Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH MT BALLN DIL 5.8F 12-722

Facility

$1,368.00

Hospital Charge Code	270623798
Hospital Revenue Code	272
Min. Negotiated Rate	$205.20
Max. Negotiated Rate	$205.20
Rate for Payer: Qualcare PPO/HMO/WC	$205.20

CATH MT BALLN DIL XXLG 14-510

Facility

$1,623.25

Hospital Charge Code	270623292V
Hospital Revenue Code	278
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$486.98
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

CATH MT BALLN DIL XXLG 14-510

Facility

$1,623.25

Hospital Charge Code	270623292V
Hospital Revenue Code	278
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

CATH MT BALLN DIL XXLG 14-552

Facility

$1,652.00

Hospital Charge Code	270624070V
Hospital Revenue Code	278
Min. Negotiated Rate	$247.80
Max. Negotiated Rate	$399.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.78
Rate for Payer: Qualcare PPO/HMO/WC	$247.80

CATH MT BALLN DIL XXLG 14-552

Facility

$1,652.00

Hospital Charge Code	270624070V
Hospital Revenue Code	278
Min. Negotiated Rate	$247.80
Max. Negotiated Rate	$826.00
Rate for Payer: Aetna Commercial	$495.60
Rate for Payer: Aetna Medicare Advantage	$495.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$421.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$421.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$421.26
Rate for Payer: Cigna Commercial	$826.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.78
Rate for Payer: Qualcare PPO/HMO/WC	$247.80

CATH MT BALLN MARSHAL 17-881

Facility

$1,064.00

Hospital Charge Code	270624313
Hospital Revenue Code	272
Min. Negotiated Rate	$138.32
Max. Negotiated Rate	$532.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$319.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.32
Rate for Payer: Cigna Commercial	$532.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.32
Rate for Payer: Oxford Commercial	$532.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.60
Rate for Payer: UnitedHealthcare Commercial	$532.00

CATH MT BALLN MARSHAL 17-881

Facility

$1,064.00

Hospital Charge Code	270624313
Hospital Revenue Code	272
Min. Negotiated Rate	$159.60
Max. Negotiated Rate	$159.60
Rate for Payer: Qualcare PPO/HMO/WC	$159.60

CATH MT BALLN USQ/5-4 225121

Facility

$1,287.25

Service Code	HCPCS C1725
Hospital Charge Code	270624347
Hospital Revenue Code	278
Min. Negotiated Rate	$193.09
Max. Negotiated Rate	$311.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.51
Rate for Payer: Qualcare PPO/HMO/WC	$193.09

CATH MT BALLN USQ/5-4 225121

Facility

$1,287.25

Service Code	HCPCS C1725
Hospital Charge Code	270624347
Hospital Revenue Code	278
Min. Negotiated Rate	$193.09
Max. Negotiated Rate	$643.62
Rate for Payer: Aetna Commercial	$386.18
Rate for Payer: Aetna Medicare Advantage	$386.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.25
Rate for Payer: Cigna Commercial	$643.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.51
Rate for Payer: Qualcare PPO/HMO/WC	$193.09

CATH MT BALLN XXL 6 18 14-559

Facility

$1,544.85

Hospital Charge Code	270626888
Hospital Revenue Code	278
Min. Negotiated Rate	$231.73
Max. Negotiated Rate	$772.42
Rate for Payer: Aetna Commercial	$463.45
Rate for Payer: Aetna Medicare Advantage	$463.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.94
Rate for Payer: Cigna Commercial	$772.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.85
Rate for Payer: Qualcare PPO/HMO/WC	$231.73

CATH MT BALLN XXL 6 18 14-559

Facility

$1,544.85

Hospital Charge Code	270626888
Hospital Revenue Code	278
Min. Negotiated Rate	$231.73
Max. Negotiated Rate	$373.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.85
Rate for Payer: Qualcare PPO/HMO/WC	$231.73

CATH MT BALN UT DILA ********

Facility

$1,096.00

Hospital Charge Code	1604552
Hospital Revenue Code	272
Min. Negotiated Rate	$164.40
Max. Negotiated Rate	$164.40
Rate for Payer: Qualcare PPO/HMO/WC	$164.40

