Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR PLACEMNT CENTRL VENOUS CATH

Facility

$8,696.85

Service Code	HCPCS 36561
Hospital Charge Code	7411454
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.53
Max. Negotiated Rate	$1,304.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.53

IR-PLACE NDLE WIRE BREAST

Facility

$133.00

Hospital Charge Code	2690010
Hospital Revenue Code	761
Min. Negotiated Rate	$17.29
Max. Negotiated Rate	$66.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$39.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.91
Rate for Payer: Cigna Commercial	$66.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.29
Rate for Payer: Oxford Commercial	$66.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.95
Rate for Payer: UnitedHealthcare Commercial	$66.50

IR-PLACE NDLE WIRE BREAST

Facility

$133.00

Hospital Charge Code	2690010
Hospital Revenue Code	761
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.95

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	411036245
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	2690475
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	2690475
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	3668362455
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	3668362455
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	321036245B
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	411036245
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	321036245B
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	321036245L
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	2691260
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	2691260
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	321036245L
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-RT

Facility

$364.00

Service Code	HCPCS 36245RT
Hospital Charge Code	2691265
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-RT

Facility

$364.00

Service Code	HCPCS 36245RT
Hospital Charge Code	321036245R
Hospital Revenue Code	361
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-RT

Facility

$364.00

Service Code	HCPCS 36245RT
Hospital Charge Code	321036245R
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-RT

Facility

$364.00

Service Code	HCPCS 36245RT
Hospital Charge Code	2691265
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST T/B-BI

Facility

$359.00

Service Code	HCPCS 3621550
Hospital Charge Code	2690455
Hospital Revenue Code	361
Min. Negotiated Rate	$53.85
Max. Negotiated Rate	$53.85
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

IR-PL CATH ART 1ST T/B-BI

Facility

$359.00

Service Code	HCPCS 3621550
Hospital Charge Code	2690455
Hospital Revenue Code	361
Min. Negotiated Rate	$46.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$107.70
Rate for Payer: Aetna Medicare Advantage	$107.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.55
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	$91.55
Rate for Payer: Cigna Commercial	$179.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

IR-PL CATH ART 1ST T/B-LT

Facility

$359.00

Service Code	HCPCS 36215LT
Hospital Charge Code	2691220
Hospital Revenue Code	361
Min. Negotiated Rate	$53.85
Max. Negotiated Rate	$53.85
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

IR-PL CATH ART 1ST T/B-LT

Facility

$359.00

Service Code	HCPCS 36215LT
Hospital Charge Code	411036215
Hospital Revenue Code	361
Min. Negotiated Rate	$53.85
Max. Negotiated Rate	$53.85
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

IR-PL CATH ART 1ST T/B-LT

Facility

$359.00

Service Code	HCPCS 36215LT
Hospital Charge Code	321036215L
Hospital Revenue Code	361
Min. Negotiated Rate	$46.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$107.70
Rate for Payer: Aetna Medicare Advantage	$107.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.55
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	$91.55
Rate for Payer: Cigna Commercial	$179.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

IR-PL CATH ART 1ST T/B-LT

Facility

$359.00

Service Code	HCPCS 36215LT
Hospital Charge Code	411036215
Hospital Revenue Code	361
Min. Negotiated Rate	$46.67
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$107.70
Rate for Payer: Aetna Medicare Advantage	$107.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.55
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	$91.55
Rate for Payer: Cigna Commercial	$179.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$53.85

Know your out-of-pocket cost for care.

All Charges