Heights University Hospital

All Charges

Charge

Type

Setting

Price

THROMB+STENT PERIPH DIALYS SEG

Facility

$73,789.50

Service Code	HCPCS 36906
Hospital Charge Code	366836906
Hospital Revenue Code	361
Min. Negotiated Rate	$11,068.42
Max. Negotiated Rate	$11,068.42
Rate for Payer: Qualcare PPO/HMO/WC	$11,068.42

THROMB+STENT PERIPH DIALYS SEG

Facility

$89,914.40

Service Code	HCPCS 36906
Hospital Charge Code	2692132
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$26,974.32
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,688.87
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

THROMB+STENT PERIPH DIALYS SEG

Facility

$73,789.50

Service Code	HCPCS 36906
Hospital Charge Code	2709027
Hospital Revenue Code	361
Min. Negotiated Rate	$11,068.42
Max. Negotiated Rate	$11,068.42
Rate for Payer: Qualcare PPO/HMO/WC	$11,068.42

THROMB+STENT PERIPH DIALYS SEG

Facility

$73,789.50

Service Code	HCPCS 36906
Hospital Charge Code	366836906
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$22,136.85
Rate for Payer: Aetna Medicare Advantage	$22,136.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,816.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,816.32
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	$18,816.32
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,592.64
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,068.42
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

THROMB+STENT PERIPH DIALYS SEG

Facility

$73,789.50

Service Code	HCPCS 36906
Hospital Charge Code	7412061
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$22,136.85
Rate for Payer: Aetna Medicare Advantage	$22,136.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,816.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,816.32
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	$18,816.32
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,592.64
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,068.42
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

THROMB+STENT PERIPH DIALYS SEG

Facility

$73,789.50

Service Code	HCPCS 36906
Hospital Charge Code	5100840
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$22,136.85
Rate for Payer: Aetna Medicare Advantage	$22,136.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,816.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,816.32
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	$18,816.32
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,592.64
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,068.42
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	5100839
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$14,622.47
Rate for Payer: Aetna Medicare Advantage	$14,622.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,429.10
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	$12,429.10
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,336.40
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	321036905
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	5100839
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	7412060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Aetna Commercial	$14,622.47
Rate for Payer: Aetna Medicare Advantage	$14,622.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,429.10
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	$12,429.10
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,336.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	321036905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	366836905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$14,622.47
Rate for Payer: Aetna Medicare Advantage	$14,622.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,429.10
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	$12,429.10
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,336.40
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	2692131
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$16,986.28
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,360.72
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	366836905
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	2692131
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	2709026
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	2709026
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$14,622.47
Rate for Payer: Aetna Medicare Advantage	$14,622.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,429.10
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	$12,429.10
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,336.40
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	7412060
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMTOMY SET SPIRA VG ULTRA

Facility

$10,225.00

Hospital Charge Code	2709006918
Hospital Revenue Code	272
Min. Negotiated Rate	$1,533.75
Max. Negotiated Rate	$1,533.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75

THROMTOMY SET SPIRA VG ULTRA

Facility

$10,225.00

Hospital Charge Code	2709006918
Hospital Revenue Code	272
Min. Negotiated Rate	$1,329.25
Max. Negotiated Rate	$5,112.50
Rate for Payer: Aetna Commercial	$3,067.50
Rate for Payer: Aetna Medicare Advantage	$3,067.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,607.38
Rate for Payer: Cigna Commercial	$5,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.25
Rate for Payer: Oxford Commercial	$5,112.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75
Rate for Payer: UnitedHealthcare Commercial	$5,112.50

THSCF-35-80-1.5-ROSEN

Facility

$94.65

Hospital Charge Code	270678328
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$47.33
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$28.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.14
Rate for Payer: Cigna Commercial	$47.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$47.33
Rate for Payer: Qualcare PPO/HMO/WC	$14.20
Rate for Payer: UnitedHealthcare Commercial	$47.33

THSCF-35-80-1.5-ROSEN

Facility

$94.65

Hospital Charge Code	270678328
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.20

Thumble Tab Accessory, Nano Fx

Facility

$1,000.00

Hospital Charge Code	270665969
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

Thumble Tab Accessory, Nano Fx

Facility

$1,000.00

Hospital Charge Code	270665969
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

THUMBWHEEL HII MICRO LENGTHENE

Facility

$1,234.65

Hospital Charge Code	270688810
Hospital Revenue Code	272
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$617.33
Rate for Payer: Aetna Commercial	$370.39
Rate for Payer: Aetna Medicare Advantage	$370.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.84
Rate for Payer: Cigna Commercial	$617.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.50
Rate for Payer: Oxford Commercial	$617.33
Rate for Payer: Qualcare PPO/HMO/WC	$185.20
Rate for Payer: UnitedHealthcare Commercial	$617.33

Know your out-of-pocket cost for care.

All Charges