Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH TITAN NON-SPLIT 15FR 55CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678026
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 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	$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 55CM

Facility

$1,025.00

Service Code	HCPCS C1750
Hospital Charge Code	270678026
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 TORCOM 5FR .038 x 80cmL

Facility

$550.00

Hospital Charge Code	270645979
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 TORCOM 5FR .038 x 80cmL

Facility

$550.00

Hospital Charge Code	270645979
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH TORCOM 5FR .038x80cmL MIK

Facility

$371.50

Hospital Charge Code	270645979C
Hospital Revenue Code	272
Min. Negotiated Rate	$55.73
Max. Negotiated Rate	$55.73
Rate for Payer: Qualcare PPO/HMO/WC	$55.73

CATH TORCOM 5FR .038x80cmL MIK

Facility

$371.50

Hospital Charge Code	270645979C
Hospital Revenue Code	272
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$185.75
Rate for Payer: Aetna Commercial	$111.45
Rate for Payer: Aetna Medicare Advantage	$111.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.73
Rate for Payer: Cigna Commercial	$185.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.30
Rate for Payer: Oxford Commercial	$185.75
Rate for Payer: Qualcare PPO/HMO/WC	$55.73
Rate for Payer: UnitedHealthcare Commercial	$185.75

CATH TORCON ADVANTAG 5F G08699

Facility

$88.55

Hospital Charge Code	270629970V
Hospital Revenue Code	272
Min. Negotiated Rate	$11.51
Max. Negotiated Rate	$44.27
Rate for Payer: Aetna Commercial	$26.57
Rate for Payer: Aetna Medicare Advantage	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.58
Rate for Payer: Cigna Commercial	$44.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.51
Rate for Payer: Oxford Commercial	$44.27
Rate for Payer: Qualcare PPO/HMO/WC	$13.28
Rate for Payer: UnitedHealthcare Commercial	$44.27

CATH TORCON ADVANTAG 5F G08699

Facility

$88.55

Hospital Charge Code	270629970V
Hospital Revenue Code	272
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$13.28
Rate for Payer: Qualcare PPO/HMO/WC	$13.28

CATH TORCON DAV 5FR .035 100cm

Facility

$125.00

Hospital Charge Code	270629970
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CATH TORCON DAV 5FR .035 100cm

Facility

$550.00

Hospital Charge Code	270629970N
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH TORCON DAV 5FR .035 100cm

Facility

$550.00

Hospital Charge Code	270629970N
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 TORCON DAV 5FR .035 100cm

Facility

$125.00

Hospital Charge Code	270629970S
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CATH TORCON DAV 5FR .035 100cm

Facility

$125.00

Hospital Charge Code	270629970
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

CATH TORCON DAV 5FR .035 100cm

Facility

$125.00

Hospital Charge Code	270629970S
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CATH TORCON HN5 5FR .038 100cm

Facility

$550.00

Hospital Charge Code	270624804
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH TORCON HN5 5FR .038 100cm

Facility

$550.00

Hospital Charge Code	270624804
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 TORCON HNB535100PNSDAV***

Facility

$71.00

Hospital Charge Code	270624007
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

CATH TORCON HNB535100PNSDAV***

Facility

$71.00

Hospital Charge Code	270624007
Hospital Revenue Code	272
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

CATH TORQR JO 100cm

Facility

$1,500.00

Service Code	HCPCS C1730
Hospital Charge Code	270675269
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CATH TORQR JO 100cm

Facility

$1,500.00

Service Code	HCPCS C1730
Hospital Charge Code	270675269
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CATH TRAILBLAZER .014 150cm

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643849N
Hospital Revenue Code	278
Min. Negotiated Rate	$606.38
Max. Negotiated Rate	$2,021.25
Rate for Payer: Aetna Commercial	$1,212.75
Rate for Payer: Aetna Medicare Advantage	$1,212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.84
Rate for Payer: Cigna Commercial	$2,021.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.28
Rate for Payer: Qualcare PPO/HMO/WC	$606.38

CATH TRAILBLAZER .014 150cm

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643849
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$372.40
Rate for Payer: Aetna Commercial	$223.44
Rate for Payer: Aetna Medicare Advantage	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.92
Rate for Payer: Cigna Commercial	$372.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TRAILBLAZER .014 150cm

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643849
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TRAILBLAZER .014 150cm

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643849N
Hospital Revenue Code	278
Min. Negotiated Rate	$606.38
Max. Negotiated Rate	$978.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.28
Rate for Payer: Qualcare PPO/HMO/WC	$606.38

Know your out-of-pocket cost for care.

All Charges