Heights University Hospital

All Charges

Charge

Type

Setting

Price

IVC

Facility

$8,512.00

Service Code	HCPCS 75825
Hospital Charge Code	7411157
Hospital Revenue Code	320
Min. Negotiated Rate	$1,276.80
Max. Negotiated Rate	$1,276.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,276.80

IVC

Facility

$8,512.00

Service Code	HCPCS 75825
Hospital Charge Code	7411157
Hospital Revenue Code	320
Min. Negotiated Rate	$219.91
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,553.60
Rate for Payer: Aetna Medicare Advantage	$2,553.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,170.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,170.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,170.56
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,106.56
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,276.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692160
Hospital Revenue Code	921
Min. Negotiated Rate	$220.80
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74117055
Hospital Revenue Code	921
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$789.00

Service Code	HCPCS 93979
Hospital Charge Code	74117055
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74116055
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115055
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115055
Hospital Revenue Code	921
Min. Negotiated Rate	$220.80
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	94053255
Hospital Revenue Code	921
Min. Negotiated Rate	$73.21
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$168.94
Rate for Payer: Aetna Medicare Advantage	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.60
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.21
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692160
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74116055
Hospital Revenue Code	921
Min. Negotiated Rate	$220.80
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC AND ILIAC VEINS DUPLEX LTD

Facility

$563.15

Service Code	HCPCS 93979
Hospital Charge Code	94053255
Hospital Revenue Code	921
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

IV CATHETER ACCUVANCE 16GX2

Facility

$18.05

Hospital Charge Code	270650281
Hospital Revenue Code	270
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$9.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$9.03

IV CATHETER ACCUVANCE 16GX2

Facility

$18.05

Hospital Charge Code	270650281
Hospital Revenue Code	270
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

IVC FILTER SENTRY

Facility

$6,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270684923
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

IVC FILTER SENTRY

Facility

$6,250.00

Service Code	HCPCS C1880
Hospital Charge Code	270684923
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

IVC & ILIAC VEINS DUPLEX

Facility

$757.65

Service Code	HCPCS 93978
Hospital Charge Code	94053215
Hospital Revenue Code	921
Min. Negotiated Rate	$98.49
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$227.29
Rate for Payer: Aetna Medicare Advantage	$227.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.20
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.49
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.65
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC & ILIAC VEINS DUPLEX

Facility

$757.65

Service Code	HCPCS 93978
Hospital Charge Code	94053215
Hospital Revenue Code	921
Min. Negotiated Rate	$113.65
Max. Negotiated Rate	$113.65
Rate for Payer: Qualcare PPO/HMO/WC	$113.65

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	2692090
Hospital Revenue Code	921
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	74116053
Hospital Revenue Code	921
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	2692090
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	74117053
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	74115053
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	74115053
Hospital Revenue Code	921
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

IVC & ILIAC VEINS DUPLEX

Facility

$17,200.00

Service Code	HCPCS 93978
Hospital Charge Code	74117053
Hospital Revenue Code	921
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

Know your out-of-pocket cost for care.

All Charges