Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$2,315.25
Max. Negotiated Rate	$2,315.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

IR TRANSCATH THERAPY

Facility

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2101169
Hospital Revenue Code	320
Min. Negotiated Rate	$499.12
Max. Negotiated Rate	$499.12
Rate for Payer: Qualcare PPO/HMO/WC	$499.12

IR TRANSCATH THERAPY

Facility

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2101169
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$998.25
Rate for Payer: Aetna Medicare Advantage	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.51
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$499.12
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR-TRANSCATH THERAPY

Facility

$4,119.00

Hospital Charge Code	2690100
Hospital Revenue Code	761
Min. Negotiated Rate	$535.47
Max. Negotiated Rate	$2,059.50
Rate for Payer: Aetna Commercial	$1,235.70
Rate for Payer: Aetna Medicare Advantage	$1,235.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,050.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,050.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,050.35
Rate for Payer: Cigna Commercial	$2,059.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.47
Rate for Payer: Oxford Commercial	$2,059.50
Rate for Payer: Qualcare PPO/HMO/WC	$617.85
Rate for Payer: UnitedHealthcare Commercial	$2,059.50

IR-TRANSCATH THERAPY

Facility

$4,119.00

Hospital Charge Code	2690100
Hospital Revenue Code	761
Min. Negotiated Rate	$617.85
Max. Negotiated Rate	$617.85
Rate for Payer: Qualcare PPO/HMO/WC	$617.85

IR TRANSCATH THERAPY INFUSION

Facility

$2,998.75

Service Code	HCPCS 75896
Hospital Charge Code	2011169
Hospital Revenue Code	320
Min. Negotiated Rate	$389.84
Max. Negotiated Rate	$1,499.38
Rate for Payer: Aetna Commercial	$899.62
Rate for Payer: Aetna Medicare Advantage	$899.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.68
Rate for Payer: Cigna Commercial	$1,499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.84
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$449.81
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRANSCATH THERAPY INFUSION

Facility

$2,998.75

Service Code	HCPCS 75896
Hospital Charge Code	2011169
Hospital Revenue Code	320
Min. Negotiated Rate	$449.81
Max. Negotiated Rate	$449.81
Rate for Payer: Qualcare PPO/HMO/WC	$449.81

IR TRANSCATH THER RAD SUP EM

Facility

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2011172
Hospital Revenue Code	320
Min. Negotiated Rate	$358.64
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$998.25
Rate for Payer: Aetna Medicare Advantage	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.51
Rate for Payer: Cigna Commercial	$358.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$499.12
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRANSCATH THER RAD SUP EM

Facility

$3,327.50

Service Code	HCPCS 75894
Hospital Charge Code	2011172
Hospital Revenue Code	320
Min. Negotiated Rate	$499.12
Max. Negotiated Rate	$499.12
Rate for Payer: Qualcare PPO/HMO/WC	$499.12

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	2680315
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$105.04
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$242.40
Rate for Payer: Aetna Medicare Advantage	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.04
Rate for Payer: Cigna Commercial	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	2680315
Hospital Revenue Code	320
Min. Negotiated Rate	$105.04
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$242.40
Rate for Payer: Aetna Medicare Advantage	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.04
Rate for Payer: Cigna Commercial	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRANSHEPATIC CHOLANGIO

Facility

$1,631.25

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$244.69
Max. Negotiated Rate	$244.69
Rate for Payer: Qualcare PPO/HMO/WC	$244.69

IR TRANSHEPATIC CHOLANGIO

Facility

$1,631.25

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$212.06
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$489.38
Rate for Payer: Aetna Medicare Advantage	$489.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.97
Rate for Payer: Cigna Commercial	$815.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.06
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.69
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRANSL PERI ATHERECT PER TI

Facility

$13,876.00

Service Code	HCPCS 35495
Hospital Charge Code	2680165
Hospital Revenue Code	361
Min. Negotiated Rate	$2,081.40
Max. Negotiated Rate	$2,081.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.40

IR TRANSL PERI ATHERECT PER TI

Facility

$13,876.00

Service Code	HCPCS 35495
Hospital Charge Code	2680165
Hospital Revenue Code	361
Min. Negotiated Rate	$1,803.88
Max. Negotiated Rate	$6,938.00
Rate for Payer: Aetna Commercial	$4,162.80
Rate for Payer: Aetna Medicare Advantage	$4,162.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.38
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	$3,538.38
Rate for Payer: Cigna Commercial	$6,938.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,803.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.40

IR TRANSL PERIP ATHERECTOMY PE

Facility

$11,101.00

Service Code	HCPCS 35493
Hospital Charge Code	2680160
Hospital Revenue Code	361
Min. Negotiated Rate	$1,443.13
Max. Negotiated Rate	$5,550.50
Rate for Payer: Aetna Commercial	$3,330.30
Rate for Payer: Aetna Medicare Advantage	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,830.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,830.76
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	$2,830.76
Rate for Payer: Cigna Commercial	$5,550.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,443.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.15

IR TRANSL PERIP ATHERECTOMY PE

Facility

$11,101.00

Service Code	HCPCS 35493
Hospital Charge Code	2680160
Hospital Revenue Code	361
Min. Negotiated Rate	$1,665.15
Max. Negotiated Rate	$1,665.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.15

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$10,145.56

Service Code	HCPCS 45000
Hospital Charge Code	2670175
Hospital Revenue Code	361
Min. Negotiated Rate	$1,318.92
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$3,043.67
Rate for Payer: Aetna Medicare Advantage	$3,043.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,587.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,587.12
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	$2,587.12
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.92
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,521.83
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$10,145.56

Service Code	HCPCS 45000
Hospital Charge Code	7411552
Hospital Revenue Code	361
Min. Negotiated Rate	$1,521.83
Max. Negotiated Rate	$1,521.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,521.83

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$10,145.56

Service Code	HCPCS 45000
Hospital Charge Code	7411552
Hospital Revenue Code	361
Min. Negotiated Rate	$1,318.92
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$3,043.67
Rate for Payer: Aetna Medicare Advantage	$3,043.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,587.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,587.12
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	$2,587.12
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.92
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,521.83
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$10,145.56

Service Code	HCPCS 45000
Hospital Charge Code	2670175
Hospital Revenue Code	361
Min. Negotiated Rate	$1,521.83
Max. Negotiated Rate	$1,521.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,521.83

IR TRLUML PERIP ATHRC BRCHIOCP

Facility

$37,614.35

Service Code	HCPCS 0237T
Hospital Charge Code	5600217
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$11,284.31
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,889.87
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IR TRLUML PERIP ATHRC BRCHIOCP

Facility

$37,614.35

Service Code	HCPCS 0237T
Hospital Charge Code	5600217
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

Know your out-of-pocket cost for care.

All Charges