Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ CARD REVASC CHRONIC ADDL

Facility

$35,998.44

Service Code	HCPCS 92944
Hospital Charge Code	74110091
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 ADDL

Facility

$35,998.44

Service Code	HCPCS 92944
Hospital Charge Code	74110091
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,999.22
Rate for Payer: Cigna Commercial	$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: 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 ADDL

Facility

$35,998.44

Service Code	HCPCS 92944
Hospital Charge Code	5100798
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 ADDL

Facility

$35,998.44

Service Code	HCPCS 92944
Hospital Charge Code	5100798
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 CARD REVASC MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	74110089
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 MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	366892941
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 MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	366892941
Hospital Revenue Code	481
Min. Negotiated Rate	$634.76
Max. Negotiated Rate	$10,799.53
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	$634.76
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 MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	5100796
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 MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	74110089
Hospital Revenue Code	481
Min. Negotiated Rate	$634.76
Max. Negotiated Rate	$10,799.53
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	$634.76
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 MI 1 VSL

Facility

$35,998.44

Service Code	HCPCS 92941
Hospital Charge Code	5100796
Hospital Revenue Code	481
Min. Negotiated Rate	$634.76
Max. Negotiated Rate	$10,799.53
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	$634.76
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 CORONARY MECH THROMBECT

Facility

$20,106.54

Service Code	HCPCS 92973
Hospital Charge Code	74110107
Hospital Revenue Code	481
Min. Negotiated Rate	$87.77
Max. Negotiated Rate	$6,031.96
Rate for Payer: Aetna Commercial	$6,031.96
Rate for Payer: Aetna Medicare Advantage	$6,031.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,127.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,127.17
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	$5,127.17
Rate for Payer: Cigna Commercial	$87.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,613.85
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.98
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

PRQ CORONARY MECH THROMBECT

Facility

$20,106.54

Service Code	HCPCS 92973
Hospital Charge Code	5100814
Hospital Revenue Code	481
Min. Negotiated Rate	$87.77
Max. Negotiated Rate	$6,031.96
Rate for Payer: Aetna Commercial	$6,031.96
Rate for Payer: Aetna Medicare Advantage	$6,031.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,127.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,127.17
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	$5,127.17
Rate for Payer: Cigna Commercial	$87.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,613.85
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.98
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

PRQ CORONARY MECH THROMBECT

Facility

$20,106.54

Service Code	HCPCS 92973
Hospital Charge Code	5100814
Hospital Revenue Code	481
Min. Negotiated Rate	$3,015.98
Max. Negotiated Rate	$3,015.98
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.98

PRQ CORONARY MECH THROMBECT

Facility

$20,106.54

Service Code	HCPCS 92973
Hospital Charge Code	74110107
Hospital Revenue Code	481
Min. Negotiated Rate	$3,015.98
Max. Negotiated Rate	$3,015.98
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.98

PRQ D-E COR REVASC CHRO ADD

Facility

$47,735.22

Service Code	HCPCS C9608
Hospital Charge Code	4110C9608
Hospital Revenue Code	480
Min. Negotiated Rate	$7,160.28
Max. Negotiated Rate	$7,160.28
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28

PRQ D-E COR REVASC CHRO ADD

Facility

$47,735.22

Service Code	HCPCS C9608
Hospital Charge Code	4110C9608
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$23,867.61
Rate for Payer: Aetna Commercial	$14,320.57
Rate for Payer: Aetna Medicare Advantage	$14,320.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,172.48
Rate for Payer: Cigna Commercial	$23,867.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,205.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PRQ D-E COR REVASC CHRO ADDL

Facility

$45,735.22

Hospital Charge Code	5100807
Hospital Revenue Code	480
Min. Negotiated Rate	$6,860.28
Max. Negotiated Rate	$6,860.28
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28

PRQ D-E COR REVASC CHRO ADDL

Facility

$45,735.22

Hospital Charge Code	5100807
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$22,867.61
Rate for Payer: Aetna Commercial	$13,720.57
Rate for Payer: Aetna Medicare Advantage	$13,720.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,662.48
Rate for Payer: Cigna Commercial	$22,867.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,945.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PRQ D-E COR REVASC CHRO ADDL

Facility

$45,735.22

Hospital Charge Code	74110100
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$22,867.61
Rate for Payer: Aetna Commercial	$13,720.57
Rate for Payer: Aetna Medicare Advantage	$13,720.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,662.48
Rate for Payer: Cigna Commercial	$22,867.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,945.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PRQ D-E COR REVASC CHRO ADDL

Facility

$45,735.22

Hospital Charge Code	74110100
Hospital Revenue Code	480
Min. Negotiated Rate	$6,860.28
Max. Negotiated Rate	$6,860.28
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28

PRQ D-E COR REVASC CHRO SIN

Facility

$47,735.22

Service Code	HCPCS C9607
Hospital Charge Code	4110C9607
Hospital Revenue Code	480
Min. Negotiated Rate	$7,160.28
Max. Negotiated Rate	$7,160.28
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28

PRQ D-E COR REVASC CHRO SIN

Facility

$47,735.22

Service Code	HCPCS C9607
Hospital Charge Code	4110C9607
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$14,320.57
Rate for Payer: Aetna Medicare Advantage	$14,320.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,172.48
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,205.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PRQ D-E COR REVASC CHRO SING

Facility

$45,735.22

Hospital Charge Code	74110099
Hospital Revenue Code	480
Min. Negotiated Rate	$6,860.28
Max. Negotiated Rate	$6,860.28
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28

PRQ D-E COR REVASC CHRO SING

Facility

$45,735.22

Hospital Charge Code	74110099
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$22,867.61
Rate for Payer: Aetna Commercial	$13,720.57
Rate for Payer: Aetna Medicare Advantage	$13,720.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,662.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,662.48
Rate for Payer: Cigna Commercial	$22,867.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,945.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,860.28
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

Know your out-of-pocket cost for care.

All Charges