CATH MT BALN UT DILA ********

Facility

$1,096.00

Hospital Charge Code	1604552
Hospital Revenue Code	272
Min. Negotiated Rate	$142.48
Max. Negotiated Rate	$548.00
Rate for Payer: Aetna Commercial	$328.80
Rate for Payer: Aetna Medicare Advantage	$328.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.48
Rate for Payer: Cigna Commercial	$548.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.48
Rate for Payer: Oxford Commercial	$548.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.40
Rate for Payer: UnitedHealthcare Commercial	$548.00

CATH MT BLMX 6/4/5.8 12-531

Facility

$2,119.25

Hospital Charge Code	270601088
Hospital Revenue Code	272
Min. Negotiated Rate	$275.50
Max. Negotiated Rate	$1,059.62
Rate for Payer: Aetna Commercial	$635.77
Rate for Payer: Aetna Medicare Advantage	$635.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.41
Rate for Payer: Cigna Commercial	$1,059.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.50
Rate for Payer: Oxford Commercial	$1,059.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.89
Rate for Payer: UnitedHealthcare Commercial	$1,059.62

CATH MT BLMX 6/4/5.8 12-531

Facility

$2,119.25

Hospital Charge Code	270601088
Hospital Revenue Code	272
Min. Negotiated Rate	$317.89
Max. Negotiated Rate	$317.89
Rate for Payer: Qualcare PPO/HMO/WC	$317.89

CATH MT BLMX 8/4/5.8 12-239

Facility

$2,404.00

Hospital Charge Code	270601083
Hospital Revenue Code	272
Min. Negotiated Rate	$360.60
Max. Negotiated Rate	$360.60
Rate for Payer: Qualcare PPO/HMO/WC	$360.60

CATH MT BLMX 8/4/5.8 12-239

Facility

$2,404.00

Hospital Charge Code	270601083
Hospital Revenue Code	272
Min. Negotiated Rate	$312.52
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$721.20
Rate for Payer: Aetna Medicare Advantage	$721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.02
Rate for Payer: Cigna Commercial	$1,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.52
Rate for Payer: Oxford Commercial	$1,202.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.60
Rate for Payer: UnitedHealthcare Commercial	$1,202.00

CATH MT BLMX BALN HI PRESS****

Facility

$947.00

Hospital Charge Code	1604537
Hospital Revenue Code	272
Min. Negotiated Rate	$142.05
Max. Negotiated Rate	$142.05
Rate for Payer: Qualcare PPO/HMO/WC	$142.05

CATH MT BLMX BALN HI PRESS****

Facility

$947.00

Hospital Charge Code	1604537
Hospital Revenue Code	272
Min. Negotiated Rate	$123.11
Max. Negotiated Rate	$473.50
Rate for Payer: Aetna Commercial	$284.10
Rate for Payer: Aetna Medicare Advantage	$284.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.49
Rate for Payer: Cigna Commercial	$473.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.11
Rate for Payer: Oxford Commercial	$473.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.05
Rate for Payer: UnitedHealthcare Commercial	$473.50

CATH MT EXPRESS 8 37 38046

Facility

$6,975.00

Hospital Charge Code	270628305V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

CATH MT EXPRESS 8 37 38046

Facility

$6,975.00

Hospital Charge Code	270628305V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

CATH MT FLUSH 5F 31528

Facility

$471.25

Hospital Charge Code	270629704
Hospital Revenue Code	272
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$70.69
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

CATH MT FLUSH 5F 31528

Facility

$471.25

Hospital Charge Code	270629704
Hospital Revenue Code	272
Min. Negotiated Rate	$61.26
Max. Negotiated Rate	$235.62
Rate for Payer: Aetna Commercial	$141.38
Rate for Payer: Aetna Medicare Advantage	$141.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.17
Rate for Payer: Cigna Commercial	$235.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.26
Rate for Payer: Oxford Commercial	$235.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.69
Rate for Payer: UnitedHealthcare Commercial	$235.62

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$75.97
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270623514N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

Know your out-of-pocket cost for care.

All Charges