Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-WITHDRAW ART BLD

Facility

$525.15

Service Code	HCPCS 36600
Hospital Charge Code	366836600
Hospital Revenue Code	361
Min. Negotiated Rate	$78.77
Max. Negotiated Rate	$78.77
Rate for Payer: Qualcare PPO/HMO/WC	$78.77

IR-WITHDRAW ART BLD

Facility

$525.15

Service Code	HCPCS 36600
Hospital Charge Code	366836600
Hospital Revenue Code	361
Min. Negotiated Rate	$68.27
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$157.54
Rate for Payer: Aetna Medicare Advantage	$157.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.91
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	$133.91
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.27
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.77
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$193.50

IR-WITHDRAW ART BLD

Facility

$111.83

Service Code	HCPCS 36600
Hospital Charge Code	7411479
Hospital Revenue Code	761
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$16.77
Rate for Payer: Qualcare PPO/HMO/WC	$16.77

IR-WITHDRAW ART BLD

Facility

$111.83

Service Code	HCPCS 36600
Hospital Charge Code	7411479
Hospital Revenue Code	761
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$33.55
Rate for Payer: Aetna Medicare Advantage	$33.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.52
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	$28.52
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.54
Rate for Payer: Oxford Commercial	$55.91
Rate for Payer: Qualcare PPO/HMO/WC	$16.77
Rate for Payer: UnitedHealthcare Commercial	$55.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

IR-WITHDRAW ART BLD

Facility

$623.55

Service Code	HCPCS 36600
Hospital Charge Code	2690060
Hospital Revenue Code	761
Min. Negotiated Rate	$93.53
Max. Negotiated Rate	$93.53
Rate for Payer: Qualcare PPO/HMO/WC	$93.53

IR-WITHDRAW ART BLD

Facility

$623.55

Service Code	HCPCS 36600
Hospital Charge Code	321036600
Hospital Revenue Code	761
Min. Negotiated Rate	$93.53
Max. Negotiated Rate	$93.53
Rate for Payer: Qualcare PPO/HMO/WC	$93.53

IR-WITHDRAW ART BLD

Facility

$623.55

Service Code	HCPCS 36600
Hospital Charge Code	2690060
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

IR-WITHDRAW ART BLD

Facility

$525.15

Service Code	HCPCS 36600
Hospital Charge Code	411036600
Hospital Revenue Code	361
Min. Negotiated Rate	$78.77
Max. Negotiated Rate	$78.77
Rate for Payer: Qualcare PPO/HMO/WC	$78.77

IR-WITHDRAW ART BLD

Facility

$525.15

Service Code	HCPCS 36600
Hospital Charge Code	411036600
Hospital Revenue Code	361
Min. Negotiated Rate	$68.27
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$157.54
Rate for Payer: Aetna Medicare Advantage	$157.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.91
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	$133.91
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.27
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.77
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$193.50

IR WRIST,ARTHROGRAPHY,RAD S &I

Facility

$1,667.37

Service Code	HCPCS 73115
Hospital Charge Code	7411666
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR WRIST,ARTHROGRAPHY,RAD S &I

Facility

$1,667.37

Service Code	HCPCS 73115
Hospital Charge Code	2680275
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR WRIST,ARTHROGRAPHY,RAD S &I

Facility

$1,667.37

Service Code	HCPCS 73115
Hospital Charge Code	2680275
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR WRIST,ARTHROGRAPHY,RAD S &I

Facility

$1,667.37

Service Code	HCPCS 73115
Hospital Charge Code	7411666
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR XPOSE FOR ENDOPROSTH FEM

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	2011290
Hospital Revenue Code	361
Min. Negotiated Rate	$198.39
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$198.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR XPOSE FOR ENDOPROSTH FEM

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	7411398
Hospital Revenue Code	361
Min. Negotiated Rate	$198.39
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$198.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR XPOSE FOR ENDOPROSTH FEM

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	7411398
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR XPOSE FOR ENDOPROSTH FEM

Facility

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	2011290
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	321034812B
Hospital Revenue Code	361
Min. Negotiated Rate	$416.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$960.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	7411786
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	2011289
Hospital Revenue Code	361
Min. Negotiated Rate	$416.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$960.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	7411786
Hospital Revenue Code	361
Min. Negotiated Rate	$416.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$960.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	321034812B
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	2011289
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	5700213
Hospital Revenue Code	361
Min. Negotiated Rate	$325.49
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$6,468.00
Rate for Payer: Aetna Medicare Advantage	$6,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,497.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,497.80
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	$5,497.80
Rate for Payer: Cigna Commercial	$325.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,802.80
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	5700213
Hospital Revenue Code	361
Min. Negotiated Rate	$3,234.00
Max. Negotiated Rate	$3,234.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00

Know your out-of-pocket cost for care.

All Charges