Heights University Hospital

All Charges

Charge

Type

Setting

Price

COIL STONE CONE 7mm 3FR

Facility

$2,065.00

Hospital Charge Code	270674383
Hospital Revenue Code	272
Min. Negotiated Rate	$309.75
Max. Negotiated Rate	$309.75
Rate for Payer: Qualcare PPO/HMO/WC	$309.75

COIL TARGET TETRA 1.5MMX2CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699391S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 1.5MMX2CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699391S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 2.0MMX45CM

Facility

$11,113.50

Service Code	HCPCS C1889
Hospital Charge Code	270699562S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,667.03
Max. Negotiated Rate	$5,556.75
Rate for Payer: Aetna Commercial	$3,334.05
Rate for Payer: Aetna Medicare Advantage	$3,334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,833.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,833.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,222.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,833.94
Rate for Payer: Cigna Commercial	$5,556.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,689.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,667.03

COIL TARGET TETRA 2.0MMX45CM

Facility

$11,113.50

Service Code	HCPCS C1889
Hospital Charge Code	270699562S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,667.03
Max. Negotiated Rate	$2,689.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,222.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,689.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,667.03

COIL TARGET TETRA 2MMX2.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699390S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 2MMX2.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699390S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,154.80
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$4,561.65
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$4,561.65
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$4,561.65
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

COLACE SOLN 1%/30ML

Facility

$25.00

Hospital Charge Code	60634582
Hospital Revenue Code	250
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

COLACE SOLN 1%/30ML

Facility

$25.00

Hospital Charge Code	60634582
Hospital Revenue Code	250
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$61.06
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$140.91
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.06
Rate for Payer: Oxford Commercial	$234.85
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$234.85

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$61.06
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$140.91
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.06
Rate for Payer: Oxford Commercial	$234.85
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$234.85

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLAPINTO RING TIPS SET

Facility

$2,348.50

Hospital Charge Code	2706000329
Hospital Revenue Code	272
Min. Negotiated Rate	$305.31
Max. Negotiated Rate	$1,174.25
Rate for Payer: Aetna Commercial	$704.55
Rate for Payer: Aetna Medicare Advantage	$704.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$598.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$598.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$598.87
Rate for Payer: Cigna Commercial	$1,174.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.31
Rate for Payer: Oxford Commercial	$1,174.25
Rate for Payer: Qualcare PPO/HMO/WC	$352.27
Rate for Payer: UnitedHealthcare Commercial	$1,174.25

COLAPINTO RING TIPS SET

Facility

$2,348.50

Hospital Charge Code	2706000329
Hospital Revenue Code	272
Min. Negotiated Rate	$352.27
Max. Negotiated Rate	$352.27
Rate for Payer: Qualcare PPO/HMO/WC	$352.27

Know your out-of-pocket cost for care.

All Charges