Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLACE DUOD/JEJ TUBE PERC

Facility

$15,699.70

Service Code	HCPCS 49441
Hospital Charge Code	1600000298
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,709.91
Rate for Payer: Aetna Commercial	$4,709.91
Rate for Payer: Aetna Medicare Advantage	$4,709.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,003.42
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	$4,003.42
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.96
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,354.95
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

PLACE DUOD/JEJ TUBE PERC

Facility

$15,699.70

Service Code	HCPCS 49441
Hospital Charge Code	1600000298
Hospital Revenue Code	360
Min. Negotiated Rate	$2,354.95
Max. Negotiated Rate	$2,354.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,354.95

PLACE GASTROSTOMY TUBE

Facility

$28,383.60

Service Code	HCPCS 43830
Hospital Charge Code	1600000857
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,515.08
Rate for Payer: Aetna Commercial	$8,515.08
Rate for Payer: Aetna Medicare Advantage	$8,515.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.82
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	$7,237.82
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.87
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.54
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PLACE GASTROSTOMY TUBE

Facility

$28,383.60

Service Code	HCPCS 43830
Hospital Charge Code	1600000857
Hospital Revenue Code	360
Min. Negotiated Rate	$4,257.54
Max. Negotiated Rate	$4,257.54
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.54

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	74110008
Hospital Revenue Code	481
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	5100044
Hospital Revenue Code	481
Min. Negotiated Rate	$3,250.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
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	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	5100044
Hospital Revenue Code	481
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT ADD

Facility

$25,000.00

Hospital Charge Code	74110008
Hospital Revenue Code	481
Min. Negotiated Rate	$3,250.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
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	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	5100043
Hospital Revenue Code	481
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	74110007
Hospital Revenue Code	481
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$4,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	5100043
Hospital Revenue Code	481
Min. Negotiated Rate	$4,160.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
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	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT BARE METAL STENT SGL

Facility

$32,000.00

Hospital Charge Code	74110007
Hospital Revenue Code	481
Min. Negotiated Rate	$4,160.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
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	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,160.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	5100042
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$19,871.19
Rate for Payer: Aetna Commercial	$11,922.71
Rate for Payer: Aetna Medicare Advantage	$11,922.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,134.30
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	$10,134.30
Rate for Payer: Cigna Commercial	$19,871.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,166.51
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	74110006
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$19,871.19
Rate for Payer: Aetna Commercial	$11,922.71
Rate for Payer: Aetna Medicare Advantage	$11,922.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,134.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,134.30
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	$10,134.30
Rate for Payer: Cigna Commercial	$19,871.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,166.51
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	5100042
Hospital Revenue Code	481
Min. Negotiated Rate	$5,961.36
Max. Negotiated Rate	$5,961.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT ADDL

Facility

$39,742.37

Hospital Charge Code	74110006
Hospital Revenue Code	481
Min. Negotiated Rate	$5,961.36
Max. Negotiated Rate	$5,961.36
Rate for Payer: Qualcare PPO/HMO/WC	$5,961.36

PLACEMENT DRUG ELUD STENT SING

Facility

$50,870.23

Hospital Charge Code	5100041
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$25,435.12
Rate for Payer: Aetna Commercial	$15,261.07
Rate for Payer: Aetna Medicare Advantage	$15,261.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,971.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,971.91
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	$12,971.91
Rate for Payer: Cigna Commercial	$25,435.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,613.13
Rate for Payer: Qualcare PPO/HMO/WC	$7,630.53

PLACEMENT DRUG ELUD STENT SING

Facility

$50,870.23

Hospital Charge Code	5100041
Hospital Revenue Code	481
Min. Negotiated Rate	$7,630.53
Max. Negotiated Rate	$7,630.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,630.53

PLACEMENT DRUG ELUD STENT SING

Facility

$50,870.23

Hospital Charge Code	74110005
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$25,435.12
Rate for Payer: Aetna Commercial	$15,261.07
Rate for Payer: Aetna Medicare Advantage	$15,261.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,971.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,971.91
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	$12,971.91
Rate for Payer: Cigna Commercial	$25,435.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,613.13
Rate for Payer: Qualcare PPO/HMO/WC	$7,630.53

PLACEMENT DRUG ELUD STENT SING

Facility

$50,870.23

Hospital Charge Code	74110005
Hospital Revenue Code	481
Min. Negotiated Rate	$7,630.53
Max. Negotiated Rate	$7,630.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,630.53

PLACEMENT IVC FILTER PERCU S&I

Facility

$1,370.00

Service Code	HCPCS 75940
Hospital Charge Code	5100316
Hospital Revenue Code	320
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

PLACEMENT IVC FILTER PERCU S&I

Facility

$1,370.00

Service Code	HCPCS 75940
Hospital Charge Code	5100316
Hospital Revenue Code	320
Min. Negotiated Rate	$178.10
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$411.00
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PLACEMENT IVC FILTER PERCUT

Facility

$6,404.13

Service Code	HCPCS 37620
Hospital Charge Code	5100315
Hospital Revenue Code	361
Min. Negotiated Rate	$832.54
Max. Negotiated Rate	$3,202.07
Rate for Payer: Aetna Commercial	$1,921.24
Rate for Payer: Aetna Medicare Advantage	$1,921.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.05
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	$1,633.05
Rate for Payer: Cigna Commercial	$3,202.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.54
Rate for Payer: Qualcare PPO/HMO/WC	$960.62

PLACEMENT IVC FILTER PERCUT

Facility

$6,404.13

Service Code	HCPCS 37620
Hospital Charge Code	5100315
Hospital Revenue Code	361
Min. Negotiated Rate	$960.62
Max. Negotiated Rate	$960.62
Rate for Payer: Qualcare PPO/HMO/WC	$960.62

PLACEMENT OF SETON

Facility

$14,972.60

Service Code	HCPCS 46020
Hospital Charge Code	1600000454
Hospital Revenue Code	360
Min. Negotiated Rate	$2,245.89
Max. Negotiated Rate	$2,245.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.89

Know your out-of-pocket cost for care.

All Charges