Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	321050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$428.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$987.75
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.02
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	321050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$2,116.00

Service Code	HCPCS 50389RT
Hospital Charge Code	7411965
Hospital Revenue Code	361
Min. Negotiated Rate	$275.08
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$634.80
Rate for Payer: Aetna Medicare Advantage	$634.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.58
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	$539.58
Rate for Payer: Cigna Commercial	$1,058.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.08
Rate for Payer: Qualcare PPO/HMO/WC	$317.40

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	366850389R
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	411050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$428.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$987.75
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.02
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$2,116.00

Service Code	HCPCS 50389RT
Hospital Charge Code	7411965
Hospital Revenue Code	361
Min. Negotiated Rate	$317.40
Max. Negotiated Rate	$317.40
Rate for Payer: Qualcare PPO/HMO/WC	$317.40

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	366850389R
Hospital Revenue Code	361
Min. Negotiated Rate	$428.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$987.75
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.02
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	2691585
Hospital Revenue Code	361
Min. Negotiated Rate	$428.02
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$987.75
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.02
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	366849460
Hospital Revenue Code	361
Min. Negotiated Rate	$483.24
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,115.16
Rate for Payer: Aetna Medicare Advantage	$1,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.89
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	$947.89
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-REM OBS G/G-J/COLO TUB

Facility

$1,892.00

Service Code	HCPCS 49460
Hospital Charge Code	7411600
Hospital Revenue Code	361
Min. Negotiated Rate	$245.96
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$567.60
Rate for Payer: Aetna Medicare Advantage	$567.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.46
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	$482.46
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.96
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.80
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-REM OBS G/G-J/COLO TUB

Facility

$1,892.00

Service Code	HCPCS 49460
Hospital Charge Code	7411600
Hospital Revenue Code	361
Min. Negotiated Rate	$283.80
Max. Negotiated Rate	$283.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.80

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	411049460
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR-REM OBS G/G-J/COLO TUB

Facility

$4,459.55

Service Code	HCPCS 49460
Hospital Charge Code	2690175
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	411049460
Hospital Revenue Code	361
Min. Negotiated Rate	$483.24
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,115.16
Rate for Payer: Aetna Medicare Advantage	$1,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.89
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	$947.89
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-REM OBS G/G-J/COLO TUB

Facility

$4,459.55

Service Code	HCPCS 49460
Hospital Charge Code	321049460
Hospital Revenue Code	361
Min. Negotiated Rate	$579.74
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,337.87
Rate for Payer: Aetna Medicare Advantage	$1,337.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.19
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	$1,137.19
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.74
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	366849460
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR-REM OBS G/G-J/COLO TUB

Facility

$4,459.55

Service Code	HCPCS 49460
Hospital Charge Code	2690175
Hospital Revenue Code	361
Min. Negotiated Rate	$579.74
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,337.87
Rate for Payer: Aetna Medicare Advantage	$1,337.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.19
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	$1,137.19
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.74
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR-REM OBS G/G-J/COLO TUB

Facility

$4,459.55

Service Code	HCPCS 49460
Hospital Charge Code	321049460
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR REM OF IMPLANT VEN ACCS DEV

Facility

$2,024.90

Service Code	HCPCS 36589
Hospital Charge Code	2004743
Hospital Revenue Code	361
Min. Negotiated Rate	$263.24
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$607.47
Rate for Payer: Aetna Medicare Advantage	$607.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.35
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	$516.35
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.24
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.74
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR REM OF IMPLANT VEN ACCS DEV

Facility

$2,024.90

Service Code	HCPCS 36589
Hospital Charge Code	2004743
Hospital Revenue Code	361
Min. Negotiated Rate	$303.74
Max. Negotiated Rate	$303.74
Rate for Payer: Qualcare PPO/HMO/WC	$303.74

IR REMOVAL OF IMPLANT VEN DEV

Facility

$2,024.90

Service Code	HCPCS 36589
Hospital Charge Code	2101148
Hospital Revenue Code	361
Min. Negotiated Rate	$263.24
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$607.47
Rate for Payer: Aetna Medicare Advantage	$607.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.35
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	$516.35
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.24
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.74
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR REMOVAL OF IMPLANT VEN DEV

Facility

$2,024.90

Service Code	HCPCS 36589
Hospital Charge Code	2101148
Hospital Revenue Code	361
Min. Negotiated Rate	$303.74
Max. Negotiated Rate	$303.74
Rate for Payer: Qualcare PPO/HMO/WC	$303.74

IR REMOVE BILE DUCT STONE

Facility

$4,222.25

Hospital Charge Code	2101151
Hospital Revenue Code	361
Min. Negotiated Rate	$548.89
Max. Negotiated Rate	$2,111.12
Rate for Payer: Aetna Commercial	$1,266.67
Rate for Payer: Aetna Medicare Advantage	$1,266.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.67
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	$1,076.67
Rate for Payer: Cigna Commercial	$2,111.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.89
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR REMOVE BILE DUCT STONE

Facility

$4,222.25

Hospital Charge Code	2101151
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

$27,397.00

Service Code	HCPCS 37183
Hospital Charge Code	2011298
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
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	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

Know your out-of-pocket cost for care.

All Charges