Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR TRANSCATH IV STENT OPEN

Facility

$41,896.20

Hospital Charge Code	5600146
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$12,568.86
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
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	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,446.51
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

XR TRANSCATH IV STENT/OPEN ADD

Facility

$41,896.20

Hospital Charge Code	5600147
Hospital Revenue Code	361
Min. Negotiated Rate	$6,284.43
Max. Negotiated Rate	$6,284.43
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

XR TRANSCATH IV STENT/OPEN ADD

Facility

$41,896.20

Hospital Charge Code	5600147
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$20,948.10
Rate for Payer: Aetna Commercial	$12,568.86
Rate for Payer: Aetna Medicare Advantage	$12,568.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,683.53
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	$10,683.53
Rate for Payer: Cigna Commercial	$20,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,446.51
Rate for Payer: Qualcare PPO/HMO/WC	$6,284.43

XR TRANSCATH OCCLUSION NON CNS

Facility

$40,990.35

Service Code	HCPCS 61626
Hospital Charge Code	7411643
Hospital Revenue Code	361
Min. Negotiated Rate	$6,148.55
Max. Negotiated Rate	$6,148.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR TRANSCATH OCCLUSION NON CNS

Facility

$40,990.35

Service Code	HCPCS 61626
Hospital Charge Code	5600178
Hospital Revenue Code	361
Min. Negotiated Rate	$6,148.55
Max. Negotiated Rate	$6,148.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR TRANSCATH OCCLUSION NON CNS

Facility

$40,990.35

Service Code	HCPCS 61626
Hospital Charge Code	7411643
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$12,297.10
Rate for Payer: Aetna Medicare Advantage	$12,297.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,452.54
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	$10,452.54
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.75
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

XR TRANSCATH OCCLUSION NON CNS

Facility

$40,990.35

Service Code	HCPCS 61626
Hospital Charge Code	5600178
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$12,297.10
Rate for Payer: Aetna Medicare Advantage	$12,297.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,452.54
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	$10,452.54
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.75
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

XR TRANSCATH RET OF FOR BODY

Facility

$3,214.45

Hospital Charge Code	5100585
Hospital Revenue Code	361
Min. Negotiated Rate	$482.17
Max. Negotiated Rate	$482.17
Rate for Payer: Qualcare PPO/HMO/WC	$482.17

XR TRANSCATH RET OF FOR BODY

Facility

$3,214.45

Hospital Charge Code	5100585
Hospital Revenue Code	361
Min. Negotiated Rate	$417.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$964.34
Rate for Payer: Aetna Medicare Advantage	$964.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.68
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	$819.68
Rate for Payer: Cigna Commercial	$1,607.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.88
Rate for Payer: Qualcare PPO/HMO/WC	$482.17

XR TRANSCATH RET PERC INT F B

Facility

$2,238.00

Service Code	HCPCS 75961
Hospital Charge Code	5100357
Hospital Revenue Code	323
Min. Negotiated Rate	$290.94
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$671.40
Rate for Payer: Aetna Medicare Advantage	$671.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.69
Rate for Payer: Cigna Commercial	$1,119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.94
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.70
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR TRANSCATH RET PERC INT F B

Facility

$2,238.00

Service Code	HCPCS 75961
Hospital Charge Code	5100357
Hospital Revenue Code	323
Min. Negotiated Rate	$335.70
Max. Negotiated Rate	$335.70
Rate for Payer: Qualcare PPO/HMO/WC	$335.70

XR TRANSLUM BAL ANG OPN VENOUS

Facility

$12,642.00

Service Code	HCPCS 35460ZX
Hospital Charge Code	2001354
Hospital Revenue Code	361
Min. Negotiated Rate	$1,643.46
Max. Negotiated Rate	$6,321.00
Rate for Payer: Aetna Commercial	$3,792.60
Rate for Payer: Aetna Medicare Advantage	$3,792.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,223.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,223.71
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	$3,223.71
Rate for Payer: Cigna Commercial	$6,321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,643.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,896.30

XR TRANSLUM BAL ANG OPN VENOUS

Facility

$12,642.00

Service Code	HCPCS 35460ZX
Hospital Charge Code	2001354
Hospital Revenue Code	361
Min. Negotiated Rate	$1,896.30
Max. Negotiated Rate	$1,896.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,896.30

XR T-TUBE CHOLANGIOGRAM

Facility

$775.25

Hospital Charge Code	2000313
Hospital Revenue Code	320
Min. Negotiated Rate	$100.78
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$232.57
Rate for Payer: Aetna Medicare Advantage	$232.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.69
Rate for Payer: Cigna Commercial	$387.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.29
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR T-TUBE CHOLANGIOGRAM

Facility

$775.25

Hospital Charge Code	2000313
Hospital Revenue Code	320
Min. Negotiated Rate	$116.29
Max. Negotiated Rate	$116.29
Rate for Payer: Qualcare PPO/HMO/WC	$116.29

XR UE LT INFANT MIN 2VW

Facility

$5,100.00

Service Code	HCPCS 73092LT
Hospital Charge Code	2002194
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR UE LT INFANT MIN 2VW

Facility

$5,100.00

Service Code	HCPCS 73092LT
Hospital Charge Code	2002194
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR UE RT INFANT MIN 2VW

Facility

$5,100.00

Service Code	HCPCS 73092RT
Hospital Charge Code	2002195
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR UE RT INFANT MIN 2VW

Facility

$5,100.00

Service Code	HCPCS 73092RT
Hospital Charge Code	2002195
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR UGI AIR CONT W BARIUM W SB

Facility

$1,544.00

Service Code	HCPCS 74249
Hospital Charge Code	2011125
Hospital Revenue Code	320
Min. Negotiated Rate	$231.60
Max. Negotiated Rate	$231.60
Rate for Payer: Qualcare PPO/HMO/WC	$231.60

XR UGI AIR CONT W BARIUM W SB

Facility

$1,544.00

Service Code	HCPCS 74249
Hospital Charge Code	2011125
Hospital Revenue Code	320
Min. Negotiated Rate	$200.72
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$463.20
Rate for Payer: Aetna Medicare Advantage	$463.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.72
Rate for Payer: Cigna Commercial	$772.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.72
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.60
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR UNLISTED PROCEDURE

Facility

$258.70

Service Code	HCPCS 76499
Hospital Charge Code	2011408
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$77.61
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR UNLISTED PROCEDURE

Facility

$258.70

Service Code	HCPCS 76499
Hospital Charge Code	2011408
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR UPPER GI

Facility

$521.00

Service Code	HCPCS 74240
Hospital Charge Code	2011410
Hospital Revenue Code	320
Min. Negotiated Rate	$67.73
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$156.30
Rate for Payer: Aetna Medicare Advantage	$156.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.85
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.73
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.15
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

XR UPPER GI

Facility

$521.00

Service Code	HCPCS 74240
Hospital Charge Code	2011410
Hospital Revenue Code	320
Min. Negotiated Rate	$78.15
Max. Negotiated Rate	$78.15
Rate for Payer: Qualcare PPO/HMO/WC	$78.15

Know your out-of-pocket cost for care.

All Charges