Heights University Hospital

All Charges

Charge

Type

Setting

Price

US DUPLEX EXTREM UNILAT

Facility

$2,497.57

Service Code	HCPCS 93971
Hospital Charge Code	2100303
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$749.27
Rate for Payer: Aetna Medicare Advantage	$749.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$636.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$636.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$636.88
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.68
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$374.64
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX EXTREM UNILAT

Facility

$2,497.57

Service Code	HCPCS 93971
Hospital Charge Code	2100303
Hospital Revenue Code	921
Min. Negotiated Rate	$374.64
Max. Negotiated Rate	$374.64
Rate for Payer: Qualcare PPO/HMO/WC	$374.64

US DUPLEX EXTREM UPPER ARTR BI

Facility

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	2100972
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

US DUPLEX EXTREM UPPER ARTR BI

Facility

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	2100972
Hospital Revenue Code	920
Min. Negotiated Rate	$568.20
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,189.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

US DUPLEX EXTREM VEIN LOW BILA

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2100402
Hospital Revenue Code	921
Min. Negotiated Rate	$518.65
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX EXTREM VEIN LOW BILA

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2100402
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX EXTREM VEIN LOWER UN

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2100410
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX EXTREM VEIN LOWER UN

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2100410
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX EXTREM VEIN UP-BILAT

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2100980
Hospital Revenue Code	921
Min. Negotiated Rate	$518.65
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX EXTREM VEIN UP-BILAT

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2100980
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX EXTREM VEIN UPPER UN

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2100394
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX EXTREM VEIN UPPER UN

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	2100394
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX EXTRM LOWER ARTR BI

Facility

$5,100.00

Service Code	HCPCS 93925
Hospital Charge Code	2100329
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

US DUPLEX EXTRM LOWER ARTR BI

Facility

$5,100.00

Service Code	HCPCS 93925
Hospital Charge Code	2100329
Hospital Revenue Code	920
Min. Negotiated Rate	$412.85
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$412.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

US DUPLEX EXTRM LOWER ARTR UNI

Facility

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	2100311
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

US DUPLEX EXTRM LOWER ARTR UNI

Facility

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	2100311
Hospital Revenue Code	920
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

US DUPLEX EXTRM UPPER ARTR UNI

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	2100337
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX EXTRM UPPER ARTR UNI

Facility

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	2100337
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX HEMODIALYSIS ACCESS

Facility

$17,200.00

Service Code	HCPCS 93990
Hospital Charge Code	2101110
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX HEMODIALYSIS ACCESS

Facility

$17,200.00

Service Code	HCPCS 93990
Hospital Charge Code	2101110
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

US DUPLEX HEMODIALYSIS ACCESS

Facility

$1,122.00

Service Code	HCPCS 93990
Hospital Charge Code	2101106
Hospital Revenue Code	921
Min. Negotiated Rate	$168.30
Max. Negotiated Rate	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$168.30

US DUPLEX HEMODIALYSIS ACCESS

Facility

$1,122.00

Service Code	HCPCS 93990
Hospital Charge Code	2101106
Hospital Revenue Code	921
Min. Negotiated Rate	$145.86
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$336.60
Rate for Payer: Aetna Medicare Advantage	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.11
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.86
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.30
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX PENILE ART/VEIN LMTD

Facility

$563.15

Service Code	HCPCS 93981
Hospital Charge Code	2301008
Hospital Revenue Code	921
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US DUPLEX PENILE ART/VEIN LMTD

Facility

$563.15

Service Code	HCPCS 93981
Hospital Charge Code	2301008
Hospital Revenue Code	921
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$168.94
Rate for Payer: Aetna Medicare Advantage	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.60
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.21
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US DUPLEX PENILE ART/VEINS CMP

Facility

$905.70

Service Code	HCPCS 93980
Hospital Charge Code	2301007
Hospital Revenue Code	921
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$135.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

Know your out-of-pocket cost for care.

All Charges