Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IRSM JT ARTHROCENTESIS

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	7411344
Hospital Revenue Code	361
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

IRSM JT ARTHROCENTESIS

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	2680025
Hospital Revenue Code	361
Min. Negotiated Rate	$141.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$327.30
Rate for Payer: Aetna Medicare Advantage	$327.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.20
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	$278.20
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IRSM JT ARTHROCENTESIS

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	2680025
Hospital Revenue Code	361
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

IRSM JT ARTHROCENTESIS

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	7411344
Hospital Revenue Code	361
Min. Negotiated Rate	$141.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$327.30
Rate for Payer: Aetna Medicare Advantage	$327.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.20
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	$278.20
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-SPINAL ARTERY INJ

Facility

$741.00

Service Code	HCPCS 62294
Hospital Charge Code	7411653
Hospital Revenue Code	361
Min. Negotiated Rate	$96.33
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$222.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.96
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	$188.96
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.33
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.15
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-SPINAL ARTERY INJ

Facility

$741.00

Service Code	HCPCS 62294
Hospital Charge Code	2690240
Hospital Revenue Code	361
Min. Negotiated Rate	$111.15
Max. Negotiated Rate	$111.15
Rate for Payer: Qualcare PPO/HMO/WC	$111.15

IR-SPINAL ARTERY INJ

Facility

$741.00

Service Code	HCPCS 62294
Hospital Charge Code	2690240
Hospital Revenue Code	361
Min. Negotiated Rate	$96.33
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$222.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.96
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	$188.96
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.33
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.15
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

IR-SPINAL ARTERY INJ

Facility

$741.00

Service Code	HCPCS 62294
Hospital Charge Code	7411653
Hospital Revenue Code	361
Min. Negotiated Rate	$111.15
Max. Negotiated Rate	$111.15
Rate for Payer: Qualcare PPO/HMO/WC	$111.15

IR SPLENOPORTOGRAPHY

Facility

$13,436.40

Service Code	HCPCS 75810
Hospital Charge Code	2000941
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR SPLENOPORTOGRAPHY

Facility

$13,436.40

Service Code	HCPCS 75810
Hospital Charge Code	2000941
Hospital Revenue Code	320
Min. Negotiated Rate	$116.88
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR STENT INT VASC TCATH EA VES

Facility

$2,237.55

Hospital Charge Code	2011155
Hospital Revenue Code	320
Min. Negotiated Rate	$290.88
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$1,118.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR STENT INT VASC TCATH EA VES

Facility

$2,237.55

Hospital Charge Code	2011155
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	321037236
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	2011160
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	2011160
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	321037236
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	2011165
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	321037237
Hospital Revenue Code	361
Min. Negotiated Rate	$201.26
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$4,684.50
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$201.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,029.95
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	321037237
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	2011165
Hospital Revenue Code	361
Min. Negotiated Rate	$201.26
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$4,684.50
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$201.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,029.95
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR STNT PLCMT INTRVSC PERC/OPN

Facility

$2,237.55

Hospital Charge Code	2600113
Hospital Revenue Code	320
Min. Negotiated Rate	$290.88
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$1,118.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR STNT PLCMT INTRVSC PERC/OPN

Facility

$2,237.55

Hospital Charge Code	2600113
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR SUTURE DRESSING TRAY/SUPPLI

Facility

$15.00

Hospital Charge Code	4800970
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

Know your out-of-pocket cost for care.

All Charges