Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-SEL CATH PLACET 1ST-BI

Facility

$242.00

Service Code	HCPCS 3601150
Hospital Charge Code	7411790
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	7411897
Hospital Revenue Code	761
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$121.00

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	7411897
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	2691155
Hospital Revenue Code	761
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$121.00

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	2691155
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	2691160
Hospital Revenue Code	361
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	321036011R
Hospital Revenue Code	361
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	321036011R
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	7411898
Hospital Revenue Code	761
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$121.00

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	7411898
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	2691160
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	2680180
Hospital Revenue Code	361
Min. Negotiated Rate	$242.95
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$5,437.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
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	$4,621.88
Rate for Payer: Cigna Commercial	$242.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,356.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	7411430
Hospital Revenue Code	361
Min. Negotiated Rate	$242.95
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$5,437.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
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	$4,621.88
Rate for Payer: Cigna Commercial	$242.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,356.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	7411430
Hospital Revenue Code	361
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$2,718.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	2680180
Hospital Revenue Code	361
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$2,718.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

IR SEL VEN CATH 1ST ORD

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	2680170
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR SEL VEN CATH 1ST ORD

Facility

$414.45

Service Code	HCPCS 36011
Hospital Charge Code	7411415
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$146.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL VEN CATH 1ST ORD

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	321036011
Hospital Revenue Code	361
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$146.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL VEN CATH 1ST ORD

Facility

$414.45

Service Code	HCPCS 36011
Hospital Charge Code	7411415
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR SEL VEN CATH 1ST ORD

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	321036011
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR SEL VEN CATH 1ST ORD

Facility

$242.00

Service Code	HCPCS 36011
Hospital Charge Code	2680170
Hospital Revenue Code	361
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$146.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL VEN CATH 2ND ORD

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	321036012
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR SEL VEN CATH 2ND ORD

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	7411416
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR SEL VEN CATH 2ND ORD

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	7411416
Hospital Revenue Code	361
Min. Negotiated Rate	$165.24
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$875.70
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$165.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR SEL VEN CATH 2ND ORD

Facility

$2,919.00

Service Code	HCPCS 36012
Hospital Charge Code	2680175
Hospital Revenue Code	361
Min. Negotiated Rate	$165.24
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$875.70
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$165.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges