Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR VENOGRAM EXTREMITY BI

Facility

$4,693.75

Service Code	HCPCS 75822
Hospital Charge Code	2001378
Hospital Revenue Code	320
Min. Negotiated Rate	$704.06
Max. Negotiated Rate	$704.06
Rate for Payer: Qualcare PPO/HMO/WC	$704.06

IR VENOGRAM EXTREMITY BI

Facility

$4,693.75

Service Code	HCPCS 75822
Hospital Charge Code	7411710
Hospital Revenue Code	320
Min. Negotiated Rate	$704.06
Max. Negotiated Rate	$704.06
Rate for Payer: Qualcare PPO/HMO/WC	$704.06

IR VENOGRAM EXTREMITY BI

Facility

$4,693.75

Service Code	HCPCS 75822
Hospital Charge Code	7411710
Hospital Revenue Code	320
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,408.12
Rate for Payer: Aetna Medicare Advantage	$1,408.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,196.91
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$610.19
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$704.06
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM EXTREMITY BI

Facility

$4,693.75

Service Code	HCPCS 75822
Hospital Charge Code	2001378
Hospital Revenue Code	320
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,408.12
Rate for Payer: Aetna Medicare Advantage	$1,408.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,196.91
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$610.19
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$704.06
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM EXTREMITY UNI

Facility

$3,630.70

Service Code	HCPCS 75820
Hospital Charge Code	2001360
Hospital Revenue Code	320
Min. Negotiated Rate	$117.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.83
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM EXTREMITY UNI

Facility

$4,693.80

Service Code	HCPCS 75820
Hospital Charge Code	7411708
Hospital Revenue Code	320
Min. Negotiated Rate	$704.07
Max. Negotiated Rate	$704.07
Rate for Payer: Qualcare PPO/HMO/WC	$704.07

IR VENOGRAM EXTREMITY UNI

Facility

$4,693.80

Service Code	HCPCS 75820
Hospital Charge Code	7411708
Hospital Revenue Code	320
Min. Negotiated Rate	$117.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,408.14
Rate for Payer: Aetna Medicare Advantage	$1,408.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,196.92
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$610.19
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$704.07
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM EXTREMITY UNI

Facility

$3,630.70

Service Code	HCPCS 75820
Hospital Charge Code	321075820
Hospital Revenue Code	320
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR VENOGRAM EXTREMITY UNI

Facility

$3,630.70

Service Code	HCPCS 75820
Hospital Charge Code	321075820
Hospital Revenue Code	320
Min. Negotiated Rate	$117.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.83
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM EXTREMITY UNI

Facility

$3,630.70

Service Code	HCPCS 75820
Hospital Charge Code	2001360
Hospital Revenue Code	320
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR VENOGRAM JUGULAR

Facility

$2,237.55

Service Code	HCPCS 75860
Hospital Charge Code	7411718
Hospital Revenue Code	320
Min. Negotiated Rate	$290.88
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM JUGULAR

Facility

$2,237.55

Service Code	HCPCS 75860
Hospital Charge Code	7411718
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR VENOGRAM JUGULAR

Facility

$2,237.55

Service Code	HCPCS 75860
Hospital Charge Code	2600132
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR VENOGRAM JUGULAR

Facility

$2,237.55

Service Code	HCPCS 75860
Hospital Charge Code	2600132
Hospital Revenue Code	320
Min. Negotiated Rate	$290.88
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM ORBITAL

Facility

$2,237.55

Service Code	HCPCS 75880
Hospital Charge Code	2600133
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR VENOGRAM ORBITAL

Facility

$2,237.55

Service Code	HCPCS 75880
Hospital Charge Code	2600133
Hospital Revenue Code	320
Min. Negotiated Rate	$119.92
Max. Negotiated Rate	$1,493.86
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM ORBITAL

Facility

$2,237.55

Service Code	HCPCS 75880
Hospital Charge Code	7411722
Hospital Revenue Code	320
Min. Negotiated Rate	$119.92
Max. Negotiated Rate	$1,493.86
Rate for Payer: Aetna Commercial	$671.26
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM ORBITAL

Facility

$2,237.55

Service Code	HCPCS 75880
Hospital Charge Code	7411722
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR VENOGRAM RENAL BILATERAL

Facility

$13,436.40

Service Code	HCPCS 75833
Hospital Charge Code	2600134
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR VENOGRAM RENAL BILATERAL

Facility

$13,436.40

Service Code	HCPCS 75833
Hospital Charge Code	2600134
Hospital Revenue Code	320
Min. Negotiated Rate	$392.70
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM RENAL LEFT

Facility

$13,436.40

Service Code	HCPCS 75831
Hospital Charge Code	2600135
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR VENOGRAM RENAL LEFT

Facility

$13,436.40

Service Code	HCPCS 75831
Hospital Charge Code	2600135
Hospital Revenue Code	320
Min. Negotiated Rate	$305.46
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM RENAL RIGHT

Facility

$13,436.40

Service Code	HCPCS 75831
Hospital Charge Code	2600136
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR VENOGRAM RENAL RIGHT

Facility

$13,436.40

Service Code	HCPCS 75831
Hospital Charge Code	2600136
Hospital Revenue Code	320
Min. Negotiated Rate	$305.46
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,030.92
Rate for Payer: Aetna Medicare Advantage	$4,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,426.28
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENOGRAM SINUS

Facility

$2,237.55

Service Code	HCPCS 75860
Hospital Charge Code	2600137
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

Know your out-of-pocket cost for care.

All Charges