Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH TRAILBLAZER .014 150CM

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643849S
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

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643849S
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 .018 150cm

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643850
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 .018 150cm

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643850
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 .018 150cm

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643850N
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 .018 150cm

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643850N
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

CATH TRAILBLAZER .018 150CM

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643850S
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 .018 150CM

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643850S
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 .035 150CM

Facility

$774.80

Service Code	HCPCS C1887
Hospital Charge Code	270644202
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$387.40
Rate for Payer: Aetna Commercial	$232.44
Rate for Payer: Aetna Medicare Advantage	$232.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.57
Rate for Payer: Cigna Commercial	$387.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLAZER .035 150CM

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270644202N
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

CATH TRAILBLAZER .035 150CM

Facility

$774.80

Service Code	HCPCS C1725
Hospital Charge Code	270644202C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$387.40
Rate for Payer: Aetna Commercial	$232.44
Rate for Payer: Aetna Medicare Advantage	$232.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.57
Rate for Payer: Cigna Commercial	$387.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLAZER .035 150CM

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270644202N
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 .035 150CM

Facility

$774.80

Service Code	HCPCS C1887
Hospital Charge Code	270644202S
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLAZER .035 150CM

Facility

$774.80

Service Code	HCPCS C1725
Hospital Charge Code	270644202C
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLAZER .035 150CM

Facility

$774.80

Service Code	HCPCS C1887
Hospital Charge Code	270644202S
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$387.40
Rate for Payer: Aetna Commercial	$232.44
Rate for Payer: Aetna Medicare Advantage	$232.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.57
Rate for Payer: Cigna Commercial	$387.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLAZER .035 150CM

Facility

$774.80

Service Code	HCPCS C1887
Hospital Charge Code	270644202
Hospital Revenue Code	278
Min. Negotiated Rate	$116.22
Max. Negotiated Rate	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.22

CATH TRAILBLZR 35CM .035

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643851N
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

CATH TRAILBLZR 35CM .035

Facility

$4,042.50

Service Code	HCPCS C1887
Hospital Charge Code	270643851N
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 TRAILBLZR 35CM .035

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643851
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 TRAILBLZR 35CM .035

Facility

$744.80

Service Code	HCPCS C1887
Hospital Charge Code	270643851
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 TRAILBZ 018 150 SC0181150

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643850C
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 TRAILBZ 018 150 SC0181150

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643850C
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 TRANSFORM OCCLUS 4X20MM

Facility

$8,323.50

Service Code	HCPCS C2628
Hospital Charge Code	270693898S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,248.53
Max. Negotiated Rate	$4,161.75
Rate for Payer: Aetna Commercial	$2,497.05
Rate for Payer: Aetna Medicare Advantage	$2,497.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,122.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,122.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,664.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,122.49
Rate for Payer: Cigna Commercial	$4,161.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,014.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,248.53

CATH TRANSFORM OCCLUS 4X20MM

Facility

$8,323.50

Service Code	HCPCS C2628
Hospital Charge Code	270693898S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,248.53
Max. Negotiated Rate	$2,014.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,664.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,014.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,248.53

CATH TRATTNER DBL BALLOON 20FR

Facility

$718.45

Hospital Charge Code	270607519
Hospital Revenue Code	272
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

Know your out-of-pocket cost for care.

All Charges