Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

CATH PIGTAIL 5/90 10500104

Facility

$159.25

Hospital Charge Code	270607200
Hospital Revenue Code	270
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$79.62
Rate for Payer: Aetna Commercial	$47.77
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$79.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$79.62

CATH PIGTAIL 5/90 10500104

Facility

$159.25

Hospital Charge Code	270607200
Hospital Revenue Code	270
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

CATH PIGTAIL 5FR 110cm

Facility

$42.50

Hospital Charge Code	270644611C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$21.25
Rate for Payer: Aetna Commercial	$12.75
Rate for Payer: Aetna Medicare Advantage	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.84
Rate for Payer: Cigna Commercial	$21.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.53
Rate for Payer: Oxford Commercial	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.38
Rate for Payer: UnitedHealthcare Commercial	$21.25

CATH PIGTAIL 5FR 110cm

Facility

$42.50

Hospital Charge Code	270644611C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$6.38
Rate for Payer: Qualcare PPO/HMO/WC	$6.38

CATH PIGTAIL 5FR 145 110cm

Facility

$275.00

Hospital Charge Code	270644615
Hospital Revenue Code	279
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CATH PIGTAIL 5FR 145 110cm

Facility

$275.00

Hospital Charge Code	270644615
Hospital Revenue Code	279
Min. Negotiated Rate	$35.75
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) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$137.50

CATH PIGTAIL 6FR ANGLED

Facility

$37.35

Hospital Charge Code	270653800N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$18.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$18.95

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800
Hospital Revenue Code	272
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$18.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$18.95

CATH PIGTAIL 6FR ANGLED

Facility

$37.35

Hospital Charge Code	270653800N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$11.21
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.86
Rate for Payer: Oxford Commercial	$18.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$18.68

CATH PIGTAIL 6FR ANGLED

Facility

$37.90

Hospital Charge Code	270653800S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766S
Hospital Revenue Code	270
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$595.00

Hospital Charge Code	270653766N
Hospital Revenue Code	270
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$89.25
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766
Hospital Revenue Code	270
Min. Negotiated Rate	$90.35
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.35
Rate for Payer: Oxford Commercial	$347.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$347.50

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766C
Hospital Revenue Code	270
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766S
Hospital Revenue Code	270
Min. Negotiated Rate	$90.35
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.35
Rate for Payer: Oxford Commercial	$347.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$347.50

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766C
Hospital Revenue Code	270
Min. Negotiated Rate	$90.35
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.35
Rate for Payer: Oxford Commercial	$347.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$347.50

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$695.00

Hospital Charge Code	270653766
Hospital Revenue Code	270
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CATH PIGTAIL 6FR DUAL LUMEN

Facility

$595.00

Hospital Charge Code	270653766N
Hospital Revenue Code	270
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$178.50
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.35
Rate for Payer: Oxford Commercial	$297.50
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Commercial	$297.50

CATH PIGTAIL SOFT-VU 5FX90CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678515C
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH PIGTAIL SOFT-VU 5FX90CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678515C
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH PIG TEMPO 5F 65c 451503V5

Facility

$88.85

Hospital Charge Code	270624915
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 PIG TEMPO 5F 65c 451503V5

Facility

$88.85

Hospital Charge Code	270624915
Hospital Revenue Code	272
Min. Negotiated Rate	$13.33
Max. Negotiated Rate	$13.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.33

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