Heights University Hospital

All Charges

Charge

Type

Setting

Price

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93459
Hospital Charge Code	366893459
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93461
Hospital Charge Code	7411243
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93461
Hospital Charge Code	7411243
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93457
Hospital Charge Code	7411231
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93457
Hospital Charge Code	7411231
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93459
Hospital Charge Code	7411239
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93455
Hospital Charge Code	7411223
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93459
Hospital Charge Code	366893459
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93459
Hospital Charge Code	7411239
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LH0 LV CORONARY SVG ANGIO

Facility

$12,026.00

Service Code	HCPCS 93455
Hospital Charge Code	7411223
Hospital Revenue Code	481
Min. Negotiated Rate	$1,563.38
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$3,607.80
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,563.38
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT ARTERY/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	74110067
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT ARTERY/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	5100666
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT ARTERY/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	74110067
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT ARTERY/VENTRICLE ANGIO

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	5100666
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT ART/GRFT ANGIO

Facility

$25,737.16

Service Code	HCPCS 93459
Hospital Charge Code	74110068
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT ART/GRFT ANGIO

Facility

$25,737.16

Service Code	HCPCS 93459
Hospital Charge Code	74110068
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT ART/GRFT ANGIO

Facility

$25,737.16

Service Code	HCPCS 93459
Hospital Charge Code	5100667
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT ART/GRFT ANGIO

Facility

$25,737.16

Service Code	HCPCS 93459
Hospital Charge Code	5100667
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT CATH CHD NM/ABN NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93595
Hospital Charge Code	411093595
Hospital Revenue Code	481
Min. Negotiated Rate	$3,345.83
Max. Negotiated Rate	$8,580.00
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

L HRT CATH CHD NM/ABN NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93595
Hospital Charge Code	411093595
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT CATH TRNSPTL PUNCTURE

Facility

$25,737.16

Service Code	HCPCS 93462
Hospital Charge Code	411093462
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

L HRT CATH TRNSPTL PUNCTURE

Facility

$25,737.16

Service Code	HCPCS 93462
Hospital Charge Code	411093462
Hospital Revenue Code	481
Min. Negotiated Rate	$190.91
Max. Negotiated Rate	$7,721.15
Rate for Payer: Aetna Commercial	$7,721.15
Rate for Payer: Aetna Medicare Advantage	$7,721.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,562.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,562.98
Rate for Payer: Cigna Commercial	$190.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

LIBRIUM/100MG

Facility

$42.00

Hospital Charge Code	60633298
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

LIBRIUM/100MG

Facility

$42.00

Hospital Charge Code	60633298
Hospital Revenue Code	250
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$12.60
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$21.00

LIBRIUM/10MG/CAP

Facility

$3.00

Hospital Charge Code	60634345
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

Know your out-of-pocket cost for care.

All Charges