Heights University Hospital

All Charges

Charge

Type

Setting

Price

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	5100788
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$13,557.97
Rate for Payer: Aetna Medicare Advantage	$13,557.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,524.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,524.27
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	$11,524.27
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,875.12
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PRQ CARDI ANGIO/ATHRECT 1 ART

Facility

$45,193.22

Service Code	HCPCS 92924
Hospital Charge Code	5100788
Hospital Revenue Code	481
Min. Negotiated Rate	$6,778.98
Max. Negotiated Rate	$6,778.98
Rate for Payer: Qualcare PPO/HMO/WC	$6,778.98

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$35,998.44

Service Code	HCPCS 92925
Hospital Charge Code	74110082
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$92,925.00

Service Code	HCPCS 92925
Hospital Charge Code	5100789
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$46,462.50
Rate for Payer: Aetna Commercial	$27,877.50
Rate for Payer: Aetna Medicare Advantage	$27,877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,695.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,695.88
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	$23,695.88
Rate for Payer: Cigna Commercial	$46,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,080.25
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,938.75
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$92,925.00

Service Code	HCPCS 92925
Hospital Charge Code	5100789
Hospital Revenue Code	481
Min. Negotiated Rate	$13,938.75
Max. Negotiated Rate	$13,938.75
Rate for Payer: Qualcare PPO/HMO/WC	$13,938.75

PRQ CARDI ANGIO/ATHRECT ADDL

Facility

$35,998.44

Service Code	HCPCS 92925
Hospital Charge Code	74110082
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	74110086
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	74110085
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	74110086
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	5100793
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	5100792
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	74110085
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92934
Hospital Charge Code	5100793
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT/ATH/ANGIO

Facility

$35,998.44

Service Code	HCPCS 92933
Hospital Charge Code	5100792
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100790
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110083
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100790
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110083
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100791
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100791
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110084
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	74110084
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARD REVASC CHRONIC 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92943
Hospital Charge Code	5100797
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARD REVASC CHRONIC 1 VSL

Facility

$58,023.05

Service Code	HCPCS 92943
Hospital Charge Code	74110090
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$17,406.92
Rate for Payer: Aetna Medicare Advantage	$17,406.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,795.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,795.88
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	$14,795.88
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,543.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,703.46
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PRQ CARD REVASC CHRONIC 1 VSL

Facility

$58,023.05

Service Code	HCPCS 92943
Hospital Charge Code	74110090
Hospital Revenue Code	481
Min. Negotiated Rate	$8,703.46
Max. Negotiated Rate	$8,703.46
Rate for Payer: Qualcare PPO/HMO/WC	$8,703.46

Know your out-of-pocket cost for care.

All Charges