Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,289.68

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$297.66
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$686.90
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
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	$583.87
Rate for Payer: Cigna Commercial	$1,144.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.66
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,289.68

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$297.66
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$686.90
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
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	$583.87
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.66
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$297.66
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$686.90
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
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	$583.87
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.66
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERITONEOCENTESIS W IMAGING

Facility

$2,422.65

Service Code	HCPCS 49083
Hospital Charge Code	2004042
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

IR PERITONEOCENTESIS W IMAGING

Facility

$2,422.65

Service Code	HCPCS 49083
Hospital Charge Code	2004042
Hospital Revenue Code	361
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,687.00
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	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	41100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	36680075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	41100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	7411847
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	7411847
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	36680075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR PICC TRAY

Facility

$43.00

Hospital Charge Code	7412026
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

IR PICC TRAY

Facility

$43.00

Hospital Charge Code	7412026
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

IR PICC TRAY

Facility

$43.00

Service Code	HCPCS A4310
Hospital Charge Code	2680395
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: Cigna Medicare Advantage	$6.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

IR PICC TRAY

Facility

$43.00

Service Code	HCPCS A4310
Hospital Charge Code	2680395
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

IR-PLACE BRSTCLIP PRCT-BI

Facility

$471.00

Hospital Charge Code	2690315
Hospital Revenue Code	361
Min. Negotiated Rate	$70.65
Max. Negotiated Rate	$70.65
Rate for Payer: Qualcare PPO/HMO/WC	$70.65

IR-PLACE BRSTCLIP PRCT-BI

Facility

$471.00

Hospital Charge Code	2690315
Hospital Revenue Code	361
Min. Negotiated Rate	$61.23
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$141.30
Rate for Payer: Aetna Medicare Advantage	$141.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.11
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	$120.11
Rate for Payer: Cigna Commercial	$235.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$70.65

Know your out-of-pocket cost for care.

All Charges