Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PROTECT IV 18G

Facility

$24.85

Hospital Charge Code	270600738
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

CATH PROTECT IV 18G

Facility

$24.85

Hospital Charge Code	270600738
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROTECT IV 20G

Facility

$24.85

Hospital Charge Code	270605145
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

CATH PROTECT IV 20G

Facility

$24.85

Hospital Charge Code	270605145
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROTECT IV 22G

Facility

$24.85

Hospital Charge Code	270600761
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

CATH PROTECT IV 22G

Facility

$24.85

Hospital Charge Code	270600761
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROTECT IV 24G

Facility

$24.85

Hospital Charge Code	270600762
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

CATH PROTECT IV 24G

Facility

$24.85

Hospital Charge Code	270600762
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$1,676.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$1,676.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$837.86
Max. Negotiated Rate	$1,351.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: Qualcare PPO/HMO/WC	$837.86

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$837.86
Max. Negotiated Rate	$2,792.88
Rate for Payer: Aetna Commercial	$1,675.72
Rate for Payer: Aetna Medicare Advantage	$1,675.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.37
Rate for Payer: Cigna Commercial	$2,792.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: Qualcare PPO/HMO/WC	$837.86

Know your out-of-pocket cost for care.

All Charges