Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH TESIO RT W/6F INTRO/TUNNE

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270658136
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATH TESIO RT W/6F INTRO/TUNNE

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270658136
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$532.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATH TESSIO 10 70 BFR-1070KD-A

Facility

$2,169.65

Hospital Charge Code	270620664
Hospital Revenue Code	272
Min. Negotiated Rate	$325.45
Max. Negotiated Rate	$325.45
Rate for Payer: Qualcare PPO/HMO/WC	$325.45

CATH TESSIO 10 70 BFR-1070KD-A

Facility

$2,169.65

Hospital Charge Code	270620664
Hospital Revenue Code	272
Min. Negotiated Rate	$282.05
Max. Negotiated Rate	$1,084.83
Rate for Payer: Aetna Commercial	$650.89
Rate for Payer: Aetna Medicare Advantage	$650.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$553.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$553.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$553.26
Rate for Payer: Cigna Commercial	$1,084.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.05
Rate for Payer: Oxford Commercial	$1,084.83
Rate for Payer: Qualcare PPO/HMO/WC	$325.45
Rate for Payer: UnitedHealthcare Commercial	$1,084.83

CATH TESSIO DUAL L 6FR MBL6

Facility

$2,812.85

Hospital Charge Code	270601076
Hospital Revenue Code	272
Min. Negotiated Rate	$421.93
Max. Negotiated Rate	$421.93
Rate for Payer: Qualcare PPO/HMO/WC	$421.93

CATH TESSIO DUAL L 6FR MBL6

Facility

$2,812.85

Hospital Charge Code	270601076
Hospital Revenue Code	272
Min. Negotiated Rate	$365.67
Max. Negotiated Rate	$1,406.42
Rate for Payer: Aetna Commercial	$843.86
Rate for Payer: Aetna Medicare Advantage	$843.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.28
Rate for Payer: Cigna Commercial	$1,406.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.67
Rate for Payer: Oxford Commercial	$1,406.42
Rate for Payer: Qualcare PPO/HMO/WC	$421.93
Rate for Payer: UnitedHealthcare Commercial	$1,406.42

CATH TESSIO KIT MCTC1035KD-A-1

Facility

$2,700.85

Hospital Charge Code	270605149
Hospital Revenue Code	278
Min. Negotiated Rate	$405.13
Max. Negotiated Rate	$1,350.42
Rate for Payer: Aetna Commercial	$810.25
Rate for Payer: Aetna Medicare Advantage	$810.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.72
Rate for Payer: Cigna Commercial	$1,350.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.61
Rate for Payer: Qualcare PPO/HMO/WC	$405.13

CATH TESSIO KIT MCTC1035KD-A-1

Facility

$2,700.85

Hospital Charge Code	270605149
Hospital Revenue Code	278
Min. Negotiated Rate	$405.13
Max. Negotiated Rate	$653.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.61
Rate for Payer: Qualcare PPO/HMO/WC	$405.13

CATH TESSIO KIT MCTC1035KDA1**

Facility

$792.00

Hospital Charge Code	1608454
Hospital Revenue Code	272
Min. Negotiated Rate	$102.96
Max. Negotiated Rate	$396.00
Rate for Payer: Aetna Commercial	$237.60
Rate for Payer: Aetna Medicare Advantage	$237.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.96
Rate for Payer: Cigna Commercial	$396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.96
Rate for Payer: Oxford Commercial	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.80
Rate for Payer: UnitedHealthcare Commercial	$396.00

CATH TESSIO KIT MCTC1035KDA1**

Facility

$792.00

Hospital Charge Code	1608454
Hospital Revenue Code	272
Min. Negotiated Rate	$118.80
Max. Negotiated Rate	$118.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.80

CATH TESSIO MBL6*******

Facility

$550.00

Hospital Charge Code	1608355
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH TESSIO MBL6*******

Facility

$550.00

Hospital Charge Code	1608355
Hospital Revenue Code	272
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$275.00

CATH TEXAS EXTERNAL

Facility

$9.65

Hospital Charge Code	270300600
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

CATH TEXAS EXTERNAL

Facility

$9.65

Hospital Charge Code	270300600
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

CATH TEXAS EXTERNAL

Facility

$20.00

Hospital Charge Code	8001711
Hospital Revenue Code	279
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

CATH TEXAS EXTERNAL

Facility

$20.00

Hospital Charge Code	8001711
Hospital Revenue Code	279
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

CATH THAL DRAINAGE 28FR

Facility

$694.40

Hospital Charge Code	270638387
Hospital Revenue Code	272
Min. Negotiated Rate	$90.27
Max. Negotiated Rate	$347.20
Rate for Payer: Aetna Commercial	$208.32
Rate for Payer: Aetna Medicare Advantage	$208.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.07
Rate for Payer: Cigna Commercial	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.27
Rate for Payer: Oxford Commercial	$347.20
Rate for Payer: Qualcare PPO/HMO/WC	$104.16
Rate for Payer: UnitedHealthcare Commercial	$347.20

CATH THAL DRAINAGE 28FR

Facility

$694.40

Hospital Charge Code	270638387
Hospital Revenue Code	272
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$104.16
Rate for Payer: Qualcare PPO/HMO/WC	$104.16

CATH THAL DRAINAGE 28FR G06354

Facility

$655.10

Hospital Charge Code	270638387V
Hospital Revenue Code	278
Min. Negotiated Rate	$98.27
Max. Negotiated Rate	$158.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.53
Rate for Payer: Qualcare PPO/HMO/WC	$98.27

CATH THAL DRAINAGE 28FR G06354

Facility

$655.10

Hospital Charge Code	270638387V
Hospital Revenue Code	278
Min. Negotiated Rate	$98.27
Max. Negotiated Rate	$327.55
Rate for Payer: Aetna Commercial	$196.53
Rate for Payer: Aetna Medicare Advantage	$196.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.05
Rate for Payer: Cigna Commercial	$327.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.53
Rate for Payer: Qualcare PPO/HMO/WC	$98.27

CATH THORAC 28FR RT ANG

Facility

$85.00

Hospital Charge Code	270600388
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$42.50

CATH THORAC 28FR RT ANG

Facility

$85.00

Hospital Charge Code	270600388
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CATH THORAC 28FR STR & R/A ***

Facility

$58.00

Hospital Charge Code	1606185
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

CATH THORAC 28FR STR & R/A ***

Facility

$58.00

Hospital Charge Code	1606185
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

CATH THORAC 32FR RT ANG

Facility

$39.83

Hospital Charge Code	270600389
Hospital Revenue Code	272
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$19.91
Rate for Payer: Aetna Commercial	$11.95
Rate for Payer: Aetna Medicare Advantage	$11.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.16
Rate for Payer: Cigna Commercial	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Oxford Commercial	$19.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.97
Rate for Payer: UnitedHealthcare Commercial	$19.91

Know your out-of-pocket cost for care.

All Charges