Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH PERIL DIAL KIT 15F MPD242

Facility

$2,450.00

Hospital Charge Code	270644735
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

CATH PERIL DIAL KIT 15F MPD242

Facility

$2,450.00

Hospital Charge Code	270644735
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

CATH PERITONEAL 42CM ST PD422S

Facility

$486.15

Hospital Charge Code	270626550
Hospital Revenue Code	278
Min. Negotiated Rate	$72.92
Max. Negotiated Rate	$117.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: Qualcare PPO/HMO/WC	$72.92

CATH PERITONEAL 42CM ST PD422S

Facility

$486.15

Hospital Charge Code	270626550
Hospital Revenue Code	278
Min. Negotiated Rate	$72.92
Max. Negotiated Rate	$243.07
Rate for Payer: Aetna Commercial	$145.84
Rate for Payer: Aetna Medicare Advantage	$145.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.97
Rate for Payer: Cigna Commercial	$243.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: Qualcare PPO/HMO/WC	$72.92

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$88.42
Max. Negotiated Rate	$294.75
Rate for Payer: Aetna Commercial	$176.85
Rate for Payer: Aetna Medicare Advantage	$176.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.32
Rate for Payer: Cigna Commercial	$294.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: Qualcare PPO/HMO/WC	$88.42

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$88.42
Max. Negotiated Rate	$142.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: Qualcare PPO/HMO/WC	$88.42

CATH PFLX BLN 12x4x80 4202040S

Facility

$1,314.45

Hospital Charge Code	270632653
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

CATH PFLX BLN 12x4x80 4202040S

Facility

$1,314.45

Hospital Charge Code	270632653
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$394.33
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

CATH PFX BLN 8x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624399
Hospital Revenue Code	272
Min. Negotiated Rate	$189.60
Max. Negotiated Rate	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$189.60

CATH PFX BLN 8x3 135c 4208030X

Facility

$1,264.00

Hospital Charge Code	270624399
Hospital Revenue Code	272
Min. Negotiated Rate	$164.32
Max. Negotiated Rate	$632.00
Rate for Payer: Aetna Commercial	$379.20
Rate for Payer: Aetna Medicare Advantage	$379.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.32
Rate for Payer: Cigna Commercial	$632.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.32
Rate for Payer: Oxford Commercial	$632.00
Rate for Payer: Qualcare PPO/HMO/WC	$189.60
Rate for Payer: UnitedHealthcare Commercial	$632.00

CATH PH-24 HOUR***

Facility

$319.20

Hospital Charge Code	2300838
Hospital Revenue Code	279
Min. Negotiated Rate	$41.50
Max. Negotiated Rate	$159.60
Rate for Payer: Aetna Commercial	$95.76
Rate for Payer: Aetna Medicare Advantage	$95.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.40
Rate for Payer: Cigna Commercial	$159.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Oxford Commercial	$159.60
Rate for Payer: Qualcare PPO/HMO/WC	$47.88
Rate for Payer: UnitedHealthcare Commercial	$159.60

CATH PH-24 HOUR***

Facility

$319.20

Hospital Charge Code	2300838
Hospital Revenue Code	279
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$47.88
Rate for Payer: Qualcare PPO/HMO/WC	$47.88

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$259.25
Rate for Payer: Aetna Commercial	$155.55
Rate for Payer: Aetna Medicare Advantage	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.22
Rate for Payer: Cigna Commercial	$259.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: Qualcare PPO/HMO/WC	$77.78

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$125.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: Qualcare PPO/HMO/WC	$77.78

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$141.60
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$141.60
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

CATH PICC LINE 5F DUAL 0720515

Facility

$9,875.00

Hospital Charge Code	270661311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

CATH PICC LINE 5F DUAL 0720515

Facility

$9,875.00

Hospital Charge Code	270661311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$2,962.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

CATH PIGT 5F 110C CRD 451593L5

Facility

$88.85

Hospital Charge Code	270624703
Hospital Revenue Code	272
Min. Negotiated Rate	$13.33
Max. Negotiated Rate	$13.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.33

CATH PIGT 5F 110C CRD 451593L5

Facility

$88.85

Hospital Charge Code	270624703
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$44.42
Rate for Payer: Aetna Commercial	$26.66
Rate for Payer: Aetna Medicare Advantage	$26.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.66
Rate for Payer: Cigna Commercial	$44.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.55
Rate for Payer: Oxford Commercial	$44.42
Rate for Payer: Qualcare PPO/HMO/WC	$13.33
Rate for Payer: UnitedHealthcare Commercial	$44.42

CATH PIGTAIL 145 5FR 110cm

Facility

$44.50

Hospital Charge Code	270644615C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$13.35
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.79
Rate for Payer: Oxford Commercial	$22.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$22.25

Know your out-of-pocket cost for care.

All Charges