Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-PREP BLADDER XRAY INJ

Facility

$634.00

Service Code	HCPCS 51605
Hospital Charge Code	7411624
Hospital Revenue Code	361
Min. Negotiated Rate	$38.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$190.20
Rate for Payer: Aetna Medicare Advantage	$190.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.67
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	$161.67
Rate for Payer: Cigna Commercial	$38.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.42
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-PREP BLADDER XRAY INJ

Facility

$634.00

Service Code	HCPCS 51605
Hospital Charge Code	2690185
Hospital Revenue Code	361
Min. Negotiated Rate	$38.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$190.20
Rate for Payer: Aetna Medicare Advantage	$190.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.67
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	$161.67
Rate for Payer: Cigna Commercial	$38.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.42
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-PREP BLADDER XRAY INJ

Facility

$634.00

Service Code	HCPCS 51605
Hospital Charge Code	2690185
Hospital Revenue Code	361
Min. Negotiated Rate	$95.10
Max. Negotiated Rate	$95.10
Rate for Payer: Qualcare PPO/HMO/WC	$95.10

IR-PREP BLADDER XRAY INJ

Facility

$634.00

Service Code	HCPCS 51605
Hospital Charge Code	7411624
Hospital Revenue Code	361
Min. Negotiated Rate	$95.10
Max. Negotiated Rate	$95.10
Rate for Payer: Qualcare PPO/HMO/WC	$95.10

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	2001359
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	321037184
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	2001359
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	321037184
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	321037185
Hospital Revenue Code	361
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$3,638.70
Rate for Payer: Aetna Commercial	$3,638.70
Rate for Payer: Aetna Medicare Advantage	$3,638.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,092.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,092.89
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	$3,092.89
Rate for Payer: Cigna Commercial	$151.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,576.77
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	321037185
Hospital Revenue Code	361
Min. Negotiated Rate	$1,819.35
Max. Negotiated Rate	$1,819.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	2001358
Hospital Revenue Code	361
Min. Negotiated Rate	$1,819.35
Max. Negotiated Rate	$1,819.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	2001358
Hospital Revenue Code	361
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$3,638.70
Rate for Payer: Aetna Commercial	$3,638.70
Rate for Payer: Aetna Medicare Advantage	$3,638.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,092.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,092.89
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	$3,092.89
Rate for Payer: Cigna Commercial	$151.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,576.77
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR PSA - PSEUDOANEURYSM INJ

Facility

$1,053.00

Service Code	HCPCS 36002
Hospital Charge Code	5600117
Hospital Revenue Code	361
Min. Negotiated Rate	$157.95
Max. Negotiated Rate	$157.95
Rate for Payer: Qualcare PPO/HMO/WC	$157.95

IR PSA - PSEUDOANEURYSM INJ

Facility

$1,053.00

Service Code	HCPCS 36002
Hospital Charge Code	7411412
Hospital Revenue Code	361
Min. Negotiated Rate	$136.89
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$315.90
Rate for Payer: Aetna Medicare Advantage	$315.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.51
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	$268.51
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.89
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.95
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR PSA - PSEUDOANEURYSM INJ

Facility

$1,053.00

Service Code	HCPCS 36002
Hospital Charge Code	5600117
Hospital Revenue Code	361
Min. Negotiated Rate	$136.89
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$315.90
Rate for Payer: Aetna Medicare Advantage	$315.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.51
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	$268.51
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.89
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.95
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR PSA - PSEUDOANEURYSM INJ

Facility

$1,053.00

Service Code	HCPCS 36002
Hospital Charge Code	7411412
Hospital Revenue Code	361
Min. Negotiated Rate	$157.95
Max. Negotiated Rate	$157.95
Rate for Payer: Qualcare PPO/HMO/WC	$157.95

IR-PSEUDOAN INJ-BI

Facility

$610.00

Service Code	HCPCS 3600250
Hospital Charge Code	2690420
Hospital Revenue Code	361
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
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	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-BI

Facility

$610.00

Service Code	HCPCS 3600250
Hospital Charge Code	7411788
Hospital Revenue Code	361
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-BI

Facility

$610.00

Service Code	HCPCS 3600250
Hospital Charge Code	2690420
Hospital Revenue Code	361
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-BI

Facility

$610.00

Service Code	HCPCS 3600250
Hospital Charge Code	7411788
Hospital Revenue Code	361
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
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	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-LT

Facility

$610.00

Service Code	HCPCS 36002LT
Hospital Charge Code	2691135
Hospital Revenue Code	761
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00

IR-PSEUDOAN INJ-LT

Facility

$610.00

Service Code	HCPCS 36002LT
Hospital Charge Code	2691135
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-LT

Facility

$610.00

Service Code	HCPCS 36002LT
Hospital Charge Code	7411893
Hospital Revenue Code	761
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00

IR-PSEUDOAN INJ-LT

Facility

$610.00

Service Code	HCPCS 36002LT
Hospital Charge Code	7411893
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

IR-PSEUDOAN INJ-RT

Facility

$3,630.70

Service Code	HCPCS 36002RT
Hospital Charge Code	321036002R
Hospital Revenue Code	361
Min. Negotiated Rate	$471.99
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,815.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

Know your out-of-pocket cost for care.

All Charges