Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR THROMBO DECLOT VASC ACCESS

Facility

$8,322.45

Service Code	HCPCS 36870
Hospital Charge Code	2011171
Hospital Revenue Code	361
Min. Negotiated Rate	$1,081.92
Max. Negotiated Rate	$4,161.23
Rate for Payer: Aetna Commercial	$2,496.74
Rate for Payer: Aetna Medicare Advantage	$2,496.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,122.22
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	$2,122.22
Rate for Payer: Cigna Commercial	$4,161.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,081.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,248.37

IR THROMBO DECLOT VASC ACCESS

Facility

$8,322.45

Service Code	HCPCS 36870
Hospital Charge Code	7411490
Hospital Revenue Code	361
Min. Negotiated Rate	$1,248.37
Max. Negotiated Rate	$1,248.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,248.37

IR THROMBO DECLOT VASC ACCESS

Facility

$8,322.45

Service Code	HCPCS 36870
Hospital Charge Code	2011171
Hospital Revenue Code	361
Min. Negotiated Rate	$1,248.37
Max. Negotiated Rate	$1,248.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,248.37

IR THROMBOLYTIC VENOUS TX

Facility

$7,142.25

Service Code	HCPCS 37212
Hospital Charge Code	7411503
Hospital Revenue Code	361
Min. Negotiated Rate	$1,071.34
Max. Negotiated Rate	$1,071.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,071.34

IR THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	321037212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	321037212
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR THROMBOLYTIC VENOUS TX

Facility

$7,142.25

Service Code	HCPCS 37212
Hospital Charge Code	7411503
Hospital Revenue Code	361
Min. Negotiated Rate	$928.49
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,142.68
Rate for Payer: Aetna Medicare Advantage	$2,142.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,821.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,821.27
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	$1,821.27
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$928.49
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,071.34
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	2011166
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	2011166
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	321037232
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	5600213
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$14,292.81
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,193.55
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$144.39
Max. Negotiated Rate	$4,763.10
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$144.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	7411522
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37232
Hospital Charge Code	366837232
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	5600213
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	321037232
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$14,292.81
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,193.55
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	7411522
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$14,292.81
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,193.55
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37232
Hospital Charge Code	366837232
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	7411521
Hospital Revenue Code	361
Min. Negotiated Rate	$19,675.12
Max. Negotiated Rate	$19,675.12
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	5600212
Hospital Revenue Code	361
Min. Negotiated Rate	$19,675.12
Max. Negotiated Rate	$19,675.12
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	7411521
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$65,583.73
Rate for Payer: Aetna Commercial	$39,350.24
Rate for Payer: Aetna Medicare Advantage	$39,350.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,447.70
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	$33,447.70
Rate for Payer: Cigna Commercial	$65,583.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,051.77
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

IR TIB/PER REVASC STENT & ATHE

Facility

$131,167.45

Service Code	HCPCS 37231
Hospital Charge Code	5600212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$65,583.73
Rate for Payer: Aetna Commercial	$39,350.24
Rate for Payer: Aetna Medicare Advantage	$39,350.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,447.70
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	$33,447.70
Rate for Payer: Cigna Commercial	$65,583.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,051.77
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,675.12
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37293
Hospital Charge Code	7411525
Hospital Revenue Code	361
Min. Negotiated Rate	$321.20
Max. Negotiated Rate	$6,732.42
Rate for Payer: Aetna Commercial	$6,732.42
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$321.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37235
Hospital Charge Code	5600216
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

Know your out-of-pocket cost for care.

All Charges