Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH THROMBECTOMY RED72

Facility

$24,625.00

Service Code	HCPCS C1757
Hospital Charge Code	270699563S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,693.75
Max. Negotiated Rate	$5,959.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,959.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,693.75

CATH THROMBECTOMY RED72

Facility

$24,625.00

Service Code	HCPCS C1757
Hospital Charge Code	270699563S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,693.75
Max. Negotiated Rate	$12,312.50
Rate for Payer: Aetna Commercial	$7,387.50
Rate for Payer: Aetna Medicare Advantage	$7,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,279.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,279.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,279.38
Rate for Payer: Cigna Commercial	$12,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,959.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,693.75

CATH THRU LUMEN 5 5F 035X80CM

Facility

$455.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747N
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$110.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

CATH THRU LUMEN 5 5F 035X80CM

Facility

$450.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747S
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

CATH THRU LUMEN 5 5F 035X80CM

Facility

$450.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

CATH THRU LUMEN 5 5F 035X80CM

Facility

$450.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747S
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

CATH THRU LUMEN 5 5F 035X80CM

Facility

$455.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747N
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$136.50
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

CATH THRU LUMEN 5 5F 035X80CM

Facility

$450.00

Service Code	HCPCS C1757
Hospital Charge Code	270670747
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

CATH THRU-LUMEN 5.5F .035X80CM

Facility

$429.65

Hospital Charge Code	27067047
Hospital Revenue Code	278
Min. Negotiated Rate	$64.45
Max. Negotiated Rate	$214.82
Rate for Payer: Aetna Commercial	$128.90
Rate for Payer: Aetna Medicare Advantage	$128.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.56
Rate for Payer: Cigna Commercial	$214.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.98
Rate for Payer: Qualcare PPO/HMO/WC	$64.45

CATH THRU-LUMEN 5.5F .035X80CM

Facility

$429.65

Hospital Charge Code	27067047
Hospital Revenue Code	278
Min. Negotiated Rate	$64.45
Max. Negotiated Rate	$103.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.98
Rate for Payer: Qualcare PPO/HMO/WC	$64.45

CATH TIGERTAIL FLEX TIP 6FR

Facility

$47.15

Service Code	HCPCS C1758
Hospital Charge Code	270650852
Hospital Revenue Code	278
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.07

CATH TIGERTAIL FLEX TIP 6FR

Facility

$47.15

Service Code	HCPCS C1758
Hospital Charge Code	270650852
Hospital Revenue Code	278
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$23.57
Rate for Payer: Aetna Commercial	$14.14
Rate for Payer: Aetna Medicare Advantage	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.02
Rate for Payer: Cigna Commercial	$23.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.07

CATH TI/ISP SI8CF/INT,SL,ATT

Facility

$2,175.00

Hospital Charge Code	2709006963
Hospital Revenue Code	272
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$326.25
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

CATH TI/ISP SI8CF/INT,SL,ATT

Facility

$2,175.00

Hospital Charge Code	2709006963
Hospital Revenue Code	272
Min. Negotiated Rate	$282.75
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$652.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.75
Rate for Payer: Oxford Commercial	$1,087.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Commercial	$1,087.50

CATH TITAN NON-SPLIT 15FR 24CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678021
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 24CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678021
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 28CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678022
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 28CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678022
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 32CM

Facility

$1,025.00

Hospital Charge Code	270678023
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 32CM

Facility

$1,025.00

Hospital Charge Code	270678023
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 36CM

Facility

$1,025.00

Hospital Charge Code	270678024
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 36CM

Facility

$1,025.00

Hospital Charge Code	270678024
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 40CM

Facility

$1,025.00

Hospital Charge Code	270678025
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 40CM

Facility

$1,025.00

Hospital Charge Code	270678025
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH TITAN NON-SPLIT 15FR 55CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678026N
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

Know your out-of-pocket cost for care.

All Charges