Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH VIP SWAN-GANZ ******

Facility

$200.00

Hospital Charge Code	8003097
Hospital Revenue Code	279
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$100.00

CATH VIP SWAN-GANZ ******

Facility

$200.00

Hospital Charge Code	8003097
Hospital Revenue Code	279
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

CATH VITRC 14PLS V1008193-40

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644151C
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 VITRC 14PLS V1008193-40

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644151S
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 VITRC 14PLS V1008193-40

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644151S
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
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

CATH VITRC 14PLS V1008193-40

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644151C
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 VON SONEBERG 16F 30 20304

Facility

$587.60

Hospital Charge Code	270630567
Hospital Revenue Code	272
Min. Negotiated Rate	$76.39
Max. Negotiated Rate	$293.80
Rate for Payer: Aetna Commercial	$176.28
Rate for Payer: Aetna Medicare Advantage	$176.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.84
Rate for Payer: Cigna Commercial	$293.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.39
Rate for Payer: Oxford Commercial	$293.80
Rate for Payer: Qualcare PPO/HMO/WC	$88.14
Rate for Payer: UnitedHealthcare Commercial	$293.80

CATH VON SONEBERG 16F 30 20304

Facility

$587.60

Hospital Charge Code	270630567
Hospital Revenue Code	272
Min. Negotiated Rate	$88.14
Max. Negotiated Rate	$88.14
Rate for Payer: Qualcare PPO/HMO/WC	$88.14

CATH VTC NEPHROSTOMY 8FR 25cm

Facility

$489.25

Service Code	HCPCS C1729
Hospital Charge Code	270601331
Hospital Revenue Code	278
Min. Negotiated Rate	$73.39
Max. Negotiated Rate	$118.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.40
Rate for Payer: Qualcare PPO/HMO/WC	$73.39

CATH VTC NEPHROSTOMY 8FR 25cm

Facility

$489.25

Service Code	HCPCS C1729
Hospital Charge Code	270601331
Hospital Revenue Code	278
Min. Negotiated Rate	$73.39
Max. Negotiated Rate	$244.62
Rate for Payer: Aetna Commercial	$146.78
Rate for Payer: Aetna Medicare Advantage	$146.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.76
Rate for Payer: Cigna Commercial	$244.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.40
Rate for Payer: Qualcare PPO/HMO/WC	$73.39

CATH WALRUS BALLOON GD 90CM

Facility

$8,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270694052S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATH WALRUS BALLOON GD 90CM

Facility

$8,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270694052S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$2,625.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATH WC ERCP PEEL AWAY PLA-1-T

Facility

$307.25

Hospital Charge Code	270618518
Hospital Revenue Code	272
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$92.17
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.94
Rate for Payer: Oxford Commercial	$153.62
Rate for Payer: Qualcare PPO/HMO/WC	$46.09
Rate for Payer: UnitedHealthcare Commercial	$153.62

CATH WC ERCP PEEL AWAY PLA-1-T

Facility

$307.25

Hospital Charge Code	270618518
Hospital Revenue Code	272
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$46.09
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

CATH WEDGE BALLON ARR 5FR

Facility

$725.00

Service Code	HCPCS C1726
Hospital Charge Code	270696315
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

CATH WEDGE BALLON ARR 5FR

Facility

$725.00

Service Code	HCPCS C1726
Hospital Charge Code	270696315
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 WH II 6X2X75 PTA 16500410

Facility

$1,116.00

Hospital Charge Code	270635678
Hospital Revenue Code	272
Min. Negotiated Rate	$145.08
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$334.80
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.08
Rate for Payer: Oxford Commercial	$558.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.40
Rate for Payer: UnitedHealthcare Commercial	$558.00

CATH WH II 6X2X75 PTA 16500410

Facility

$1,116.00

Hospital Charge Code	270635678
Hospital Revenue Code	272
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$167.40
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

CATH WILDCAT GW SUPPORT 5FR

Facility

$7,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270647588N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

CATH WILDCAT GW SUPPORT 5FR

Facility

$7,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270647588
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

CATH WILDCAT GW SUPPORT 5FR

Facility

$7,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270647588N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

CATH WILDCAT GW SUPPORT 5FR

Facility

$7,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270647588
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

CATH WILDCAT GW SUPPORT 6FR

Facility

$6,975.00

Hospital Charge Code	270644955C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

CATH WILDCAT GW SUPPORT 6FR

Facility

$7,975.00

Service Code	HCPCS C1769
Hospital Charge Code	270644955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

CATH WILDCAT GW SUPPORT 6FR

Facility

$7,975.00

Service Code	HCPCS C1769
Hospital Charge Code	270644955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

Know your out-of-pocket cost for care.

All Charges