Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH SHOCKWAVE S4 IVL 3.5X40MM

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270698155S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$69.56
Max. Negotiated Rate	$69.56
Rate for Payer: Qualcare PPO/HMO/WC	$69.56

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$231.88
Rate for Payer: Aetna Commercial	$139.12
Rate for Payer: Aetna Medicare Advantage	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.26
Rate for Payer: Cigna Commercial	$231.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.29
Rate for Payer: Oxford Commercial	$231.88
Rate for Payer: Qualcare PPO/HMO/WC	$69.56
Rate for Payer: UnitedHealthcare Commercial	$231.88

CATH SILICATH

Facility

$25.00

Hospital Charge Code	8000341
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

CATH SILICATH

Facility

$25.00

Hospital Charge Code	8000341
Hospital Revenue Code	279
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$94.61
Max. Negotiated Rate	$152.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$94.61
Max. Negotiated Rate	$315.35
Rate for Payer: Aetna Commercial	$189.21
Rate for Payer: Aetna Medicare Advantage	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.83
Rate for Payer: Cigna Commercial	$315.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61

CATH SILVERHAWK 135x2.2 P4024

Facility

$14,975.00

Hospital Charge Code	270634057
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$4,492.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 135x2.2 P4024

Facility

$14,975.00

Hospital Charge Code	270634057
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 1.85 135 P4028

Facility

$14,975.00

Hospital Charge Code	270637763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$4,492.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 1.85 135 P4028

Facility

$14,975.00

Hospital Charge Code	270637763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK 3 5 110C P4016

Facility

$17,335.25

Hospital Charge Code	270635437
Hospital Revenue Code	278
Min. Negotiated Rate	$2,600.29
Max. Negotiated Rate	$8,667.62
Rate for Payer: Aetna Commercial	$5,200.57
Rate for Payer: Aetna Medicare Advantage	$5,200.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,420.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,420.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,467.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,420.49
Rate for Payer: Cigna Commercial	$8,667.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,195.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,600.29

CATH SILVERHAWK 3 5 110C P4016

Facility

$17,335.25

Hospital Charge Code	270635437
Hospital Revenue Code	278
Min. Negotiated Rate	$2,600.29
Max. Negotiated Rate	$4,195.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,467.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,195.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,600.29

CATH SILVERHAWK 6 0 110 P4056

Facility

$15,750.00

Hospital Charge Code	270643309C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$3,811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

CATH SILVERHAWK 6 0 110 P4056

Facility

$15,750.00

Hospital Charge Code	270643309C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$7,875.00
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: Aetna Commercial	$4,725.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$4,492.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATHSILVERHAWKLSMLGVESTIPW/ME

Facility

$15,625.00

Hospital Charge Code	2709004022
Hospital Revenue Code	272
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$2,343.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

CATHSILVERHAWKLSMLGVESTIPW/ME

Facility

$15,625.00

Hospital Charge Code	2709004022
Hospital Revenue Code	272
Min. Negotiated Rate	$2,031.25
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$4,687.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,031.25
Rate for Payer: Oxford Commercial	$7,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Commercial	$7,812.50

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,298.75
Max. Negotiated Rate	$7,662.50
Rate for Payer: Aetna Commercial	$4,597.50
Rate for Payer: Aetna Medicare Advantage	$4,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,907.88
Rate for Payer: Cigna Commercial	$7,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,298.75
Max. Negotiated Rate	$3,708.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75

CATHSILVERHAWKMSMMEDVESTIPSTDW

Facility

$15,625.00

Hospital Charge Code	2709004024
Hospital Revenue Code	272
Min. Negotiated Rate	$2,031.25
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$4,687.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,031.25
Rate for Payer: Oxford Commercial	$7,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Commercial	$7,812.50

CATHSILVERHAWKMSMMEDVESTIPSTDW

Facility

$15,625.00

Hospital Charge Code	2709004024
Hospital Revenue Code	272
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$2,343.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

CATH SILVERHAWK SS+ P4030

Facility

$15,725.00

Hospital Charge Code	270643355C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,358.75
Max. Negotiated Rate	$7,862.50
Rate for Payer: Aetna Commercial	$4,717.50
Rate for Payer: Aetna Medicare Advantage	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,009.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,009.88
Rate for Payer: Cigna Commercial	$7,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,805.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.75

CATH SILVERHAWK SS+ P4030

Facility

$14,750.00

Service Code	HCPCS C1714
Hospital Charge Code	270643355
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$4,425.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

Know your out-of-pocket cost for care.

All Charges