Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,917.75
Max. Negotiated Rate	$3,093.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75

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	$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

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,917.75
Max. Negotiated Rate	$6,392.50
Rate for Payer: Aetna Commercial	$3,835.50
Rate for Payer: Aetna Medicare Advantage	$3,835.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,260.18
Rate for Payer: Cigna Commercial	$6,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75

CATH TARGET TETRA 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
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 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
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 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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 TENCHOFF****

Facility

$146.00

Hospital Charge Code	8001802
Hospital Revenue Code	279
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

CATH TENCHOFF****

Facility

$146.00

Hospital Charge Code	8001802
Hospital Revenue Code	279
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

CATH TENCKHOFF

Facility

$578.00

Hospital Charge Code	1603133
Hospital Revenue Code	272
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$289.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.70
Rate for Payer: UnitedHealthcare Commercial	$289.00

CATH TENCKHOFF

Facility

$288.00

Hospital Charge Code	1608165
Hospital Revenue Code	272
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

CATH TENCKHOFF

Facility

$288.00

Hospital Charge Code	1608165
Hospital Revenue Code	272
Min. Negotiated Rate	$37.44
Max. Negotiated Rate	$144.00
Rate for Payer: Aetna Commercial	$86.40
Rate for Payer: Aetna Medicare Advantage	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.44
Rate for Payer: Cigna Commercial	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$144.00

CATH TENCKHOFF

Facility

$578.00

Hospital Charge Code	1603133
Hospital Revenue Code	272
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

CATH TENCKHOFF PERITONL 60087

Facility

$739.25

Hospital Charge Code	270608944
Hospital Revenue Code	272
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$369.62
Rate for Payer: Aetna Commercial	$221.78
Rate for Payer: Aetna Medicare Advantage	$221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.51
Rate for Payer: Cigna Commercial	$369.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.10
Rate for Payer: Oxford Commercial	$369.62
Rate for Payer: Qualcare PPO/HMO/WC	$110.89
Rate for Payer: UnitedHealthcare Commercial	$369.62

CATH TENCKHOFF PERITONL 60087

Facility

$739.25

Hospital Charge Code	270608944
Hospital Revenue Code	272
Min. Negotiated Rate	$110.89
Max. Negotiated Rate	$110.89
Rate for Payer: Qualcare PPO/HMO/WC	$110.89

CATH TESIO LEFT SIDE 11FR 52CM

Facility

$1,505.00

Service Code	HCPCS C1750
Hospital Charge Code	270620402
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

CATH TESIO LEFT SIDE 11FR 52CM

Facility

$1,505.00

Service Code	HCPCS C1750
Hospital Charge Code	270620402
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$752.50
Rate for Payer: Aetna Commercial	$451.50
Rate for Payer: Aetna Medicare Advantage	$451.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.77
Rate for Payer: Cigna Commercial	$752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

CATH TESIO RIGHT BFR-6

Facility

$380.85

Hospital Charge Code	270621660
Hospital Revenue Code	272
Min. Negotiated Rate	$49.51
Max. Negotiated Rate	$190.43
Rate for Payer: Aetna Commercial	$114.25
Rate for Payer: Aetna Medicare Advantage	$114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.12
Rate for Payer: Cigna Commercial	$190.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.51
Rate for Payer: Oxford Commercial	$190.43
Rate for Payer: Qualcare PPO/HMO/WC	$57.13
Rate for Payer: UnitedHealthcare Commercial	$190.43

CATH TESIO RIGHT BFR-6

Facility

$380.85

Hospital Charge Code	270621660
Hospital Revenue Code	272
Min. Negotiated Rate	$57.13
Max. Negotiated Rate	$57.13
Rate for Payer: Qualcare PPO/HMO/WC	$57.13

Know your out-of-pocket cost for care.

All Charges