Heights University Hospital

All Charges

Charge

Type

Setting

Price

THROMBOLYTIC ART/VEN THERAPY

Facility

$13,241.04

Service Code	HCPCS 37213
Hospital Charge Code	2692244
Hospital Revenue Code	361
Min. Negotiated Rate	$1,986.16
Max. Negotiated Rate	$1,986.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,986.16

THROMBOLYTIC ART/VEN THERAPY

Facility

$6,404.20

Service Code	HCPCS 37213
Hospital Charge Code	321037213
Hospital Revenue Code	361
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,921.26
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.55
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

THROMBOLYTIC ART/VEN THERAPY

Facility

$6,404.20

Service Code	HCPCS 37213
Hospital Charge Code	321037213
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

THROMBOLYTIC ART/VEN THERAPY

Facility

$13,241.04

Service Code	HCPCS 37213
Hospital Charge Code	2692244
Hospital Revenue Code	361
Min. Negotiated Rate	$1,721.34
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,972.31
Rate for Payer: Aetna Medicare Advantage	$3,972.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,376.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,376.47
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	$3,376.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,721.34
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,986.16
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

THROMBOLYTIC ART/VEN THERAPY

Facility

$10,333.93

Service Code	HCPCS 37213
Hospital Charge Code	7411506
Hospital Revenue Code	361
Min. Negotiated Rate	$1,550.09
Max. Negotiated Rate	$1,550.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.09

THROMBOLYTIC ART/VEN THERAPY

Facility

$10,333.93

Service Code	HCPCS 37213
Hospital Charge Code	7411506
Hospital Revenue Code	361
Min. Negotiated Rate	$1,343.41
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,100.18
Rate for Payer: Aetna Medicare Advantage	$3,100.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,635.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,635.15
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	$2,635.15
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.41
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.09
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

THROMBOLYTIC DEVICE ROTATOR

Facility

$781.30

Hospital Charge Code	270664875
Hospital Revenue Code	270
Min. Negotiated Rate	$117.19
Max. Negotiated Rate	$117.19
Rate for Payer: Qualcare PPO/HMO/WC	$117.19

THROMBOLYTIC DEVICE ROTATOR

Facility

$781.30

Hospital Charge Code	270664875
Hospital Revenue Code	270
Min. Negotiated Rate	$101.57
Max. Negotiated Rate	$390.65
Rate for Payer: Aetna Commercial	$234.39
Rate for Payer: Aetna Medicare Advantage	$234.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.23
Rate for Payer: Cigna Commercial	$390.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.57
Rate for Payer: Oxford Commercial	$390.65
Rate for Payer: Qualcare PPO/HMO/WC	$117.19
Rate for Payer: UnitedHealthcare Commercial	$390.65

THROMBOLYTIC VENOUS THEARPY

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	5600230
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

THROMBOLYTIC VENOUS THEARPY

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	5600230
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
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	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

THROMBOLYTIC VENOUS THERAPY

Facility

$4,631.03

Service Code	HCPCS 37212
Hospital Charge Code	7411504
Hospital Revenue Code	361
Min. Negotiated Rate	$602.03
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,389.31
Rate for Payer: Aetna Medicare Advantage	$1,389.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,180.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,180.91
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	$1,180.91
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$602.03
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$694.65
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

THROMBOLYTIC VENOUS THERAPY

Facility

$12,462.85

Service Code	HCPCS 37212
Hospital Charge Code	411037212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

THROMBOLYTIC VENOUS THERAPY

Facility

$4,631.03

Service Code	HCPCS 37212
Hospital Charge Code	7411504
Hospital Revenue Code	361
Min. Negotiated Rate	$694.65
Max. Negotiated Rate	$694.65
Rate for Payer: Qualcare PPO/HMO/WC	$694.65

THROMBOLYTIC VENOUS THERAPY

Facility

$5,081.82

Service Code	HCPCS 37212
Hospital Charge Code	2692243
Hospital Revenue Code	361
Min. Negotiated Rate	$762.27
Max. Negotiated Rate	$762.27
Rate for Payer: Qualcare PPO/HMO/WC	$762.27

THROMBOLYTIC VENOUS THERAPY

Facility

$12,462.85

Service Code	HCPCS 37212
Hospital Charge Code	366837212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

THROMBOLYTIC VENOUS THERAPY

Facility

$12,462.85

Service Code	HCPCS 37212
Hospital Charge Code	411037212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

THROMBOLYTIC VENOUS THERAPY

Facility

$5,081.82

Service Code	HCPCS 37212
Hospital Charge Code	2692243
Hospital Revenue Code	361
Min. Negotiated Rate	$660.64
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,524.55
Rate for Payer: Aetna Medicare Advantage	$1,524.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,295.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,295.86
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	$1,295.86
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.64
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$762.27
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

THROMBOLYTIC VENOUS THERAPY

Facility

$12,462.85

Service Code	HCPCS 37212
Hospital Charge Code	366837212
Hospital Revenue Code	361
Min. Negotiated Rate	$1,620.17
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,738.86
Rate for Payer: Aetna Medicare Advantage	$3,738.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,178.03
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	$3,178.03
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,620.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

THROMBOPLASTIN INHIBTN,TISSUE

Facility

$53.00

Service Code	HCPCS 85705
Hospital Charge Code	38477051
Hospital Revenue Code	305
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$9.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.28
Rate for Payer: Cigna Commercial	$9.63
Rate for Payer: Cigna Medicare Advantage	$4.82
Rate for Payer: Clover Medicare Advantage	$9.15
Rate for Payer: EmblemHealth Commercial	$28.89
Rate for Payer: Humana Medicare Advantage	$9.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.21
Rate for Payer: Wellcare Medicare Advantage	$9.63

THROMBOPLASTIN INHIBTN,TISSUE

Facility

$53.00

Service Code	HCPCS 85705
Hospital Charge Code	38477051
Hospital Revenue Code	305
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

THROMBOPLASTIN TIME PARTIAL

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	401485730
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.47
Rate for Payer: Aetna Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.02
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: Cigna Medicare Advantage	$3.00
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.37
Rate for Payer: Wellcare Medicare Advantage	$6.01

THROMBOPLASTIN TIME PARTIAL

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	401485730
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THROMBOSTAT/10000U/10ML

Facility

$227.00

Hospital Charge Code	60634288
Hospital Revenue Code	250
Min. Negotiated Rate	$29.51
Max. Negotiated Rate	$113.50
Rate for Payer: Aetna Commercial	$68.10
Rate for Payer: Aetna Medicare Advantage	$68.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.88
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.51
Rate for Payer: Oxford Commercial	$113.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.05
Rate for Payer: UnitedHealthcare Commercial	$113.50

THROMBOSTAT/10000U/10ML

Facility

$227.00

Hospital Charge Code	60634288
Hospital Revenue Code	250
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

THROMBOSTAT/10KU

Facility

$210.00

Hospital Charge Code	60634024
Hospital Revenue Code	250
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

Know your out-of-pocket cost for care.

All Charges