Heights University Hospital

All Charges

Charge

Type

Setting

Price

VENOGRAM UPPER EXTREMITY

Facility

$4,693.75

Service Code	HCPCS 75822
Hospital Charge Code	5100565
Hospital Revenue Code	320
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,408.12
Rate for Payer: Aetna Medicare Advantage	$1,408.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,196.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,196.91
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$610.19
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$704.06
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VENOGRAM UPPER EXTREMITY SVC

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	74110054
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

VENOGRAM UPPER EXTREMITY SVC

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	5100566
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

VENOGRAM UPPER EXTREMITY SVC

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	5100566
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

VENOGRAM UPPER EXTREMITY SVC

Facility

$3,084.40

Service Code	HCPCS 75827
Hospital Charge Code	74110054
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

VENOGRAM UPPER EXTRY BILATERAL

Facility

$331.55

Service Code	HCPCS 3601150
Hospital Charge Code	5100567
Hospital Revenue Code	361
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

VENOGRAM UPPER EXTRY BILATERAL

Facility

$331.55

Service Code	HCPCS 3601150
Hospital Charge Code	5100567
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

VENOUS ******

Facility

$160.00

Hospital Charge Code	8002438
Hospital Revenue Code	279
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

VENOUS ******

Facility

$160.00

Hospital Charge Code	8002438
Hospital Revenue Code	279
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

VENOUS ACCESS DEVICE MAINTEN**

Facility

$68.40

Service Code	HCPCS 96530
Hospital Charge Code	3400108
Hospital Revenue Code	331
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$20.52
Rate for Payer: Aetna Medicare Advantage	$20.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$34.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.26
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

VENOUS ACCESS DEVICE MAINTEN**

Facility

$68.40

Service Code	HCPCS 96530
Hospital Charge Code	3400108
Hospital Revenue Code	331
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$10.26
Rate for Payer: Qualcare PPO/HMO/WC	$10.26

VENOUS BLOOD GAS SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	397360012
Hospital Revenue Code	301
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$188.34
Rate for Payer: Aetna Commercial	$84.47
Rate for Payer: Aetna Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.52
Rate for Payer: Cigna Commercial	$26.07
Rate for Payer: Cigna Medicare Advantage	$13.04
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.34
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.63
Rate for Payer: Wellcare Medicare Advantage	$26.07

VENOUS BLOOD GAS SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	397360012
Hospital Revenue Code	301
Min. Negotiated Rate	$188.34
Max. Negotiated Rate	$188.34
Rate for Payer: Qualcare PPO/HMO/WC	$188.34

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	7411798
Hospital Revenue Code	361
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	2680385
Hospital Revenue Code	361
Min. Negotiated Rate	$105.69
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$243.90
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
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	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.69
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	7411798
Hospital Revenue Code	361
Min. Negotiated Rate	$105.69
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$243.90
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
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	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.69
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	2680385
Hospital Revenue Code	361
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74117044
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2692185
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2692185
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74115044
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74115044
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	94053275
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	94053275
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

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74116044
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

Know your out-of-pocket cost for care.

All Charges