Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	5700191
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	321037187L
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$18,307.80

Service Code	HCPCS 37187RT
Hospital Charge Code	7411917
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,153.90
Rate for Payer: Aetna Commercial	$5,492.34
Rate for Payer: Aetna Medicare Advantage	$5,492.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,668.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,668.49
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	$4,668.49
Rate for Payer: Cigna Commercial	$9,153.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,380.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	321037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	321037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	366837187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	366837187R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	411037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	5600190
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	411037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$18,307.80

Service Code	HCPCS 37187RT
Hospital Charge Code	7411917
Hospital Revenue Code	361
Min. Negotiated Rate	$2,746.17
Max. Negotiated Rate	$2,746.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	5600190
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS SAMPLING-RENINS

Facility

$2,640.00

Service Code	HCPCS 75893
Hospital Charge Code	2002129
Hospital Revenue Code	320
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

IR VENOUS SAMPLING-RENINS

Facility

$2,640.00

Service Code	HCPCS 75893
Hospital Charge Code	2002129
Hospital Revenue Code	320
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Medicare Advantage	$792.00
Rate for Payer: Aetna Commercial	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$673.20
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.20
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	7411760
Hospital Revenue Code	341
Min. Negotiated Rate	$174.84
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,093.95
Rate for Payer: Aetna Medicare Advantage	$1,093.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$929.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$929.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$929.85
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.04
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$546.97
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	2680365
Hospital Revenue Code	341
Min. Negotiated Rate	$174.84
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,093.95
Rate for Payer: Aetna Medicare Advantage	$1,093.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$929.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$929.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$929.85
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.04
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$546.97
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	2680365
Hospital Revenue Code	341
Min. Negotiated Rate	$546.97
Max. Negotiated Rate	$546.97
Rate for Payer: Qualcare PPO/HMO/WC	$546.97

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	7411760
Hospital Revenue Code	341
Min. Negotiated Rate	$546.97
Max. Negotiated Rate	$546.97
Rate for Payer: Qualcare PPO/HMO/WC	$546.97

IR VESICULOGRAPHY

Facility

$906.25

Service Code	HCPCS 74440
Hospital Charge Code	2600139
Hospital Revenue Code	320
Min. Negotiated Rate	$45.25
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$271.88
Rate for Payer: Aetna Medicare Advantage	$271.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.09
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.81
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.94
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR VESICULOGRAPHY

Facility

$906.25

Service Code	HCPCS 74440
Hospital Charge Code	2600139
Hospital Revenue Code	320
Min. Negotiated Rate	$135.94
Max. Negotiated Rate	$135.94
Rate for Payer: Qualcare PPO/HMO/WC	$135.94

IR VNGRM SUPEROR SAGITAL SINUS

Facility

$2,237.55

Service Code	HCPCS 75870
Hospital Charge Code	2600138
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR VNGRM SUPEROR SAGITAL SINUS

Facility

$2,237.55

Service Code	HCPCS 75870
Hospital Charge Code	7411720
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	$305.46
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 VNGRM SUPEROR SAGITAL SINUS

Facility

$2,237.55

Service Code	HCPCS 75870
Hospital Charge Code	2600138
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	$305.46
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 VNGRM SUPEROR SAGITAL SINUS

Facility

$2,237.55

Service Code	HCPCS 75870
Hospital Charge Code	7411720
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR-WITHDRAW ART BLD

Facility

$623.55

Service Code	HCPCS 36600
Hospital Charge Code	321036600
Hospital Revenue Code	761
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$187.06
Rate for Payer: Aetna Medicare Advantage	$187.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.01
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.06
Rate for Payer: Oxford Commercial	$311.77
Rate for Payer: Qualcare PPO/HMO/WC	$93.53
Rate for Payer: UnitedHealthcare Commercial	$311.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

Know your out-of-pocket cost for care.

All Charges