Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-PL CATH ART 3RD T/B-LT

Facility

$486.00

Service Code	HCPCS 36217LT
Hospital Charge Code	2691240
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-LT

Facility

$486.00

Service Code	HCPCS 36217LT
Hospital Charge Code	366836217L
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-LT

Facility

$486.00

Service Code	HCPCS 36217LT
Hospital Charge Code	321036217L
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-LT

Facility

$486.00

Service Code	HCPCS 36217LT
Hospital Charge Code	2691240
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-LT

Facility

$486.00

Service Code	HCPCS 36217LT
Hospital Charge Code	366836217L
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	366836217R
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	366836217R
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	411036217R
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	411036217R
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	2691245
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	2691245
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	321036217R
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART 3RD T/B-RT

Facility

$486.00

Service Code	HCPCS 36217RT
Hospital Charge Code	321036217R
Hospital Revenue Code	361
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.80
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	3668362485
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	7411797
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	2690480
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	411036248
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	3668362485
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	2690480
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	7411797
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	321036248B
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	321036248B
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-BI

Facility

$484.00

Service Code	HCPCS 3624850
Hospital Charge Code	411036248
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-LT

Facility

$484.00

Service Code	HCPCS 36248LT
Hospital Charge Code	2691270
Hospital Revenue Code	361
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-LT

Facility

$484.00

Service Code	HCPCS 36248LT
Hospital Charge Code	321036248L
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

Know your out-of-pocket cost for care.

All Charges