Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	2000935
Hospital Revenue Code	320
Min. Negotiated Rate	$333.23
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) NJ Health	$333.23
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 PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	366874363
Hospital Revenue Code	320
Min. Negotiated Rate	$333.23
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) NJ Health	$333.23
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 PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	411074363
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR PERC TRAN DIL BILIARY DUCTS

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411676
Hospital Revenue Code	320
Min. Negotiated Rate	$271.44
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$626.40
Rate for Payer: Aetna Medicare Advantage	$626.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.44
Rate for Payer: Cigna Commercial	$1,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	366874363
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR PERC TRAN DIL BILIARY DUCTS

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	321074363
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR PERC TRANSLM BAL ANG VENOUS

Facility

$5,659.55

Service Code	HCPCS 35476
Hospital Charge Code	2001355
Hospital Revenue Code	361
Min. Negotiated Rate	$735.74
Max. Negotiated Rate	$2,829.78
Rate for Payer: Aetna Commercial	$1,697.87
Rate for Payer: Aetna Medicare Advantage	$1,697.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,443.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,443.19
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	$1,443.19
Rate for Payer: Cigna Commercial	$2,829.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.74
Rate for Payer: Qualcare PPO/HMO/WC	$848.93

IR PERC TRANSLM BAL ANG VENOUS

Facility

$5,659.55

Service Code	HCPCS 35476
Hospital Charge Code	2001355
Hospital Revenue Code	361
Min. Negotiated Rate	$848.93
Max. Negotiated Rate	$848.93
Rate for Payer: Qualcare PPO/HMO/WC	$848.93

IR-PERCUT ABLATE LIVER RF

Facility

$14,506.00

Service Code	HCPCS 47380
Hospital Charge Code	2690130
Hospital Revenue Code	361
Min. Negotiated Rate	$1,463.89
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,351.80
Rate for Payer: Aetna Medicare Advantage	$4,351.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.03
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	$3,699.03
Rate for Payer: Cigna Commercial	$1,463.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.90
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-PERCUT ABLATE LIVER RF

Facility

$14,506.00

Service Code	HCPCS 47380
Hospital Charge Code	2690130
Hospital Revenue Code	361
Min. Negotiated Rate	$2,175.90
Max. Negotiated Rate	$2,175.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.90

IR-PERCUT ABLATE LIVER RF

Facility

$14,506.00

Service Code	HCPCS 47380
Hospital Charge Code	7411555
Hospital Revenue Code	361
Min. Negotiated Rate	$1,463.89
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,351.80
Rate for Payer: Aetna Medicare Advantage	$4,351.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.03
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	$3,699.03
Rate for Payer: Cigna Commercial	$1,463.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.90
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR-PERCUT ABLATE LIVER RF

Facility

$14,506.00

Service Code	HCPCS 47380
Hospital Charge Code	7411555
Hospital Revenue Code	361
Min. Negotiated Rate	$2,175.90
Max. Negotiated Rate	$2,175.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.90

IR PERCUTANEOUS GI TUBE PLCMNT

Facility

$602.00

Service Code	HCPCS 74350
Hospital Charge Code	2600107
Hospital Revenue Code	320
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

IR PERCUTANEOUS GI TUBE PLCMNT

Facility

$602.00

Service Code	HCPCS 74350
Hospital Charge Code	2600107
Hospital Revenue Code	320
Min. Negotiated Rate	$78.26
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$180.60
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERCUTANEOUS NEPHROSTOMY

Facility

$2,217.65

Hospital Charge Code	2002103
Hospital Revenue Code	320
Min. Negotiated Rate	$288.29
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$665.29
Rate for Payer: Aetna Medicare Advantage	$665.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$565.50
Rate for Payer: Cigna Commercial	$1,108.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.29
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$332.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERCUTANEOUS NEPHROSTOMY

Facility

$2,217.65

Hospital Charge Code	2002103
Hospital Revenue Code	320
Min. Negotiated Rate	$332.65
Max. Negotiated Rate	$332.65
Rate for Payer: Qualcare PPO/HMO/WC	$332.65

IR PERCUTANEOUS TRANS PORT

Facility

$13,436.40

Service Code	HCPCS 75885
Hospital Charge Code	2001628
Hospital Revenue Code	320
Min. Negotiated Rate	$267.04
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERCUTANEOUS TRANS PORT

Facility

$13,436.40

Service Code	HCPCS 75885
Hospital Charge Code	2001628
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR PERCUT VERTEBROPLASTY FLUOR

Facility

$980.50

Service Code	HCPCS 72291
Hospital Charge Code	2101179
Hospital Revenue Code	320
Min. Negotiated Rate	$127.47
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$294.15
Rate for Payer: Aetna Medicare Advantage	$294.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.03
Rate for Payer: Cigna Commercial	$490.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.47
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.07
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR PERCUT VERTEBROPLASTY FLUOR

Facility

$980.50

Service Code	HCPCS 72291
Hospital Charge Code	2101179
Hospital Revenue Code	320
Min. Negotiated Rate	$147.07
Max. Negotiated Rate	$147.07
Rate for Payer: Qualcare PPO/HMO/WC	$147.07

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$792.48
Max. Negotiated Rate	$3,048.00
Rate for Payer: Aetna Commercial	$1,828.80
Rate for Payer: Aetna Medicare Advantage	$1,828.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.48
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	$1,554.48
Rate for Payer: Cigna Commercial	$3,048.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.48
Rate for Payer: Qualcare PPO/HMO/WC	$914.40

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$914.40
Max. Negotiated Rate	$914.40
Rate for Payer: Qualcare PPO/HMO/WC	$914.40

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,202.10
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$3,202.10
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

Know your out-of-pocket cost for care.

All Charges