Code	272
Min. Negotiated Rate	$115.78
Max. Negotiated Rate	$115.78
Rate for Payer: Qualcare PPO/HMO/WC	$115.78

IRIS RETRACTOR DISPOSABLE

Facility

$252.00

Hospital Charge Code	270338751
Hospital Revenue Code	272
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

IRIS RETRACTOR DISPOSABLE

Facility

$252.00

Hospital Charge Code	270338751
Hospital Revenue Code	272
Min. Negotiated Rate	$32.76
Max. Negotiated Rate	$126.00
Rate for Payer: Aetna Commercial	$75.60
Rate for Payer: Aetna Medicare Advantage	$75.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.26
Rate for Payer: Cigna Commercial	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
Rate for Payer: UnitedHealthcare Commercial	$126.00

IRIS TRANSLIMBAL RETRACTOR

Facility

$490.00

Hospital Charge Code	270659778
Hospital Revenue Code	270
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

IRIS TRANSLIMBAL RETRACTOR

Facility

$490.00

Hospital Charge Code	270659778
Hospital Revenue Code	270
Min. Negotiated Rate	$63.70
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$147.00
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$245.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Commercial	$245.00

IR IVC FILTER

Facility

$7,400.85

Service Code	HCPCS 37619
Hospital Charge Code	7411537
Hospital Revenue Code	361
Min. Negotiated Rate	$1,110.13
Max. Negotiated Rate	$1,110.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.13

IR IVC FILTER

Facility

$7,400.85

Service Code	HCPCS 37619
Hospital Charge Code	5600016
Hospital Revenue Code	361
Min. Negotiated Rate	$962.11
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$2,220.26
Rate for Payer: Aetna Medicare Advantage	$2,220.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,887.22
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	$1,887.22
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$962.11
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.13
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR IVC FILTER

Facility

$7,400.85

Service Code	HCPCS 37619
Hospital Charge Code	5600016
Hospital Revenue Code	361
Min. Negotiated Rate	$1,110.13
Max. Negotiated Rate	$1,110.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.13

IR IVC FILTER

Facility

$7,400.85

Service Code	HCPCS 37619
Hospital Charge Code	7411537
Hospital Revenue Code	361
Min. Negotiated Rate	$962.11
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$2,220.26
Rate for Payer: Aetna Medicare Advantage	$2,220.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,887.22
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	$1,887.22
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$962.11
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.13
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR IVC FLTER PLCMNT PERCUTNOUS

Facility

$5,100.00

Hospital Charge Code	2600090
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR IVC FLTER PLCMNT PERCUTNOUS

Facility

$5,100.00

Hospital Charge Code	2600090
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR IV US EACH ADD VESSEL ADDON

Facility

$1,517.60

Hospital Charge Code	5700193
Hospital Revenue Code	361
Min. Negotiated Rate	$227.64
Max. Negotiated Rate	$227.64
Rate for Payer: Qualcare PPO/HMO/WC	$227.64

IR IV US EACH ADD VESSEL ADDON

Facility

$1,517.60

Hospital Charge Code	5700193
Hospital Revenue Code	361
Min. Negotiated Rate	$197.29
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$455.28
Rate for Payer: Aetna Medicare Advantage	$455.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.99
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	$386.99
Rate for Payer: Cigna Commercial	$758.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.29
Rate for Payer: Qualcare PPO/HMO/WC	$227.64

Know your out-of-pocket cost for care.

All Charges