Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRANS BALLN ANG TIB-BI

Facility

$61,616.39

Service Code	HCPCS 3722850
Hospital Charge Code	2690540
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-BI

Facility

$61,616.39

Service Code	HCPCS 3722850
Hospital Charge Code	7411807
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	7411934
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	2691410
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	2691410
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	366837228L
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	321037228L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	321037228L
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	366837228L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-LT

Facility

$61,616.39

Service Code	HCPCS 37228LT
Hospital Charge Code	7411934
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	2691415
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	366837228R
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	7411935
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	366837228R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	7411935
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	321037228R
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	321037228R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALLN ANG TIB-RT

Facility

$61,616.39

Service Code	HCPCS 37228RT
Hospital Charge Code	2691415
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

IR-TRANS BALN ANG PCUT-BI

Facility

$11,225.00

Service Code	HCPCS 3547650
Hospital Charge Code	7411787
Hospital Revenue Code	761
Min. Negotiated Rate	$1,459.25
Max. Negotiated Rate	$5,612.50
Rate for Payer: Aetna Commercial	$3,367.50
Rate for Payer: Aetna Medicare Advantage	$3,367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,862.38
Rate for Payer: Cigna Commercial	$5,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.25
Rate for Payer: Oxford Commercial	$5,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75
Rate for Payer: UnitedHealthcare Commercial	$5,612.50

IR-TRANS BALN ANG PCUT-BI

Facility

$11,225.00

Service Code	HCPCS 3547650
Hospital Charge Code	2690415
Hospital Revenue Code	761
Min. Negotiated Rate	$1,459.25
Max. Negotiated Rate	$5,612.50
Rate for Payer: Aetna Commercial	$3,367.50
Rate for Payer: Aetna Medicare Advantage	$3,367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,862.38
Rate for Payer: Cigna Commercial	$5,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.25
Rate for Payer: Oxford Commercial	$5,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75
Rate for Payer: UnitedHealthcare Commercial	$5,612.50

IR-TRANS BALN ANG PCUT-BI

Facility

$11,225.00

Service Code	HCPCS 3547650
Hospital Charge Code	7411787
Hospital Revenue Code	761
Min. Negotiated Rate	$1,683.75
Max. Negotiated Rate	$1,683.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75

IR-TRANS BALN ANG PCUT-BI

Facility

$11,225.00

Service Code	HCPCS 3547650
Hospital Charge Code	2690415
Hospital Revenue Code	761
Min. Negotiated Rate	$1,683.75
Max. Negotiated Rate	$1,683.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75

IR-TRANS BALN ANG PCUT-LT

Facility

$11,225.00

Service Code	HCPCS 35476LT
Hospital Charge Code	7411891
Hospital Revenue Code	761
Min. Negotiated Rate	$1,459.25
Max. Negotiated Rate	$5,612.50
Rate for Payer: Aetna Commercial	$3,367.50
Rate for Payer: Aetna Medicare Advantage	$3,367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,862.38
Rate for Payer: Cigna Commercial	$5,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.25
Rate for Payer: Oxford Commercial	$5,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75
Rate for Payer: UnitedHealthcare Commercial	$5,612.50

IR-TRANS BALN ANG PCUT-LT

Facility

$11,225.00

Service Code	HCPCS 35476LT
Hospital Charge Code	7411891
Hospital Revenue Code	761
Min. Negotiated Rate	$1,683.75
Max. Negotiated Rate	$1,683.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75

IR-TRANS BALN ANG PCUT-LT

Facility

$11,225.00

Service Code	HCPCS 35476LT
Hospital Charge Code	2691125
Hospital Revenue Code	761
Min. Negotiated Rate	$1,459.25
Max. Negotiated Rate	$5,612.50
Rate for Payer: Aetna Commercial	$3,367.50
Rate for Payer: Aetna Medicare Advantage	$3,367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,862.38
Rate for Payer: Cigna Commercial	$5,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.25
Rate for Payer: Oxford Commercial	$5,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75
Rate for Payer: UnitedHealthcare Commercial	$5,612.50

Know your out-of-pocket cost for care.

All Charges