Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

IP

$27,397.00

Service Code	HCPCS 37183
Hospital Charge Code	321037183
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 REMOVE HEPATIC SHUNT (TIPS)

Facility

OP

$25,423.30

Service Code	HCPCS 37183
Hospital Charge Code	411037183
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
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	$6,482.94
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

IP

$25,423.30

Service Code	HCPCS 37183
Hospital Charge Code	411037183
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

IP

$25,423.30

Service Code	HCPCS 37183
Hospital Charge Code	366837183
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

IP

$41,896.20

Service Code	HCPCS 37183
Hospital Charge Code	7411493
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

OP

$25,423.30

Service Code	HCPCS 37183
Hospital Charge Code	366837183
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
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	$6,482.94
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

IP

$27,397.00

Service Code	HCPCS 37183
Hospital Charge Code	2011298
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 REMOVE HEPATIC SHUNT (TIPS)

Facility

OP

$41,896.20

Service Code	HCPCS 37183
Hospital Charge Code	7411493
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$12,568.86
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
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	$10,683.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,446.51
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR REMOVE HEPATIC SHUNT (TIPS)

Facility

OP

$27,397.00

Service Code	HCPCS 37183
Hospital Charge Code	321037183
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

IR-REM/REPL URET STNT-BI

Facility

IP

$7,568.00

Service Code	HCPCS 5038250
Hospital Charge Code	2690610
Hospital Revenue Code	361
Min. Negotiated Rate	$1,135.20
Max. Negotiated Rate	$1,135.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20

IR-REM/REPL URET STNT-BI

Facility

OP

$7,568.00

Service Code	HCPCS 5038250
Hospital Charge Code	2690610
Hospital Revenue Code	361
Min. Negotiated Rate	$983.84
Max. Negotiated Rate	$3,784.00
Rate for Payer: Aetna Commercial	$2,270.40
Rate for Payer: Aetna Medicare Advantage	$2,270.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,929.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,929.84
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	$1,929.84
Rate for Payer: Cigna Commercial	$3,784.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20

IR-REM/REPL URET STNT-BI

Facility

OP

$7,568.00

Service Code	HCPCS 5038250
Hospital Charge Code	7411819
Hospital Revenue Code	361
Min. Negotiated Rate	$983.84
Max. Negotiated Rate	$3,784.00
Rate for Payer: Aetna Commercial	$2,270.40
Rate for Payer: Aetna Medicare Advantage	$2,270.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,929.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,929.84
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	$1,929.84
Rate for Payer: Cigna Commercial	$3,784.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20

IR-REM/REPL URET STNT-BI

Facility

IP

$7,568.00

Service Code	HCPCS 5038250
Hospital Charge Code	7411819
Hospital Revenue Code	361
Min. Negotiated Rate	$1,135.20
Max. Negotiated Rate	$1,135.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20

IR-REM/REPL URET STNT-LT

Facility

IP

$10,187.80

Service Code	HCPCS 50382RT
Hospital Charge Code	411050382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

OP

$10,187.80

Service Code	HCPCS 50382RT
Hospital Charge Code	366850382R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

IP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	366850382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

OP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	2691550
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

IP

$7,568.00

Service Code	HCPCS 50382LT
Hospital Charge Code	7411958
Hospital Revenue Code	361
Min. Negotiated Rate	$1,135.20
Max. Negotiated Rate	$1,135.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20

IR-REM/REPL URET STNT-LT

Facility

OP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	321050382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

OP

$10,187.80

Service Code	HCPCS 50382RT
Hospital Charge Code	411050382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

OP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	366850382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,324.41
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,056.34
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

IP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	2691550
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

IP

$10,187.80

Service Code	HCPCS 50382RT
Hospital Charge Code	366850382R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

IP

$10,187.80

Service Code	HCPCS 50382LT
Hospital Charge Code	321050382L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM/REPL URET STNT-LT

Facility

OP

$7,568.00

Service Code	HCPCS 50382LT
Hospital Charge Code	7411958
Hospital Revenue Code	361
Min. Negotiated Rate	$983.84
Max. Negotiated Rate	$3,784.00
Rate for Payer: Aetna Commercial	$2,270.40
Rate for Payer: Aetna Medicare Advantage	$2,270.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,929.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,929.84
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	$1,929.84
Rate for Payer: Cigna Commercial	$3,784.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,135.20