Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR RENAL CYST STUDY TRANSLUM W

Facility

$664.85

Service Code	HCPCS 74470
Hospital Charge Code	2004760
Hospital Revenue Code	320
Min. Negotiated Rate	$99.73
Max. Negotiated Rate	$99.73
Rate for Payer: Qualcare PPO/HMO/WC	$99.73

IR RENAL PELVIS DRAINAGE PERC

Facility

$3,730.45

Service Code	HCPCS 50392
Hospital Charge Code	2004521
Hospital Revenue Code	361
Min. Negotiated Rate	$484.96
Max. Negotiated Rate	$1,865.22
Rate for Payer: Aetna Commercial	$1,119.13
Rate for Payer: Aetna Medicare Advantage	$1,119.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$951.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$951.26
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	$951.26
Rate for Payer: Cigna Commercial	$1,865.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.96
Rate for Payer: Qualcare PPO/HMO/WC	$559.57

IR RENAL PELVIS DRAINAGE PERC

Facility

$3,730.45

Service Code	HCPCS 50392
Hospital Charge Code	2004521
Hospital Revenue Code	361
Min. Negotiated Rate	$559.57
Max. Negotiated Rate	$559.57
Rate for Payer: Qualcare PPO/HMO/WC	$559.57

IR-RENAL/PERIREN ABCES-LT

Facility

$4,600.00

Service Code	HCPCS 50021LT
Hospital Charge Code	2691530
Hospital Revenue Code	361
Min. Negotiated Rate	$690.00
Max. Negotiated Rate	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

IR-RENAL/PERIREN ABCES-LT

Facility

$4,600.00

Service Code	HCPCS 50021LT
Hospital Charge Code	2691530
Hospital Revenue Code	361
Min. Negotiated Rate	$598.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$1,380.00
Rate for Payer: Aetna Medicare Advantage	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.00
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	$1,173.00
Rate for Payer: Cigna Commercial	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

IR-RENAL/PERIREN ABCES-RT

Facility

$4,600.00

Service Code	HCPCS 50021RT
Hospital Charge Code	2691535
Hospital Revenue Code	361
Min. Negotiated Rate	$690.00
Max. Negotiated Rate	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

IR-RENAL/PERIREN ABCES-RT

Facility

$4,600.00

Service Code	HCPCS 50021RT
Hospital Charge Code	2691535
Hospital Revenue Code	361
Min. Negotiated Rate	$598.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$1,380.00
Rate for Payer: Aetna Medicare Advantage	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.00
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	$1,173.00
Rate for Payer: Cigna Commercial	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

IR RENAL/VISCERAL PTA

Facility

$21,962.30

Service Code	HCPCS 35471
Hospital Charge Code	5600014
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
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	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR RENAL/VISCERAL PTA

Facility

$21,962.30

Service Code	HCPCS 35471
Hospital Charge Code	7411407
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR RENAL/VISCERAL PTA

Facility

$21,962.30

Service Code	HCPCS 35471
Hospital Charge Code	7411407
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
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	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR RENAL/VISCERAL PTA

Facility

$21,962.30

Service Code	HCPCS 35471
Hospital Charge Code	5600014
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR REPAIR ARTERIAL BLOCK (BRA)

Facility

$11,253.65

Service Code	HCPCS 35458
Hospital Charge Code	2011282
Hospital Revenue Code	361
Min. Negotiated Rate	$1,688.05
Max. Negotiated Rate	$1,688.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.05

IR REPAIR ARTERIAL BLOCK (BRA)

Facility

$11,253.65

Service Code	HCPCS 35458
Hospital Charge Code	7411404
Hospital Revenue Code	361
Min. Negotiated Rate	$1,688.05
Max. Negotiated Rate	$1,688.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.05

IR REPAIR ARTERIAL BLOCK (BRA)

Facility

$11,253.65

Service Code	HCPCS 35458
Hospital Charge Code	2011282
Hospital Revenue Code	361
Min. Negotiated Rate	$1,462.97
Max. Negotiated Rate	$5,626.82
Rate for Payer: Aetna Commercial	$3,376.09
Rate for Payer: Aetna Medicare Advantage	$3,376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,869.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,869.68
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	$2,869.68
Rate for Payer: Cigna Commercial	$5,626.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.05

IR REPAIR ARTERIAL BLOCK (BRA)

Facility

$11,253.65

Service Code	HCPCS 35458
Hospital Charge Code	7411404
Hospital Revenue Code	361
Min. Negotiated Rate	$1,462.97
Max. Negotiated Rate	$5,626.82
Rate for Payer: Aetna Commercial	$3,376.09
Rate for Payer: Aetna Medicare Advantage	$3,376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,869.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,869.68
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	$2,869.68
Rate for Payer: Cigna Commercial	$5,626.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.05

IR REPAIR ARTERY BLOCKAGE, EA

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	2011280
Hospital Revenue Code	320
Min. Negotiated Rate	$232.09
Max. Negotiated Rate	$232.09
Rate for Payer: Qualcare PPO/HMO/WC	$232.09

IR REPAIR ARTERY BLOCKAGE, EA

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	7411737
Hospital Revenue Code	320
Min. Negotiated Rate	$232.09
Max. Negotiated Rate	$232.09
Rate for Payer: Qualcare PPO/HMO/WC	$232.09

IR REPAIR ARTERY BLOCKAGE, EA

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	7411737
Hospital Revenue Code	320
Min. Negotiated Rate	$201.14
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$464.18
Rate for Payer: Aetna Medicare Advantage	$464.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.55
Rate for Payer: Cigna Commercial	$773.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.09
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR REPAIR ARTERY BLOCKAGE, EA

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	2011280
Hospital Revenue Code	320
Min. Negotiated Rate	$201.14
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$464.18
Rate for Payer: Aetna Medicare Advantage	$464.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.55
Rate for Payer: Cigna Commercial	$773.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.09
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR REPAIR OF INFRARENAL AAA

Facility

$37,500.00

Service Code	HCPCS 34805
Hospital Charge Code	7411396
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
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	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

IR REPAIR OF INFRARENAL AAA

Facility

$37,500.00

Service Code	HCPCS 34805
Hospital Charge Code	5700210
Hospital Revenue Code	361
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$5,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

IR REPAIR OF INFRARENAL AAA

Facility

$37,500.00

Service Code	HCPCS 34805
Hospital Charge Code	5700210
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
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	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

IR REPAIR OF INFRARENAL AAA

Facility

$37,500.00

Service Code	HCPCS 34805
Hospital Charge Code	7411396
Hospital Revenue Code	361
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$5,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

IR REPAIR TUNNELED CV CATH

Facility

$4,914.50

Service Code	HCPCS 36576
Hospital Charge Code	411036576
Hospital Revenue Code	361
Min. Negotiated Rate	$638.88
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,474.35
Rate for Payer: Aetna Medicare Advantage	$1,474.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,253.20
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	$1,253.20
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR REPAIR TUNNELED CV CATH

Facility

$6,404.20

Service Code	HCPCS 36576
Hospital Charge Code	2011277
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

Know your out-of-pocket cost for care.

All Charges