Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRANSCATH OCCUL CNS

Facility

$8,623.00

Service Code	HCPCS 61624
Hospital Charge Code	7411642
Hospital Revenue Code	361
Min. Negotiated Rate	$1,120.99
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$2,586.90
Rate for Payer: Aetna Medicare Advantage	$2,586.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,198.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,198.86
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	$2,198.86
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,120.99
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.45
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR-TRANSCATH OCCUL CNS

Facility

$8,623.00

Service Code	HCPCS 61624
Hospital Charge Code	2690220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,120.99
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$2,586.90
Rate for Payer: Aetna Medicare Advantage	$2,586.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,198.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,198.86
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	$2,198.86
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,120.99
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.45
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR-TRANSCATH OCCUL CNS

Facility

$8,623.00

Service Code	HCPCS 61624
Hospital Charge Code	7411642
Hospital Revenue Code	361
Min. Negotiated Rate	$1,293.45
Max. Negotiated Rate	$1,293.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.45

IR-TRANSCATH OCCUL CNS

Facility

$8,623.00

Service Code	HCPCS 61624
Hospital Charge Code	2690220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,293.45
Max. Negotiated Rate	$1,293.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.45

IR-TRANSCATH OCCULSION-BI

Facility

$26,826.00

Service Code	HCPCS 3720450
Hospital Charge Code	2690485
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,413.00
Rate for Payer: Aetna Commercial	$8,047.80
Rate for Payer: Aetna Medicare Advantage	$8,047.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,840.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,840.63
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	$6,840.63
Rate for Payer: Cigna Commercial	$13,413.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,487.38
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR-TRANSCATH OCCULSION-BI

Facility

$26,826.00

Service Code	HCPCS 3720450
Hospital Charge Code	2690485
Hospital Revenue Code	361
Min. Negotiated Rate	$4,023.90
Max. Negotiated Rate	$4,023.90
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR-TRANSCATH OCCULSION-LT

Facility

$26,826.00

Service Code	HCPCS 37204LT
Hospital Charge Code	2691300
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,413.00
Rate for Payer: Aetna Commercial	$8,047.80
Rate for Payer: Aetna Medicare Advantage	$8,047.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,840.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,840.63
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	$6,840.63
Rate for Payer: Cigna Commercial	$13,413.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,487.38
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR-TRANSCATH OCCULSION-LT

Facility

$26,826.00

Service Code	HCPCS 37204LT
Hospital Charge Code	2691300
Hospital Revenue Code	361
Min. Negotiated Rate	$4,023.90
Max. Negotiated Rate	$4,023.90
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR-TRANSCATH OCCULSION-RT

Facility

$26,826.00

Hospital Charge Code	2691305
Hospital Revenue Code	361
Min. Negotiated Rate	$4,023.90
Max. Negotiated Rate	$4,023.90
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR-TRANSCATH OCCULSION-RT

Facility

$26,826.00

Hospital Charge Code	2691305
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,413.00
Rate for Payer: Aetna Commercial	$8,047.80
Rate for Payer: Aetna Medicare Advantage	$8,047.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,840.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,840.63
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	$6,840.63
Rate for Payer: Cigna Commercial	$13,413.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,487.38
Rate for Payer: Qualcare PPO/HMO/WC	$4,023.90

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	7411508
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

IR TRANSCATH STENT CCA W/EPS

Facility

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	2600147
Hospital Revenue Code	361
Min. Negotiated Rate	$961.50
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,630.50
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
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	$3,935.93
Rate for Payer: Cigna Commercial	$961.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,006.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	2600146
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

IR TRANSCATH STENT CCA W/EPS

Facility

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	2600147
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	2600146
Hospital Revenue Code	361
Min. Negotiated Rate	$961.50
Max. Negotiated Rate	$7,522.89
Rate for Payer: Aetna Commercial	$7,522.89
Rate for Payer: Aetna Medicare Advantage	$7,522.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,394.46
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	$6,394.46
Rate for Payer: Cigna Commercial	$961.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,259.92
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	411037215
Hospital Revenue Code	361
Min. Negotiated Rate	$3,761.45
Max. Negotiated Rate	$3,761.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	7411508
Hospital Revenue Code	361
Min. Negotiated Rate	$961.50
Max. Negotiated Rate	$7,522.89
Rate for Payer: Aetna Commercial	$7,522.89
Rate for Payer: Aetna Medicare Advantage	$7,522.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,394.46
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	$6,394.46
Rate for Payer: Cigna Commercial	$961.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,259.92
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/EPS

Facility

$25,076.30

Service Code	HCPCS 37215
Hospital Charge Code	411037215
Hospital Revenue Code	361
Min. Negotiated Rate	$961.50
Max. Negotiated Rate	$7,522.89
Rate for Payer: Aetna Commercial	$7,522.89
Rate for Payer: Aetna Medicare Advantage	$7,522.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,394.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,394.46
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	$6,394.46
Rate for Payer: Cigna Commercial	$961.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,259.92
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,761.45
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/EPS

Facility

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	321037215
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/EPS

Facility

$15,435.00

Service Code	HCPCS 37215
Hospital Charge Code	321037215
Hospital Revenue Code	361
Min. Negotiated Rate	$961.50
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,630.50
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
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	$3,935.93
Rate for Payer: Cigna Commercial	$961.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,006.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/O EPS

Facility

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	7411509
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,717.50
Rate for Payer: Aetna Commercial	$4,630.50
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
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	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,006.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/O EPS

Facility

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	2600152
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/O EPS

Facility

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	2600152
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,717.50
Rate for Payer: Aetna Commercial	$4,630.50
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
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	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,006.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR TRANSCATH STENT CCA W/O EPS

Facility

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	411037216
Hospital Revenue Code	361
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH STENT CCA W/O EPS

Facility

$15,435.00

Service Code	HCPCS 37216
Hospital Charge Code	411037216
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,717.50
Rate for Payer: Aetna Commercial	$4,630.50
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
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	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,006.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges