Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	32100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	36680238T5
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	32100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	2690845
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	36680238T5
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	41100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	2690845
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	41100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	32100238TL
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	2690850
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	32100238TL
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	2690850
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	32100238TR
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	2690855
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	32100238TR
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$28,175.37
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,209.33
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	2690855
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE RENAL-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690525
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-TRANS ARTHERE RENAL-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411515
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$22,721.20
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,845.85
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-TRANS ARTHERE RENAL-BI

Facility

$8,231.00

Service Code	HCPCS 3722550
Hospital Charge Code	7411804
Hospital Revenue Code	361
Min. Negotiated Rate	$1,070.03
Max. Negotiated Rate	$4,115.50
Rate for Payer: Aetna Commercial	$2,469.30
Rate for Payer: Aetna Medicare Advantage	$2,469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,098.91
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	$2,098.91
Rate for Payer: Cigna Commercial	$4,115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65

IR-TRANS ARTHERE RENAL-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690525
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$25,808.44
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,183.66
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-TRANS ARTHERE RENAL-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411515
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-TRANS ARTHERE RENAL-BI

Facility

$8,231.00

Service Code	HCPCS 3722550
Hospital Charge Code	7411804
Hospital Revenue Code	361
Min. Negotiated Rate	$1,234.65
Max. Negotiated Rate	$1,234.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412043
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-TRANS ARTHERE RENAL-LT

Facility

$8,231.00

Service Code	HCPCS 37225LT
Hospital Charge Code	7411927
Hospital Revenue Code	361
Min. Negotiated Rate	$1,070.03
Max. Negotiated Rate	$4,115.50
Rate for Payer: Aetna Commercial	$2,469.30
Rate for Payer: Aetna Medicare Advantage	$2,469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,098.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,098.91
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	$2,098.91
Rate for Payer: Cigna Commercial	$4,115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2691375
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

Know your out-of-pocket cost for care.

All Charges