Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH TRATTNER DBL BALLOON 20FR

Facility

$718.45

Hospital Charge Code	270607519
Hospital Revenue Code	272
Min. Negotiated Rate	$93.40
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$215.53
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.40
Rate for Payer: Oxford Commercial	$359.23
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$359.23

CATH TRAUMA VENTRIC 3.3x1.9MM

Facility

$1,350.00

Service Code	HCPCS C1729
Hospital Charge Code	270695019
Hospital Revenue Code	278
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$326.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.70
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

CATH TRAUMA VENTRIC 3.3x1.9MM

Facility

$1,350.00

Service Code	HCPCS C1729
Hospital Charge Code	270695019
Hospital Revenue Code	278
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$405.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.70
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

CATH TRBHWK 8F THS-LS-C

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270642993C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$5,092.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH TRBHWK 8F THS-LS-C

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270642993C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHTR BLLN AMPHRN .35X20X130

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657924
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHTR BLLN AMPHRN .35X20X130

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657924
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHTR BLLN AMPHRN .35X60X130

Facility

$1,000.00

Hospital Charge Code	270657930
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHTR BLLN AMPHRN .35X60X130

Facility

$1,000.00

Hospital Charge Code	270657930
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHTR BLLN AMPHRN .35X80X130

Facility

$725.00

Service Code	HCPCS C1725
Hospital Charge Code	270657926
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

CATHTR BLLN AMPHRN .35X80X130

Facility

$725.00

Service Code	HCPCS C1725
Hospital Charge Code	270657926
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

CATH TRBO ELITE OTW 1.7 417152

Facility

$12,500.00

Hospital Charge Code	270638467C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TRBO ELITE OTW 1.7 417152

Facility

$12,500.00

Hospital Charge Code	270638467C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TRBO ELTE OTW 1.4 414-151

Facility

$12,500.00

Hospital Charge Code	270638466C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TRBO ELTE OTW 1.4 414-151

Facility

$12,500.00

Hospital Charge Code	270638466C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH TREATMENT ROOM***

Facility

$562.00

Service Code	HCPCS 99201
Hospital Charge Code	5100201
Hospital Revenue Code	769
Min. Negotiated Rate	$73.06
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$168.60
Rate for Payer: Aetna Medicare Advantage	$168.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.31
Rate for Payer: Cigna Commercial	$281.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.06
Rate for Payer: Oxford Commercial	$281.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.30
Rate for Payer: UnitedHealthcare Commercial	$281.00

CATH TREATMENT ROOM***

Facility

$562.00

Service Code	HCPCS 99201
Hospital Charge Code	5100201
Hospital Revenue Code	769
Min. Negotiated Rate	$84.30
Max. Negotiated Rate	$84.30
Rate for Payer: Qualcare PPO/HMO/WC	$84.30

CATH TREK CORON/2.5MMX12MM

Facility

$850.00

Hospital Charge Code	2709007085
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATH TREK CORON/2.5MMX12MM

Facility

$850.00

Hospital Charge Code	2709007085
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATH TREK CORON 2.5MMX15MM

Facility

$850.00

Hospital Charge Code	2709007078
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATH TREK CORON 2.5MMX15MM

Facility

$850.00

Hospital Charge Code	2709007078
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATH TREK CORON2.5MMX20MM

Facility

$850.00

Hospital Charge Code	2709007079
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATH TREK CORON2.5MMX20MM

Facility

$850.00

Hospital Charge Code	2709007079
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATH TREK CORON/2.5MMX30MM

Facility

$850.00

Hospital Charge Code	2709007080
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATH TREK CORON/2.5MMX30MM

Facility

$850.00

Hospital Charge Code	2709007080
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

Know your out-of-pocket cost for care.

All Charges