Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634772V
Hospital Revenue Code	278
Min. Negotiated Rate	$208.06
Max. Negotiated Rate	$693.55
Rate for Payer: Aetna Commercial	$416.13
Rate for Payer: Aetna Medicare Advantage	$416.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.71
Rate for Payer: Cigna Commercial	$693.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: Qualcare PPO/HMO/WC	$208.06

CATH SYNERGY 6-10 135cm 19378

Facility

$1,387.10

Hospital Charge Code	270634772V
Hospital Revenue Code	278
Min. Negotiated Rate	$208.06
Max. Negotiated Rate	$335.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.68
Rate for Payer: Qualcare PPO/HMO/WC	$208.06

CATH SYNERGY 6 4 75c 035 19361

Facility

$868.00

Hospital Charge Code	270625137
Hospital Revenue Code	272
Min. Negotiated Rate	$112.84
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$260.40
Rate for Payer: Aetna Medicare Advantage	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.34
Rate for Payer: Cigna Commercial	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.84
Rate for Payer: Oxford Commercial	$434.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.20
Rate for Payer: UnitedHealthcare Commercial	$434.00

CATH SYNERGY 6 4 75c 035 19361

Facility

$868.00

Hospital Charge Code	270625137
Hospital Revenue Code	272
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Qualcare PPO/HMO/WC	$130.20

CATH SYNERGY 7-10 135cm 19413

Facility

$1,376.00

Hospital Charge Code	270634772
Hospital Revenue Code	278
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$688.00
Rate for Payer: Aetna Commercial	$412.80
Rate for Payer: Aetna Medicare Advantage	$412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.88
Rate for Payer: Cigna Commercial	$688.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

CATH SYNERGY 7-10 135cm 19413

Facility

$1,376.00

Hospital Charge Code	270634772
Hospital Revenue Code	278
Min. Negotiated Rate	$206.40
Max. Negotiated Rate	$332.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.99
Rate for Payer: Qualcare PPO/HMO/WC	$206.40

CATH SYNERGY 7MM 4CM 75CM .035

Facility

$304.00

Hospital Charge Code	270625140
Hospital Revenue Code	278
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.57
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

CATH SYNERGY 7MM 4CM 75CM .035

Facility

$304.00

Hospital Charge Code	270625140
Hospital Revenue Code	278
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$73.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.57
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

CATH SYNERGY 8m 4c 75c 19431

Facility

$868.00

Hospital Charge Code	270625141
Hospital Revenue Code	272
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Qualcare PPO/HMO/WC	$130.20

CATH SYNERGY 8m 4c 75c 19431

Facility

$868.00

Hospital Charge Code	270625141
Hospital Revenue Code	272
Min. Negotiated Rate	$112.84
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$260.40
Rate for Payer: Aetna Medicare Advantage	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.34
Rate for Payer: Cigna Commercial	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.84
Rate for Payer: Oxford Commercial	$434.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.20
Rate for Payer: UnitedHealthcare Commercial	$434.00

CATH SYNY 5m 2c 135c.035 19318

Facility

$1,416.85

Hospital Charge Code	270625132
Hospital Revenue Code	278
Min. Negotiated Rate	$212.53
Max. Negotiated Rate	$708.42
Rate for Payer: Aetna Commercial	$425.06
Rate for Payer: Aetna Medicare Advantage	$425.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.30
Rate for Payer: Cigna Commercial	$708.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.88
Rate for Payer: Qualcare PPO/HMO/WC	$212.53

CATH SYNY 5m 2c 135c.035 19318

Facility

$1,416.85

Hospital Charge Code	270625132
Hospital Revenue Code	278
Min. Negotiated Rate	$212.53
Max. Negotiated Rate	$342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.88
Rate for Payer: Qualcare PPO/HMO/WC	$212.53

CATH SYS NEPHRO FLEX 14F 27182

Facility

$425.00

Hospital Charge Code	270624215V
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH SYS NEPHRO FLEX 14F 27182

Facility

$425.00

Hospital Charge Code	270624215V
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699380S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

Know your out-of-pocket cost for care.

All Charges