Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARTERIAL PVR/SEG LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	74115034
Hospital Revenue Code	921
Min. Negotiated Rate	$315.10
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	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$514.20
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

ARTERIAL PVR/SEG LOW EXT BI

Facility

$551.00

Service Code	HCPCS 93923
Hospital Charge Code	74116034
Hospital Revenue Code	921
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

ARTERIAL PVR/SEG LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	74115034
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 STUDIES LOWER EXTREM

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	2684010
Hospital Revenue Code	921
Min. Negotiated Rate	$315.10
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	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$514.20
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

ARTERIAL STUDIES LOWER EXTREM

Facility

$1,440.90

Service Code	HCPCS 93923
Hospital Charge Code	74117032
Hospital Revenue Code	921
Min. Negotiated Rate	$187.32
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$432.27
Rate for Payer: Aetna Medicare Advantage	$432.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.43
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.32
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.13
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL STUDIES LOWER EXTREM

Facility

$1,440.90

Service Code	HCPCS 93923
Hospital Charge Code	74117032
Hospital Revenue Code	921
Min. Negotiated Rate	$216.13
Max. Negotiated Rate	$216.13
Rate for Payer: Qualcare PPO/HMO/WC	$216.13

ARTERIAL STUDIES LOWER EXTREM

Facility

$1,440.90

Service Code	HCPCS 93923
Hospital Charge Code	74115032
Hospital Revenue Code	921
Min. Negotiated Rate	$216.13
Max. Negotiated Rate	$216.13
Rate for Payer: Qualcare PPO/HMO/WC	$216.13

ARTERIAL STUDIES LOWER EXTREM

Facility

$1,440.90

Service Code	HCPCS 93923
Hospital Charge Code	74115032
Hospital Revenue Code	921
Min. Negotiated Rate	$187.32
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$432.27
Rate for Payer: Aetna Medicare Advantage	$432.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.43
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.32
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.13
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL STUDIES LOWER EXTREM

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	2684010
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 STUDIES LOWER EXTREM

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	74116032
Hospital Revenue Code	921
Min. Negotiated Rate	$315.10
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	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$514.20
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

ARTERIAL STUDIES LOWER EXTREM

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	74116032
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 STUDIES UPP OR LOW

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	421593923
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 STUDIES UPP OR LOW

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	421593923
Hospital Revenue Code	921
Min. Negotiated Rate	$315.10
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	$315.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$514.20
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

ARTERIAL VENOUS LINE W/IV

Facility

$85.65

Hospital Charge Code	8200180
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$25.70
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.13
Rate for Payer: Oxford Commercial	$42.83
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Commercial	$42.83

ARTERIAL VENOUS LINE W/IV

Facility

$85.65

Hospital Charge Code	8200180
Hospital Revenue Code	272
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$12.85
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

ARTERIAL VEVOUS LINE W/O IV

Facility

$65.65

Hospital Charge Code	8200198
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

ARTERIAL VEVOUS LINE W/O IV

Facility

$65.65

Hospital Charge Code	8200198
Hospital Revenue Code	272
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$32.83
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$32.83

ARTERION MARK IV INJ SYST150ML

Facility

$43.80

Hospital Charge Code	270699516S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$21.90
Rate for Payer: Aetna Commercial	$13.14
Rate for Payer: Aetna Medicare Advantage	$13.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.17
Rate for Payer: Cigna Commercial	$21.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.69
Rate for Payer: Oxford Commercial	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.57
Rate for Payer: UnitedHealthcare Commercial	$21.90

ARTERION MARK IV INJ SYST150ML

Facility

$43.80

Hospital Charge Code	270699516S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$6.57

ARTERY XRAY ARM/LEG

Facility

$15,468.50

Service Code	HCPCS 75710
Hospital Charge Code	1600000866
Hospital Revenue Code	360
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

ARTERY XRAY ARM/LEG

Facility

$15,468.50

Service Code	HCPCS 75710
Hospital Charge Code	1600000866
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

ARTERY X-RAYS ABDOMEN

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	321075726
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,535.25
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS ABDOMEN

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	2004877
Hospital Revenue Code	323
Min. Negotiated Rate	$266.51
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,535.25
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERY X-RAYS ABDOMEN

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	321075726
Hospital Revenue Code	323
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

ARTERY X-RAYS ABDOMEN

Facility

$25,628.45

Service Code	HCPCS 75726
Hospital Charge Code	2004877
Hospital Revenue Code	323
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

Know your out-of-pocket cost for care.

All Charges