Heights University Hospital

All Charges

Charge

Type

Setting

Price

PTCA NDRU ELU STEN 1VE-LC

Facility

$28,383.00

Service Code	HCPCS 92980LC
Hospital Charge Code	7411191
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU ELU STEN 1VE-LC

Facility

$28,383.00

Hospital Charge Code	7411283
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU ELU STEN 1VE-RC

Facility

$28,383.00

Hospital Charge Code	7411279
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU ELU STEN 1VE-RC

Facility

$28,383.00

Service Code	HCPCS 92980RC
Hospital Charge Code	7411187
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU ELU STEN 1VE-RC

Facility

$28,383.00

Service Code	HCPCS 92980RC
Hospital Charge Code	7411187
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
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	$7,237.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA NDRU ELU STEN 1VE-RC

Facility

$28,383.00

Hospital Charge Code	7411279
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA-SINGLE VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92982
Hospital Charge Code	7411199
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-SINGLE VESSEL-LC

Facility

$14,507.00

Service Code	HCPCS 92982
Hospital Charge Code	7411199
Hospital Revenue Code	481
Min. Negotiated Rate	$1,885.91
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$4,352.10
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.91
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-SINGLE VESSEL-LD

Facility

$14,507.00

Hospital Charge Code	7411201
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-SINGLE VESSEL-LD

Facility

$14,507.00

Hospital Charge Code	7411201
Hospital Revenue Code	481
Min. Negotiated Rate	$1,885.91
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$4,352.10
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.91
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-SINGLE VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92982RC
Hospital Charge Code	7411203
Hospital Revenue Code	481
Min. Negotiated Rate	$2,176.05
Max. Negotiated Rate	$2,176.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PTCA-SINGLE VESSEL-RC

Facility

$14,507.00

Service Code	HCPCS 92982RC
Hospital Charge Code	7411203
Hospital Revenue Code	481
Min. Negotiated Rate	$1,885.91
Max. Negotiated Rate	$7,253.50
Rate for Payer: Aetna Commercial	$4,352.10
Rate for Payer: Aetna Medicare Advantage	$4,352.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,699.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,699.28
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	$3,699.28
Rate for Payer: Cigna Commercial	$7,253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.91
Rate for Payer: Qualcare PPO/HMO/WC	$2,176.05

PT CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$260.94
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.07
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$686.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$34,486.68

Hospital Charge Code	1
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,486.21
Rate for Payer: Aetna Medicare Advantage	$18,486.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,713.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,713.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,713.28
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.69
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PTCA UNSUCESSFUL

Facility

$34,486.68

Hospital Charge Code	1
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,243.34
Rate for Payer: Aetna Commercial	$10,346.00
Rate for Payer: Aetna Medicare Advantage	$10,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,794.10
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	$8,794.10
Rate for Payer: Cigna Commercial	$17,243.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,483.27
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,486.21
Rate for Payer: Aetna Medicare Advantage	$18,486.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,713.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,713.28
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	$15,713.28
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.69
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,486.21
Rate for Payer: Aetna Medicare Advantage	$18,486.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,713.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,713.28
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	$15,713.28
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.69
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	5100615
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	5100615
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$17,243.34
Rate for Payer: Aetna Commercial	$10,346.00
Rate for Payer: Aetna Medicare Advantage	$10,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,794.10
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	$8,794.10
Rate for Payer: Cigna Commercial	$17,243.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,483.27
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	74110055
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

Know your out-of-pocket cost for care.

All Charges