Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR ELBOW COMPLETE BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	2011334
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ELBOW LT 2 VIEWS

Facility

$259.25

Service Code	HCPCS 73070LT
Hospital Charge Code	2002418
Hospital Revenue Code	320
Min. Negotiated Rate	$33.70
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$77.78
Rate for Payer: Aetna Medicare Advantage	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.11
Rate for Payer: Cigna Commercial	$129.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ELBOW LT 2 VIEWS

Facility

$259.25

Service Code	HCPCS 73070LT
Hospital Charge Code	2002418
Hospital Revenue Code	320
Min. Negotiated Rate	$38.89
Max. Negotiated Rate	$38.89
Rate for Payer: Qualcare PPO/HMO/WC	$38.89

XR ELBOW MIN 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	2000040
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ELBOW MIN 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	2000040
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ELBOW MIN 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	2000041
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ELBOW MIN 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	2000041
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ELBOW RT 2 VIEWS

Facility

$259.25

Service Code	HCPCS 73070RT
Hospital Charge Code	2002419
Hospital Revenue Code	320
Min. Negotiated Rate	$38.89
Max. Negotiated Rate	$38.89
Rate for Payer: Qualcare PPO/HMO/WC	$38.89

XR ELBOW RT 2 VIEWS

Facility

$259.25

Service Code	HCPCS 73070RT
Hospital Charge Code	2002419
Hospital Revenue Code	320
Min. Negotiated Rate	$33.70
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$77.78
Rate for Payer: Aetna Medicare Advantage	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.11
Rate for Payer: Cigna Commercial	$129.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ENDOVAS REPR AAA INFRARENAL

Facility

$1,600.00

Service Code	HCPCS 34800
Hospital Charge Code	7411392
Hospital Revenue Code	361
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

XR ENDOVAS REPR AAA INFRARENAL

Facility

$1,600.00

Service Code	HCPCS 34800
Hospital Charge Code	2600154
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

XR ENDOVAS REPR AAA INFRARENAL

Facility

$1,600.00

Service Code	HCPCS 34800
Hospital Charge Code	7411392
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

XR ENDOVAS REPR AAA INFRARENAL

Facility

$1,600.00

Service Code	HCPCS 34800
Hospital Charge Code	2600154
Hospital Revenue Code	361
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
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	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

XR ENDOVENOUS LASER 1ST VEIN

Facility

$12,426.40

Service Code	HCPCS 36478
Hospital Charge Code	7411443
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR ENDOVENOUS LASER 1ST VEIN

Facility

$12,426.40

Service Code	HCPCS 36478
Hospital Charge Code	7411443
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR ENDOVENOUS LASER 1ST VEIN

Facility

$12,426.40

Service Code	HCPCS 36478
Hospital Charge Code	5600121
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR ENDOVENOUS LASER 1ST VEIN

Facility

$12,426.40

Service Code	HCPCS 36478
Hospital Charge Code	5600121
Hospital Revenue Code	361
Min. Negotiated Rate	$1,615.43
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR ENDOVENOUS LASER VEIN ADDON

Facility

$12,426.40

Service Code	HCPCS 36479
Hospital Charge Code	7411444
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR ENDOVENOUS LASER VEIN ADDON

Facility

$12,426.40

Service Code	HCPCS 36479
Hospital Charge Code	5600122
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR ENDOVENOUS LASER VEIN ADDON

Facility

$12,426.40

Service Code	HCPCS 36479
Hospital Charge Code	5600122
Hospital Revenue Code	361
Min. Negotiated Rate	$128.30
Max. Negotiated Rate	$3,727.92
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$128.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR ENDOVENOUS LASER VEIN ADDON

Facility

$12,426.40

Service Code	HCPCS 36479
Hospital Charge Code	7411444
Hospital Revenue Code	361
Min. Negotiated Rate	$128.30
Max. Negotiated Rate	$3,727.92
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$128.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

XR ENDOVENOUS RF 1ST VEIN

Facility

$19,888.55

Service Code	HCPCS 36475
Hospital Charge Code	7411441
Hospital Revenue Code	361
Min. Negotiated Rate	$2,983.28
Max. Negotiated Rate	$2,983.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.28

XR ENDOVENOUS RF 1ST VEIN

Facility

$19,888.55

Service Code	HCPCS 36475
Hospital Charge Code	7411441
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$5,966.56
Rate for Payer: Aetna Medicare Advantage	$5,966.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,071.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,071.58
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	$5,071.58
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,585.51
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

XR ENDOVENOUS RF VEIN ADD ON

Facility

$12,426.40

Service Code	HCPCS 36476
Hospital Charge Code	7411442
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR ENDOVENOUS RF VEIN ADD ON

Facility

$12,426.40

Service Code	HCPCS 36476
Hospital Charge Code	7411442
Hospital Revenue Code	361
Min. Negotiated Rate	$126.27
Max. Negotiated Rate	$3,727.92
Rate for Payer: Aetna Commercial	$3,727.92
Rate for Payer: Aetna Medicare Advantage	$3,727.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.73
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	$3,168.73
Rate for Payer: Cigna Commercial	$126.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,615.43
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges