Heights University Hospital

All Charges

Charge

Type

Setting

Price

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5700321
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

VASC EMBOLIZE/OCCL ARTERY HEMO

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	411037244
Hospital Revenue Code	361
Min. Negotiated Rate	$7,877.09
Max. Negotiated Rate	$7,877.09
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$52,513.90

Service Code	HCPCS 37242
Hospital Charge Code	7411530
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$15,754.17
Rate for Payer: Aetna Medicare Advantage	$15,754.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,391.04
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	$13,391.04
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,826.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	366837242
Hospital Revenue Code	361
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	741100108
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	4110935100
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	366837242
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$52,513.90

Service Code	HCPCS 37242
Hospital Charge Code	7411530
Hospital Revenue Code	361
Min. Negotiated Rate	$7,877.09
Max. Negotiated Rate	$7,877.09
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	321037242
Hospital Revenue Code	361
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	321037242
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	1600000864
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	741100108
Hospital Revenue Code	361
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	1600000864
Hospital Revenue Code	360
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	5700316
Hospital Revenue Code	361
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	5700316
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$17,205.63
Rate for Payer: Aetna Medicare Advantage	$17,205.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,624.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,624.78
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	$14,624.78
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,455.77
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

VASC EMBOLIZE/OCCLUDE ARTERY

Facility

$57,352.09

Service Code	HCPCS 37242
Hospital Charge Code	4110935100
Hospital Revenue Code	481
Min. Negotiated Rate	$8,602.81
Max. Negotiated Rate	$8,602.81
Rate for Payer: Qualcare PPO/HMO/WC	$8,602.81

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$52,548.60

Service Code	HCPCS 37243
Hospital Charge Code	366837243
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$15,764.58
Rate for Payer: Aetna Medicare Advantage	$15,764.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,399.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,399.89
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	$13,399.89
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,831.32
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	321037243
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

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$52,513.90

Service Code	HCPCS 37243
Hospital Charge Code	7411532
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
Rate for Payer: Aetna Commercial	$15,754.17
Rate for Payer: Aetna Medicare Advantage	$15,754.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,391.04
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	$13,391.04
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,826.81
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$52,513.90

Service Code	HCPCS 37243
Hospital Charge Code	7411532
Hospital Revenue Code	361
Min. Negotiated Rate	$7,877.09
Max. Negotiated Rate	$7,877.09
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$52,548.60

Service Code	HCPCS 37243
Hospital Charge Code	366837243
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	321037243
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	5700317
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

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$52,548.60

Service Code	HCPCS 37243
Hospital Charge Code	411037243
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

VASC EMBOLIZE/OCCLUDE ORGAN

Facility

$56,620.95

Service Code	HCPCS 37243
Hospital Charge Code	5700317
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Better Health Medicaid	$23,802.30
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

Know your out-of-pocket cost for care.

All Charges