Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARTERIAL DUPLEX U/L UE

Facility

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	74116042
Hospital Revenue Code	921
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

ARTERIAL DUPLEX U/L UE

Facility

$757.65

Service Code	HCPCS 93931
Hospital Charge Code	94053200
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	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.20
Rate for Payer: Cigna Commercial	$248.96
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

ARTERIAL DUPLEX U/L UE

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74115042
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
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	$289.80
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

ARTERIAL DUPLEX U/L UE

Facility

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	2692060
Hospital Revenue Code	921
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DUPLEX U/L UE

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74115042
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 DUPLEX U/L UE

Facility

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	7411766
Hospital Revenue Code	921
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DUPLEX U/L UE

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74117042
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 DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	2692135
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
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	$289.80
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

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74116043
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 DUPLEX UPPER EXT LTD

Facility

$757.65

Service Code	HCPCS 93931
Hospital Charge Code	94053235
Hospital Revenue Code	921
Min. Negotiated Rate	$113.65
Max. Negotiated Rate	$113.65
Rate for Payer: Qualcare PPO/HMO/WC	$113.65

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74116043
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
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	$289.80
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

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74115043
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
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	$289.80
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

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74115043
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 DUPLEX UPPER EXT LTD

Facility

$757.65

Service Code	HCPCS 93931
Hospital Charge Code	94053235
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	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.20
Rate for Payer: Cigna Commercial	$248.96
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

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74117043
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
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	$289.80
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

ARTERIAL DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	2692135
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 DUPLEX UPPER EXT LTD

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74117043
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 EMBOLECTOMY CATHETER

Facility

$291.00

Hospital Charge Code	270331786
Hospital Revenue Code	278
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$87.30
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

ARTERIAL EMBOLECTOMY CATHETER

Facility

$291.00

Hospital Charge Code	270331786
Hospital Revenue Code	278
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$70.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

ARTERIAL GRAFT COMPONENT

Facility

$4,600.00

Hospital Charge Code	270645660
Hospital Revenue Code	272
Min. Negotiated Rate	$598.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$1,380.00
Rate for Payer: Aetna Medicare Advantage	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,173.00
Rate for Payer: Cigna Commercial	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.00
Rate for Payer: Oxford Commercial	$2,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00
Rate for Payer: UnitedHealthcare Commercial	$2,300.00

ARTERIAL GRAFT COMPONENT

Facility

$4,600.00

Hospital Charge Code	270645660
Hospital Revenue Code	272
Min. Negotiated Rate	$690.00
Max. Negotiated Rate	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

ARTERIAL LINE INSERTION

Facility

$414.00

Service Code	HCPCS 36140
Hospital Charge Code	83091005
Hospital Revenue Code	361
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
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	$105.57
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ARTERIAL LINE INSERTION

Facility

$414.00

Service Code	HCPCS 36140
Hospital Charge Code	83092005
Hospital Revenue Code	361
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
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	$105.57
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ARTERIAL LINE INSERTION

Facility

$414.00

Service Code	HCPCS 36140
Hospital Charge Code	83091005
Hospital Revenue Code	361
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

ARTERIAL LINE INSERTION

Facility

$414.00

Service Code	HCPCS 36140
Hospital Charge Code	83080005
Hospital Revenue Code	361
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
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	$105.57
Rate for Payer: Cigna Commercial	$84.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges