Heights University Hospital

All Charges

Charge

Type

Setting

Price

REVSC EVASC IVT ANGIO CPLX 1

Facility

$27,397.00

Service Code	HCPCS 37256
Hospital Charge Code	404637256
Hospital Revenue Code	481
Min. Negotiated Rate	$3,561.61
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO CPLX 1

Facility

$27,397.00

Service Code	HCPCS 37256
Hospital Charge Code	403437256
Hospital Revenue Code	481
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO CPLX 1

Facility

$27,397.00

Service Code	HCPCS 37256
Hospital Charge Code	404637256
Hospital Revenue Code	481
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO CPLX 1

Facility

$27,397.00

Service Code	HCPCS 37256
Hospital Charge Code	403437256
Hospital Revenue Code	481
Min. Negotiated Rate	$3,561.61
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO SF 1ST

Facility

$27,397.00

Service Code	HCPCS 37254
Hospital Charge Code	403437254
Hospital Revenue Code	481
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO SF 1ST

Facility

$27,397.00

Service Code	HCPCS 37254
Hospital Charge Code	404637254
Hospital Revenue Code	481
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO SF 1ST

Facility

$27,397.00

Service Code	HCPCS 37254
Hospital Charge Code	404637254
Hospital Revenue Code	481
Min. Negotiated Rate	$3,561.61
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ANGIO SF 1ST

Facility

$27,397.00

Service Code	HCPCS 37254
Hospital Charge Code	403437254
Hospital Revenue Code	481
Min. Negotiated Rate	$3,561.61
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

REVSC EVASC IVT ST CPLX 1ST

Facility

$61,616.39

Service Code	HCPCS 37260
Hospital Charge Code	404637260
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT ST CPLX 1ST

Facility

$61,616.39

Service Code	HCPCS 37260
Hospital Charge Code	403437260
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT ST CPLX 1ST

Facility

$61,616.39

Service Code	HCPCS 37260
Hospital Charge Code	403437260
Hospital Revenue Code	481
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT ST CPLX 1ST

Facility

$61,616.39

Service Code	HCPCS 37260
Hospital Charge Code	404637260
Hospital Revenue Code	481
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT ST CPLX EA

Facility

$15,877.00

Service Code	HCPCS 37261
Hospital Charge Code	403437261
Hospital Revenue Code	481
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT ST CPLX EA

Facility

$15,877.00

Service Code	HCPCS 37261
Hospital Charge Code	403437261
Hospital Revenue Code	481
Min. Negotiated Rate	$206.59
Max. Negotiated Rate	$4,763.10
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$206.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT ST CPLX EA

Facility

$15,877.00

Service Code	HCPCS 37261
Hospital Charge Code	404637261
Hospital Revenue Code	481
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT ST CPLX EA

Facility

$15,877.00

Service Code	HCPCS 37261
Hospital Charge Code	404637261
Hospital Revenue Code	481
Min. Negotiated Rate	$206.59
Max. Negotiated Rate	$4,763.10
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$206.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT STENT SF 1ST

Facility

$61,616.39

Service Code	HCPCS 37258
Hospital Charge Code	404637258
Hospital Revenue Code	481
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT STENT SF 1ST

Facility

$61,616.39

Service Code	HCPCS 37258
Hospital Charge Code	403437258
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT STENT SF 1ST

Facility

$61,616.39

Service Code	HCPCS 37258
Hospital Charge Code	404637258
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$18,484.92
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,010.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT STENT SF 1ST

Facility

$61,616.39

Service Code	HCPCS 37258
Hospital Charge Code	403437258
Hospital Revenue Code	481
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

REVSC EVASC IVT STENT SF EA

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	404637259
Hospital Revenue Code	481
Min. Negotiated Rate	$194.41
Max. Negotiated Rate	$4,763.10
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$194.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT STENT SF EA

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	404637259
Hospital Revenue Code	481
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT STENT SF EA

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	403437259
Hospital Revenue Code	481
Min. Negotiated Rate	$194.41
Max. Negotiated Rate	$4,763.10
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$194.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC IVT STENT SF EA

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	403437259
Hospital Revenue Code	481
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

REVSC EVASC TPVT ST CPLX 1stLT

Facility

$108,892.35

Service Code	HCPCS 37286
Hospital Charge Code	404637286
Hospital Revenue Code	481
Min. Negotiated Rate	$16,333.85
Max. Negotiated Rate	$16,333.85
Rate for Payer: Qualcare PPO/HMO/WC	$16,333.85

Know your out-of-pocket cost for care.

All Charges