Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH MCV URETER OPEN TIP***

Facility

$50.00

Hospital Charge Code	1604594
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

CATH MCV URETER OPEN TIP***

Facility

$50.00

Hospital Charge Code	1604594
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CATH MCV URET STAMEY 400-162

Facility

$91.25

Hospital Charge Code	270601095
Hospital Revenue Code	272
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

CATH MCV URET STAMEY 400-162

Facility

$91.25

Hospital Charge Code	270601095
Hospital Revenue Code	272
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$45.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$45.62

CATH MEDT 8703W

Facility

$3,642.45

Hospital Charge Code	270612539
Hospital Revenue Code	272
Min. Negotiated Rate	$546.37
Max. Negotiated Rate	$546.37
Rate for Payer: Qualcare PPO/HMO/WC	$546.37

CATH MEDT 8703W

Facility

$3,642.45

Hospital Charge Code	270612539
Hospital Revenue Code	272
Min. Negotiated Rate	$473.52
Max. Negotiated Rate	$1,821.22
Rate for Payer: Aetna Commercial	$1,092.73
Rate for Payer: Aetna Medicare Advantage	$1,092.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$928.82
Rate for Payer: Cigna Commercial	$1,821.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.52
Rate for Payer: Oxford Commercial	$1,821.22
Rate for Payer: Qualcare PPO/HMO/WC	$546.37
Rate for Payer: UnitedHealthcare Commercial	$1,821.22

CATH MEDT PERIT CSF STD 22014

Facility

$668.00

Hospital Charge Code	270612723
Hospital Revenue Code	272
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

CATH MEDT PERIT CSF STD 22014

Facility

$668.00

Hospital Charge Code	270612723
Hospital Revenue Code	272
Min. Negotiated Rate	$86.84
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$200.40
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.84
Rate for Payer: Oxford Commercial	$334.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.20
Rate for Payer: UnitedHealthcare Commercial	$334.00

CATH MEDT VENTRICULAR 41101

Facility

$718.45

Hospital Charge Code	270603371
Hospital Revenue Code	272
Min. Negotiated Rate	$93.40
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$215.53
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.40
Rate for Payer: Oxford Commercial	$359.23
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$359.23

CATH MEDT VENTRICULAR 41101

Facility

$718.45

Hospital Charge Code	270603371
Hospital Revenue Code	272
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

CATH MEIWEISSEN 65x15c 46-413

Facility

$385.60

Hospital Charge Code	270628918V
Hospital Revenue Code	278
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$93.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.32
Rate for Payer: Qualcare PPO/HMO/WC	$57.84

CATH MEIWEISSEN 65x15c 46-413

Facility

$385.60

Hospital Charge Code	270628918V
Hospital Revenue Code	278
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$192.80
Rate for Payer: Aetna Commercial	$115.68
Rate for Payer: Aetna Medicare Advantage	$115.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.33
Rate for Payer: Cigna Commercial	$192.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.32
Rate for Payer: Qualcare PPO/HMO/WC	$57.84

CATH MEIWEISSEN 65x15c 46-413

Facility

$382.60

Hospital Charge Code	270628918
Hospital Revenue Code	278
Min. Negotiated Rate	$57.39
Max. Negotiated Rate	$92.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.59
Rate for Payer: Qualcare PPO/HMO/WC	$57.39

CATH MEIWEISSEN 65x15c 46-413

Facility

$382.60

Hospital Charge Code	270628918
Hospital Revenue Code	278
Min. Negotiated Rate	$57.39
Max. Negotiated Rate	$191.30
Rate for Payer: Aetna Commercial	$114.78
Rate for Payer: Aetna Medicare Advantage	$114.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.56
Rate for Payer: Cigna Commercial	$191.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.59
Rate for Payer: Qualcare PPO/HMO/WC	$57.39

CATH MEWEN 5F .035 100CM 46411

Facility

$365.00

Service Code	HCPCS C1887
Hospital Charge Code	27062688
Hospital Revenue Code	272
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$109.50
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.45
Rate for Payer: Oxford Commercial	$182.50
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$182.50

CATH MEWEN 5F .035 100CM 46411

Facility

$365.00

Service Code	HCPCS C1887
Hospital Charge Code	27062688
Hospital Revenue Code	272
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088V
Hospital Revenue Code	278
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088V
Hospital Revenue Code	278
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$122.66
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.94
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088
Hospital Revenue Code	272
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

CATH MEWEN 5F 035 100CM 46411

Facility

$408.85

Hospital Charge Code	270626088
Hospital Revenue Code	272
Min. Negotiated Rate	$53.15
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$122.66
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.15
Rate for Payer: Oxford Commercial	$204.43
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$204.43

CATH MICRO EXCELSIOR XT-17

Facility

$4,836.15

Service Code	HCPCS C1887
Hospital Charge Code	270695290S
Hospital Revenue Code	278
Min. Negotiated Rate	$725.42
Max. Negotiated Rate	$2,418.07
Rate for Payer: Aetna Commercial	$1,450.85
Rate for Payer: Aetna Medicare Advantage	$1,450.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,233.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,233.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$967.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,233.22
Rate for Payer: Cigna Commercial	$2,418.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.35
Rate for Payer: Qualcare PPO/HMO/WC	$725.42

CATH MICRO EXCELSIOR XT-17

Facility

$4,836.15

Service Code	HCPCS C1887
Hospital Charge Code	270695290S
Hospital Revenue Code	278
Min. Negotiated Rate	$725.42
Max. Negotiated Rate	$1,170.35
Rate for Payer: Qualcare PPO/HMO/WC	$725.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$967.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.35

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	270689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$708.94
Max. Negotiated Rate	$1,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: Qualcare PPO/HMO/WC	$708.94

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	270689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$708.94
Max. Negotiated Rate	$2,363.12
Rate for Payer: Aetna Commercial	$1,417.88
Rate for Payer: Aetna Medicare Advantage	$1,417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.19
Rate for Payer: Cigna Commercial	$2,363.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: Qualcare PPO/HMO/WC	$708.94

CATH MICRO EXCEL SL 10STR 2TIP

Facility

$4,726.25

Service Code	HCPCS C1769
Hospital Charge Code	278689725S
Hospital Revenue Code	278
Min. Negotiated Rate	$708.94
Max. Negotiated Rate	$2,363.12
Rate for Payer: Aetna Commercial	$1,417.88
Rate for Payer: Aetna Medicare Advantage	$1,417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.19
Rate for Payer: Cigna Commercial	$2,363.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.75
Rate for Payer: Qualcare PPO/HMO/WC	$708.94

Know your out-of-pocket cost for care.

All Charges