Heights University Hospital

All Charges

Charge

Type

Setting

Price

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 VENOUS

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	411037241
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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 VENOUS

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	366837241
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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 VENOUS

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	366837241
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASC EMBOLIZE/OCCLUDE VENOUS

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	411037241
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCU EMBO OR OCCLU

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5701100
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

VASCU EMBO OR OCCLU

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	7411534
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

VASCU EMBO OR OCCLU

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5701100
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

VASCU EMBO OR OCCLU

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	7411534
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

VASCULAR DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270675442
Hospital Revenue Code	272
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$13.80

VASCULAR DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270675442
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

VASCULAR DILATOR 6FR 0.038IN

Facility

$27.61

Hospital Charge Code	270673020
Hospital Revenue Code	272
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.59
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$13.80

VASCULAR DILATOR 6FR 0.038IN

Facility

$27.61

Hospital Charge Code	270673020
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	5701110
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	321037241
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	321037241
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	5701110
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411528
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411528
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	2692118
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411529
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411529
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	2692118
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	$17,017.92
Rate for Payer: Aetna Medicare Advantage	$17,017.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,465.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,465.23
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	$14,465.23
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,374.43
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
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

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$919.50
Max. Negotiated Rate	$3,065.00
Rate for Payer: Aetna Commercial	$1,839.00
Rate for Payer: Aetna Medicare Advantage	$1,839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,563.15
Rate for Payer: Cigna Commercial	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: Qualcare PPO/HMO/WC	$919.50

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$919.50
Max. Negotiated Rate	$1,483.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: Qualcare PPO/HMO/WC	$919.50

Know your out-of-pocket cost for care.

All Charges