Heights University Hospital

All Charges

Charge

Type

Setting

Price

VEIN SAPHENOUS 71-80CM

Facility

$38,250.00

Service Code	HCPCS C1768
Hospital Charge Code	270676724
Hospital Revenue Code	278
Min. Negotiated Rate	$5,737.50
Max. Negotiated Rate	$19,125.00
Rate for Payer: Aetna Commercial	$11,475.00
Rate for Payer: Aetna Medicare Advantage	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,753.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,753.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,753.75
Rate for Payer: Cigna Commercial	$19,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,256.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,737.50

VEIN SAPHENOUS 80-100CM

Facility

$46,750.00

Hospital Charge Code	270680417
Hospital Revenue Code	278
Min. Negotiated Rate	$7,012.50
Max. Negotiated Rate	$23,375.00
Rate for Payer: Aetna Commercial	$14,025.00
Rate for Payer: Aetna Medicare Advantage	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,921.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,921.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,921.25
Rate for Payer: Cigna Commercial	$23,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,313.50
Rate for Payer: Qualcare PPO/HMO/WC	$7,012.50

VEIN SAPHENOUS 80-100CM

Facility

$46,750.00

Hospital Charge Code	270680417
Hospital Revenue Code	278
Min. Negotiated Rate	$7,012.50
Max. Negotiated Rate	$11,313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,313.50
Rate for Payer: Qualcare PPO/HMO/WC	$7,012.50

VEIN SAPHENOUS TISS 56 V010-56

Facility

$20,732.85

Hospital Charge Code	270630638
Hospital Revenue Code	278
Min. Negotiated Rate	$3,109.93
Max. Negotiated Rate	$10,366.42
Rate for Payer: Aetna Commercial	$6,219.85
Rate for Payer: Aetna Medicare Advantage	$6,219.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,146.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,286.88
Rate for Payer: Cigna Commercial	$10,366.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,017.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,109.93

VEIN SAPHENOUS TISS 56 V010-56

Facility

$20,732.85

Hospital Charge Code	270630638
Hospital Revenue Code	278
Min. Negotiated Rate	$3,109.93
Max. Negotiated Rate	$5,017.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,146.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,017.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,109.93

VEIN STRIPPER

Facility

$816.75

Hospital Charge Code	270VE022
Hospital Revenue Code	272
Min. Negotiated Rate	$122.51
Max. Negotiated Rate	$122.51
Rate for Payer: Qualcare PPO/HMO/WC	$122.51

VEIN STRIPPER

Facility

$816.75

Hospital Charge Code	270VE022
Hospital Revenue Code	272
Min. Negotiated Rate	$106.18
Max. Negotiated Rate	$408.38
Rate for Payer: Aetna Commercial	$245.03
Rate for Payer: Aetna Medicare Advantage	$245.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.27
Rate for Payer: Cigna Commercial	$408.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.18
Rate for Payer: Oxford Commercial	$408.38
Rate for Payer: Qualcare PPO/HMO/WC	$122.51
Rate for Payer: UnitedHealthcare Commercial	$408.38

VEIN STRIPPER ******

Facility

$60.00

Hospital Charge Code	1608116
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

VEIN STRIPPER ******

Facility

$60.00

Hospital Charge Code	1608116
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

VEIN X-RAY ARM/LEG

Facility

$3,591.14

Service Code	HCPCS 75820
Hospital Charge Code	366875820
Hospital Revenue Code	320
Min. Negotiated Rate	$117.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,077.34
Rate for Payer: Aetna Medicare Advantage	$1,077.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.74
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.85
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$538.67
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY ARM/LEG

Facility

$3,591.14

Service Code	HCPCS 75820
Hospital Charge Code	411075820
Hospital Revenue Code	320
Min. Negotiated Rate	$538.67
Max. Negotiated Rate	$538.67
Rate for Payer: Qualcare PPO/HMO/WC	$538.67

VEIN X-RAY ARM/LEG

Facility

$3,591.14

Service Code	HCPCS 75820
Hospital Charge Code	366875820
Hospital Revenue Code	320
Min. Negotiated Rate	$538.67
Max. Negotiated Rate	$538.67
Rate for Payer: Qualcare PPO/HMO/WC	$538.67

VEIN X-RAY ARM/LEG

Facility

$3,591.14

Service Code	HCPCS 75820
Hospital Charge Code	411075820
Hospital Revenue Code	320
Min. Negotiated Rate	$117.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,077.34
Rate for Payer: Aetna Medicare Advantage	$1,077.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.74
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.85
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$538.67
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY CHEST

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	366875827
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

VEIN X-RAY CHEST

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	411075827
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

VEIN X-RAY CHEST

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	366875827
Hospital Revenue Code	320
Min. Negotiated Rate	$388.96
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$925.32
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.97
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY CHEST

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	411075827
Hospital Revenue Code	320
Min. Negotiated Rate	$388.96
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$925.32
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.97
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY NECK

Facility

$14,614.45

Service Code	HCPCS 75860
Hospital Charge Code	366875860
Hospital Revenue Code	320
Min. Negotiated Rate	$353.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,384.34
Rate for Payer: Aetna Medicare Advantage	$4,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,726.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,726.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,726.68
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY NECK

Facility

$14,614.45

Service Code	HCPCS 75860
Hospital Charge Code	366875860
Hospital Revenue Code	320
Min. Negotiated Rate	$2,192.17
Max. Negotiated Rate	$2,192.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17

VEIN X-RAY NECK

Facility

$14,614.45

Service Code	HCPCS 75860
Hospital Charge Code	411075860
Hospital Revenue Code	320
Min. Negotiated Rate	$353.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,384.34
Rate for Payer: Aetna Medicare Advantage	$4,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,726.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,726.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,726.68
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY NECK

Facility

$14,614.45

Service Code	HCPCS 75860
Hospital Charge Code	411075860
Hospital Revenue Code	320
Min. Negotiated Rate	$2,192.17
Max. Negotiated Rate	$2,192.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17

VEIN X-RAY SKULL

Facility

$3,591.40

Service Code	HCPCS 75870
Hospital Charge Code	366875870
Hospital Revenue Code	320
Min. Negotiated Rate	$538.71
Max. Negotiated Rate	$538.71
Rate for Payer: Qualcare PPO/HMO/WC	$538.71

VEIN X-RAY SKULL

Facility

$3,591.40

Service Code	HCPCS 75870
Hospital Charge Code	411075870
Hospital Revenue Code	320
Min. Negotiated Rate	$305.46
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,077.42
Rate for Payer: Aetna Medicare Advantage	$1,077.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.81
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$538.71
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY SKULL

Facility

$3,591.40

Service Code	HCPCS 75870
Hospital Charge Code	366875870
Hospital Revenue Code	320
Min. Negotiated Rate	$305.46
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$1,077.42
Rate for Payer: Aetna Medicare Advantage	$1,077.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.81
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$538.71
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VEIN X-RAY SKULL

Facility

$3,591.40

Service Code	HCPCS 75870
Hospital Charge Code	411075870
Hospital Revenue Code	320
Min. Negotiated Rate	$538.71
Max. Negotiated Rate	$538.71
Rate for Payer: Qualcare PPO/HMO/WC	$538.71

Know your out-of-pocket cost for care.

All Charges