Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
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

$47,642.70

Service Code	HCPCS 37230
Hospital Charge Code	7411520
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/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$28,310.47
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	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC W/TLA

Facility

$22,441.40

Service Code	HCPCS 37228
Hospital Charge Code	7411518
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/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$28,310.47
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	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$26,274.30
Rate for Payer: Aetna Commercial	$15,764.58
Rate for Payer: Aetna Medicare Advantage	$15,764.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,399.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,399.89
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	$13,399.89
Rate for Payer: Cigna Commercial	$26,274.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,831.32
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$15,764.58
Rate for Payer: Aetna Medicare Advantage	$15,764.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,399.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,399.89
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	$13,399.89
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,831.32
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$22,441.40

Service Code	HCPCS 37228
Hospital Charge Code	7411518
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 W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
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 TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
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 TL ANGIOPLSTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	2600170
Hospital Revenue Code	323
Min. Negotiated Rate	$1,410.56
Max. Negotiated Rate	$1,410.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56

IR TL ANGIOPLSTY TIBIOPERONEAL

Facility

$9,403.75

Hospital Charge Code	2600170
Hospital Revenue Code	323
Min. Negotiated Rate	$1,222.49
Max. Negotiated Rate	$4,701.88
Rate for Payer: Aetna Commercial	$2,821.12
Rate for Payer: Aetna Medicare Advantage	$2,821.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.96
Rate for Payer: Cigna Commercial	$4,701.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.49
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.56
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR-TRANCATH RETRIEVAL

Facility

$3,724.00

Hospital Charge Code	2690105
Hospital Revenue Code	761
Min. Negotiated Rate	$484.12
Max. Negotiated Rate	$1,862.00
Rate for Payer: Aetna Commercial	$1,117.20
Rate for Payer: Aetna Medicare Advantage	$1,117.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$949.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$949.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$949.62
Rate for Payer: Cigna Commercial	$1,862.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.12
Rate for Payer: Oxford Commercial	$1,862.00
Rate for Payer: Qualcare PPO/HMO/WC	$558.60
Rate for Payer: UnitedHealthcare Commercial	$1,862.00

IR-TRANCATH RETRIEVAL

Facility

$3,724.00

Hospital Charge Code	2690105
Hospital Revenue Code	761
Min. Negotiated Rate	$558.60
Max. Negotiated Rate	$558.60
Rate for Payer: Qualcare PPO/HMO/WC	$558.60

IR-TRANS ARTHER BRACHI-BI

Facility

$37,914.35

Service Code	HCPCS 0237T50
Hospital Charge Code	2690830
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,957.17
Rate for Payer: Aetna Commercial	$11,374.31
Rate for Payer: Aetna Medicare Advantage	$11,374.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,668.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,668.16
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	$9,668.16
Rate for Payer: Cigna Commercial	$18,957.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,928.87
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHER BRACHI-BI

Facility

$37,914.35

Service Code	HCPCS 0237T50
Hospital Charge Code	2690830
Hospital Revenue Code	361
Min. Negotiated Rate	$5,687.15
Max. Negotiated Rate	$5,687.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHER BRACHI-LT

Facility

$37,914.35

Service Code	HCPCS 0237TLT
Hospital Charge Code	2690835
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,957.17
Rate for Payer: Aetna Commercial	$11,374.31
Rate for Payer: Aetna Medicare Advantage	$11,374.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,668.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,668.16
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	$9,668.16
Rate for Payer: Cigna Commercial	$18,957.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,928.87
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHER BRACHI-LT

Facility

$37,914.35

Service Code	HCPCS 0237TLT
Hospital Charge Code	2690835
Hospital Revenue Code	361
Min. Negotiated Rate	$5,687.15
Max. Negotiated Rate	$5,687.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHER BRACHI-RT

Facility

$37,914.35

Service Code	HCPCS 0237TRT
Hospital Charge Code	2690840
Hospital Revenue Code	361
Min. Negotiated Rate	$5,687.15
Max. Negotiated Rate	$5,687.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHER BRACHI-RT

Facility

$37,914.35

Service Code	HCPCS 0237TRT
Hospital Charge Code	2690840
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$18,957.17
Rate for Payer: Aetna Commercial	$11,374.31
Rate for Payer: Aetna Medicare Advantage	$11,374.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,668.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,668.16
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	$9,668.16
Rate for Payer: Cigna Commercial	$18,957.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,928.87
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

IR-TRANS ARTHERECT AORTIC

Facility

$37,914.35

Service Code	HCPCS 0236T
Hospital Charge Code	2690825
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$11,374.31
Rate for Payer: Aetna Medicare Advantage	$11,374.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,668.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,668.16
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	$9,668.16
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,928.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR-TRANS ARTHERECT AORTIC

Facility

$37,914.35

Service Code	HCPCS 0236T
Hospital Charge Code	2690825
Hospital Revenue Code	361
Min. Negotiated Rate	$5,687.15
Max. Negotiated Rate	$5,687.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,687.15

Know your out-of-pocket cost for care.

All Charges