Heights University Hospital

All Charges

Charge

Type

Setting

Price

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	366836251
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-LT

Facility

$8,741.00

Service Code	HCPCS 36251LT
Hospital Charge Code	7411912
Hospital Revenue Code	361
Min. Negotiated Rate	$1,311.15
Max. Negotiated Rate	$1,311.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANGIO-W/AORTA-LT

Facility

$8,741.00

Service Code	HCPCS 36251LT
Hospital Charge Code	7411912
Hospital Revenue Code	361
Min. Negotiated Rate	$1,136.33
Max. Negotiated Rate	$4,370.50
Rate for Payer: Aetna Commercial	$2,622.30
Rate for Payer: Aetna Medicare Advantage	$2,622.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,228.95
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	$2,228.95
Rate for Payer: Cigna Commercial	$4,370.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,136.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	2691280
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	366836251
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	321036251R
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	321036251R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	2691285
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	2691285
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$8,741.00

Service Code	HCPCS 36251RT
Hospital Charge Code	7411913
Hospital Revenue Code	361
Min. Negotiated Rate	$1,136.33
Max. Negotiated Rate	$4,370.50
Rate for Payer: Aetna Commercial	$2,622.30
Rate for Payer: Aetna Medicare Advantage	$2,622.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,228.95
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	$2,228.95
Rate for Payer: Cigna Commercial	$4,370.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,136.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANGIO-W/AORTA-RT

Facility

$8,741.00

Service Code	HCPCS 36251RT
Hospital Charge Code	7411913
Hospital Revenue Code	361
Min. Negotiated Rate	$1,311.15
Max. Negotiated Rate	$1,311.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	366836253L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	2691290
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	366836253L
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	2691290
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	321036253L
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	321036253L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 25628RT
Hospital Charge Code	321036253R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	7411915
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 25628RT
Hospital Charge Code	321036253R
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	7411915
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	2691295
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	2691295
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

Know your out-of-pocket cost for care.

All Charges