Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRNS IV STNT PRC-IN-RT

Facility

$53,150.12

Service Code	HCPCS 37205RT
Hospital Charge Code	2691315
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$26,575.06
Rate for Payer: Aetna Commercial	$15,945.04
Rate for Payer: Aetna Medicare Advantage	$15,945.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,553.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,553.28
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	$13,553.28
Rate for Payer: Cigna Commercial	$26,575.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,909.52
Rate for Payer: Qualcare PPO/HMO/WC	$7,972.52

IR TRNSLMNAL BALN ANGIO VENOUS

Facility

$21,962.30

Service Code	HCPCS 75978
Hospital Charge Code	2600116
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRNSLMNAL BALN ANGIO VENOUS

Facility

$21,962.30

Service Code	HCPCS 75978
Hospital Charge Code	7411742
Hospital Revenue Code	320
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$6,588.69
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,855.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRNSLMNAL BALN ANGIO VENOUS

Facility

$21,962.30

Service Code	HCPCS 75978
Hospital Charge Code	2600116
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR TRNSLMNAL BALN ANGIO VENOUS

Facility

$21,962.30

Service Code	HCPCS 75978
Hospital Charge Code	7411742
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$6,404.20

Service Code	HCPCS 75887
Hospital Charge Code	2600115
Hospital Revenue Code	320
Min. Negotiated Rate	$339.40
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$3,084.40

Service Code	HCPCS 75887
Hospital Charge Code	366875887
Hospital Revenue Code	320
Min. Negotiated Rate	$339.40
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$925.32
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.97
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$3,084.40

Service Code	HCPCS 75887
Hospital Charge Code	7411724
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$6,404.20

Service Code	HCPCS 75887
Hospital Charge Code	2600115
Hospital Revenue Code	320
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$3,084.40

Service Code	HCPCS 75887
Hospital Charge Code	7411724
Hospital Revenue Code	320
Min. Negotiated Rate	$339.40
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$925.32
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.97
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TRSHPTC PRTGRPY W/O HMO EVL

Facility

$3,084.40

Service Code	HCPCS 75887
Hospital Charge Code	366875887
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR TUBE OR CATH CHANGE

Facility

$5,100.00

Service Code	HCPCS 75984
Hospital Charge Code	2600117
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR TUBE OR CATH CHANGE

Facility

$5,100.00

Service Code	HCPCS 75984
Hospital Charge Code	2600117
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHANGE

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411745
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHANGE

Facility

$5,100.00

Service Code	HCPCS 75984
Hospital Charge Code	321075984
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHANGE

Facility

$5,100.00

Service Code	HCPCS 75984
Hospital Charge Code	321075984
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR TUBE OR CATH CHANGE

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411745
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411746
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411746
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600118
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600118
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600120
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411747
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600120
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411747
Hospital Revenue Code	320
Min. Negotiated Rate	$96.21
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$482.65
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$106.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges