Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH OPTI RADIAL TIGER 4.0 6F

Facility

$1,400.00

Service Code	HCPCS C1894
Hospital Charge Code	270645657
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

CATH OPTI RADIAL TIGER 4.0 6F

Facility

$1,400.00

Service Code	HCPCS C1894
Hospital Charge Code	270645657
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

CATH OPTI RADIAL TIGER 4.0 6FR

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270645657C
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CATH OPTI RADIAL TIGER 4.0 6FR

Facility

$275.00

Service Code	HCPCS C1894
Hospital Charge Code	270645657C
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CATH OPTITORQUE 5FR TIGER

Facility

$55.00

Hospital Charge Code	270645260N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

CATH OPTITORQUE 5FR TIGER

Facility

$225.00

Hospital Charge Code	270645260S
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH OPTITORQUE 5FR TIGER

Facility

$225.00

Hospital Charge Code	270645260S
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

CATH OPTITORQUE 5FR TIGER

Facility

$55.00

Hospital Charge Code	270645260N
Hospital Revenue Code	272
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

CATH OPT JAC RAD 3.5 5F 405021

Facility

$225.00

Hospital Charge Code	270643742C
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

CATH OPT JAC RAD 3.5 5F 405021

Facility

$225.00

Hospital Charge Code	270643742C
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH OPT RAD TIG 4.0 6F 406011

Facility

$225.00

Service Code	HCPCS C1894
Hospital Charge Code	270643104C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH OPT RAD TIG 4.0 6F 406011

Facility

$225.00

Service Code	HCPCS C1894
Hospital Charge Code	270643104C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH OTW,XK/19CM SPILT KIT

Facility

$1,925.00

Hospital Charge Code	2709006964
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH OTW,XK/19CM SPILT KIT

Facility

$1,925.00

Hospital Charge Code	2709006964
Hospital Revenue Code	272
Min. Negotiated Rate	$250.25
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$577.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.25
Rate for Payer: Oxford Commercial	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$962.50

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,925.00

Hospital Charge Code	270661422N
Hospital Revenue Code	272
Min. Negotiated Rate	$250.25
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$577.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.25
Rate for Payer: Oxford Commercial	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$962.50

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,825.00

Hospital Charge Code	270661422
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,825.00

Hospital Charge Code	270661422S
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,825.00

Hospital Charge Code	270661422
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,825.00

Hospital Charge Code	270661422S
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH OTW XK 19 ST SPLT 5913190

Facility

$1,925.00

Hospital Charge Code	270661422N
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH OTW,XK,23CM SPLIT KIT

Facility

$1,925.00

Hospital Charge Code	2709006965
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH OTW,XK,23CM SPLIT KIT

Facility

$1,925.00

Hospital Charge Code	2709006965
Hospital Revenue Code	272
Min. Negotiated Rate	$250.25
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$577.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.25
Rate for Payer: Oxford Commercial	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$962.50

CATH OTW,XK/27CM SPLIT KIT

Facility

$1,925.00

Hospital Charge Code	2709006966
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

CATH OTW,XK/27CM SPLIT KIT

Facility

$1,925.00

Hospital Charge Code	2709006966
Hospital Revenue Code	272
Min. Negotiated Rate	$250.25
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$577.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.25
Rate for Payer: Oxford Commercial	$962.50
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$962.50

CATH OTW,XK/31CM SPLIT KIT

Facility

$1,925.00

Hospital Charge Code	2709006967
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

Know your out-of-pocket cost for care.

All Charges