Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$1,864.00
Max. Negotiated Rate	$11,220.70
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	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

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	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	321037229
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	321037229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$26,974.32
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/ATHER

Facility

$47,642.70

Service Code	HCPCS 37229
Hospital Charge Code	7411519
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 W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$40,048.22
Rate for Payer: Aetna Commercial	$24,028.94
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$40,048.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,412.54
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$44,957.00
Rate for Payer: Aetna Commercial	$26,974.20
Rate for Payer: Aetna Medicare Advantage	$26,974.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.07
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	$22,928.07
Rate for Payer: Cigna Commercial	$44,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.82
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$26,974.32
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$13,487.10
Max. Negotiated Rate	$13,487.10
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$24,028.94
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,412.54
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/ATHER

Facility

$47,642.70

Service Code	HCPCS 37229
Hospital Charge Code	7411519
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	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	7411523
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	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	5600214
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$23,821.35
Rate for Payer: Cigna Commercial	$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: MagnaCare PPO/Direct Plus/Exchange/WC	$6,193.55
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	7411523
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 TIBPER REVASC W/ATHER ADD-O

Facility

$47,642.70

Service Code	HCPCS 37233
Hospital Charge Code	5600214
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 W/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$26,974.32
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/STENT

Facility

$47,642.70

Service Code	HCPCS 37230
Hospital Charge Code	7411520
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	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/STENT

Facility

$80,096.45

Service Code	HCPCS 37230
Hospital Charge Code	366837230
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$40,048.22
Rate for Payer: Aetna Commercial	$24,028.94
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$40,048.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,412.54
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$26,974.32
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TIB/PER REVASC W/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$24,028.94
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,412.54
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

Know your out-of-pocket cost for care.

All Charges