Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH PROWLER SEL PL 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
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 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
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 PRUITT AORTIC OCCLUSION

Facility

$1,345.00

Hospital Charge Code	270606466
Hospital Revenue Code	278
Min. Negotiated Rate	$201.75
Max. Negotiated Rate	$325.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.49
Rate for Payer: Qualcare PPO/HMO/WC	$201.75

CATH PRUITT AORTIC OCCLUSION

Facility

$1,345.00

Hospital Charge Code	270606466
Hospital Revenue Code	278
Min. Negotiated Rate	$201.75
Max. Negotiated Rate	$672.50
Rate for Payer: Aetna Commercial	$403.50
Rate for Payer: Aetna Medicare Advantage	$403.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.98
Rate for Payer: Cigna Commercial	$672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.49
Rate for Payer: Qualcare PPO/HMO/WC	$201.75

CATH PTA AVATR 5x40 422-5040X

Facility

$2,281.65

Hospital Charge Code	270634581
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVATR 5x40 422-5040X

Facility

$2,281.65

Hospital Charge Code	270634581
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$684.50
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVIA 4x20x75 4224020S

Facility

$2,281.65

Hospital Charge Code	270633138
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVIA 4x20x75 4224020S

Facility

$2,281.65

Hospital Charge Code	270633138
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$684.50
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVIAT 5.0x20 4225020S

Facility

$2,300.00

Hospital Charge Code	270631233V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIAT 5.0x20 4225020S

Facility

$456.40

Hospital Charge Code	270631233
Hospital Revenue Code	278
Min. Negotiated Rate	$68.46
Max. Negotiated Rate	$228.20
Rate for Payer: Aetna Commercial	$136.92
Rate for Payer: Aetna Medicare Advantage	$136.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.38
Rate for Payer: Cigna Commercial	$228.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.45
Rate for Payer: Qualcare PPO/HMO/WC	$68.46

CATH PTA AVIAT 5.0x20 4225020S

Facility

$456.40

Hospital Charge Code	270631233
Hospital Revenue Code	278
Min. Negotiated Rate	$68.46
Max. Negotiated Rate	$110.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.45
Rate for Payer: Qualcare PPO/HMO/WC	$68.46

CATH PTA AVIAT 5.0x20 4225020S

Facility

$2,300.00

Hospital Charge Code	270631233V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 4X20 135CM

Facility

$2,300.00

Hospital Charge Code	270633271
Hospital Revenue Code	272
Min. Negotiated Rate	$299.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.00
Rate for Payer: Oxford Commercial	$1,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Commercial	$1,150.00

CATH PTA AVIATOR 4X20 135CM

Facility

$2,300.00

Hospital Charge Code	270633271
Hospital Revenue Code	272
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 5X20 142CM

Facility

$2,300.00

Hospital Charge Code	270631233C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 5X20 142CM

Facility

$2,300.00

Hospital Charge Code	270631233C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 6x40 135cm

Facility

$2,300.00

Hospital Charge Code	270634512
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATOR 6x40 135cm

Facility

$2,300.00

Hospital Charge Code	270634512
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATR 7x20 422-7020X

Facility

$2,281.65

Hospital Charge Code	270633272
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$552.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVIATR 7x20 422-7020X

Facility

$2,300.00

Hospital Charge Code	270633272V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVIATR 7x20 422-7020X

Facility

$2,300.00

Hospital Charge Code	270633272V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60

CATH PTA AVIATR 7x20 422-7020X

Facility

$2,281.65

Hospital Charge Code	270633272
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$684.50
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

CATH PTA AVR 4x40 135 4224040X

Facility

$2,300.00

Hospital Charge Code	270634853V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVR 4x40 135 4224040X

Facility

$2,300.00

Hospital Charge Code	270634853V
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH PTA AVR 4x40 135 4224040X

Facility

$2,281.65

Hospital Charge Code	270634853
Hospital Revenue Code	278
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$684.50
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.16
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

Know your out-of-pocket cost for care.

All Charges