Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERI BALLN ANG BRA ADD-BI

Facility

$12,748.00

Service Code	HCPCS 3547550
Hospital Charge Code	7411055
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA ADD-BI

Facility

$12,748.00

Service Code	HCPCS 3547550
Hospital Charge Code	7411055
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA ADD-LT

Facility

$12,748.00

Service Code	HCPCS 35475LT
Hospital Charge Code	7411057
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA ADD-LT

Facility

$12,748.00

Service Code	HCPCS 35475LT
Hospital Charge Code	7411057
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA ADD-RT

Facility

$12,748.00

Service Code	HCPCS 35475RT
Hospital Charge Code	7411059
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA ADD-RT

Facility

$12,748.00

Service Code	HCPCS 35475RT
Hospital Charge Code	7411059
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-BI

Facility

$12,748.00

Service Code	HCPCS 3547550
Hospital Charge Code	7411061
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-BI

Facility

$12,748.00

Service Code	HCPCS 3547550
Hospital Charge Code	7411061
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-LT

Facility

$12,748.00

Service Code	HCPCS 35475LT
Hospital Charge Code	7411063
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-LT

Facility

$12,748.00

Service Code	HCPCS 35475LT
Hospital Charge Code	7411063
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-RT

Facility

$12,748.00

Service Code	HCPCS 35475RT
Hospital Charge Code	7411065
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG BRA INI-RT

Facility

$12,748.00

Service Code	HCPCS 35475RT
Hospital Charge Code	7411065
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-BI

Facility

$12,748.00

Service Code	HCPCS 3547150
Hospital Charge Code	7411039
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-BI

Facility

$12,748.00

Service Code	HCPCS 3547150
Hospital Charge Code	7411039
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-LT

Facility

$12,748.00

Service Code	HCPCS 35471LT
Hospital Charge Code	7411041
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-LT

Facility

$12,748.00

Service Code	HCPCS 35471LT
Hospital Charge Code	7411041
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-RT

Facility

$12,748.00

Service Code	HCPCS 35471RT
Hospital Charge Code	7411043
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V ADD-RT

Facility

$12,748.00

Service Code	HCPCS 35471RT
Hospital Charge Code	7411043
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-BI

Facility

$12,748.00

Service Code	HCPCS 3547150
Hospital Charge Code	7411045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-BI

Facility

$12,748.00

Service Code	HCPCS 3547150
Hospital Charge Code	7411045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-LT

Facility

$12,748.00

Service Code	HCPCS 35471LT
Hospital Charge Code	7411047
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-LT

Facility

$12,748.00

Service Code	HCPCS 35471LT
Hospital Charge Code	7411047
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-RT

Facility

$12,748.00

Service Code	HCPCS 35471RT
Hospital Charge Code	7411049
Hospital Revenue Code	361
Min. Negotiated Rate	$1,912.20
Max. Negotiated Rate	$1,912.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERI BALLN ANG R/V INI-RT

Facility

$12,748.00

Service Code	HCPCS 35471RT
Hospital Charge Code	7411049
Hospital Revenue Code	361
Min. Negotiated Rate	$1,657.24
Max. Negotiated Rate	$6,374.00
Rate for Payer: Aetna Commercial	$3,824.40
Rate for Payer: Aetna Medicare Advantage	$3,824.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,250.74
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	$3,250.74
Rate for Payer: Cigna Commercial	$6,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.20

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404133017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

Know your out-of-pocket cost for care.

All Charges