Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH VERIPATH 8FR LIMA 50cm

Facility

$575.00

Hospital Charge Code	270653088
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR LIMA 50cm

Facility

$575.00

Hospital Charge Code	270653088
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR M/PURP 50cm

Facility

$575.00

Hospital Charge Code	270653069
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15

CATH VERIPATH 8FR M/PURP 50cm

Facility

$575.00

Hospital Charge Code	270653069
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR RDC1 50cm

Facility

$575.00

Hospital Charge Code	270653077
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR RDC1 50cm

Facility

$575.00

Hospital Charge Code	270653077
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR RDC 50cm

Facility

$575.00

Hospital Charge Code	270653084
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERIPATH 8FR RDC 50cm

Facility

$575.00

Hospital Charge Code	270653084
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH VERSA KATH EPIP 21G

Facility

$365.00

Service Code	HCPCS A4300
Hospital Charge Code	270638921
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$88.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CATH VERSA KATH EPIP 21G

Facility

$365.00

Service Code	HCPCS A4300
Hospital Charge Code	270638921
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$109.50
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CATH VESSEL SIZING 5FR 65cm

Facility

$452.55

Service Code	HCPCS C1887
Hospital Charge Code	270624529
Hospital Revenue Code	278
Min. Negotiated Rate	$67.88
Max. Negotiated Rate	$226.28
Rate for Payer: Aetna Commercial	$135.76
Rate for Payer: Aetna Medicare Advantage	$135.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.40
Rate for Payer: Cigna Commercial	$226.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.52
Rate for Payer: Qualcare PPO/HMO/WC	$67.88

CATH VESSEL SIZING 5FR 65cm

Facility

$452.55

Service Code	HCPCS C1887
Hospital Charge Code	270624529
Hospital Revenue Code	278
Min. Negotiated Rate	$67.88
Max. Negotiated Rate	$109.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.52
Rate for Payer: Qualcare PPO/HMO/WC	$67.88

CATH VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584C
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 VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584C
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 VIA 14+6X20 135 100819720

Facility

$1,425.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817N
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CATH VIA 14+6X20 135 100819720

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817C
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 VIA 14+6X20 135 100819720

Facility

$1,425.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817N
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CATH VIA 14+6X20 135 100819720

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817C
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 VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815O
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$5,069.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815O
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$10,475.00
Rate for Payer: Aetna Commercial	$6,285.00
Rate for Payer: Aetna Medicare Advantage	$6,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,342.25
Rate for Payer: Cigna Commercial	$10,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$10,475.00
Rate for Payer: Aetna Commercial	$6,285.00
Rate for Payer: Aetna Medicare Advantage	$6,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,342.25
Rate for Payer: Cigna Commercial	$10,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$5,069.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MMX7.5CM 6FR

Facility

$19,750.00

Service Code	HCPCS C1874
Hospital Charge Code	270692151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CATH VIABAHN 6MMX7.5CM 6FR

Facility

$19,750.00

Service Code	HCPCS C1874
Hospital Charge Code	270692151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$5,925.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CATH VIATRAC 14PLS V1008197-30

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644113C
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

Know your out-of-pocket cost for care.

All Charges