Heights University Hospital

All Charges

Charge

Type

Setting

Price

ART BYP FEMORAL- FEMORAL

Facility

$8,481.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$1,272.15
Max. Negotiated Rate	$1,272.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.15

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$6,124.20
Max. Negotiated Rate	$6,124.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$1,047.23
Max. Negotiated Rate	$12,248.40
Rate for Payer: Aetna Commercial	$12,248.40
Rate for Payer: Aetna Medicare Advantage	$12,248.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,411.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,411.14
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	$10,411.14
Rate for Payer: Cigna Commercial	$1,047.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,307.64
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$4,969.50
Max. Negotiated Rate	$8,017.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$4,969.50
Max. Negotiated Rate	$16,565.00
Rate for Payer: Aetna Commercial	$9,939.00
Rate for Payer: Aetna Medicare Advantage	$9,939.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,448.15
Rate for Payer: Cigna Commercial	$16,565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,326.75
Max. Negotiated Rate	$4,422.50
Rate for Payer: Aetna Commercial	$2,653.50
Rate for Payer: Aetna Medicare Advantage	$2,653.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,255.47
Rate for Payer: Cigna Commercial	$4,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,326.75
Max. Negotiated Rate	$2,140.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$1,474.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$3,047.50
Rate for Payer: Aetna Commercial	$1,828.50
Rate for Payer: Aetna Medicare Advantage	$1,828.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,554.22
Rate for Payer: Cigna Commercial	$3,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$84.47
Rate for Payer: Aetna Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.52
Rate for Payer: Cigna Commercial	$26.07
Rate for Payer: Cigna Medicare Advantage	$13.04
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.02
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.63
Rate for Payer: Wellcare Medicare Advantage	$26.07

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$110.02
Max. Negotiated Rate	$110.02
Rate for Payer: Qualcare PPO/HMO/WC	$110.02

ARTERIAL BLOOD GASS pH LEVEL**

Facility

$48.00

Service Code	HCPCS 82800
Hospital Charge Code	9500638
Hospital Revenue Code	419
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$35.64
Rate for Payer: Aetna Medicare Advantage	$11.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.30
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: Cigna Medicare Advantage	$11.00
Rate for Payer: Clover Medicare Advantage	$10.45
Rate for Payer: EmblemHealth Commercial	$33.00
Rate for Payer: Humana Medicare Advantage	$11.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$1,004.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.66
Rate for Payer: Wellcare Medicare Advantage	$11.00

ARTERIAL BLOOD GASS pH LEVEL**

Facility

$48.00

Service Code	HCPCS 82800
Hospital Charge Code	9500638
Hospital Revenue Code	419
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74116031
Hospital Revenue Code	921
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$68.70
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.40
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
Hospital Revenue Code	921
Min. Negotiated Rate	$253.00
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	$253.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$316.85
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

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74116031
Hospital Revenue Code	921
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74117031
Hospital Revenue Code	921
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$68.70
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.40
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
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

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74117031
Hospital Revenue Code	921
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	94053175
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

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	94053175
Hospital Revenue Code	921
Min. Negotiated Rate	$253.00
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	$253.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$316.85
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

ARTERIAL DOPPLER UPP LOW EXTR

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	2692035
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

ARTERIAL DOPPLER UPP LOW EXTR

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	2692035
Hospital Revenue Code	921
Min. Negotiated Rate	$253.00
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	$253.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$316.85
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