Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE MTK VAPO 2.3 225201

Facility

$1,112.85

Hospital Charge Code	270619166
Hospital Revenue Code	272
Min. Negotiated Rate	$144.67
Max. Negotiated Rate	$556.42
Rate for Payer: Aetna Commercial	$333.86
Rate for Payer: Aetna Medicare Advantage	$333.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.78
Rate for Payer: Cigna Commercial	$556.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.67
Rate for Payer: Oxford Commercial	$556.42
Rate for Payer: Qualcare PPO/HMO/WC	$166.93
Rate for Payer: UnitedHealthcare Commercial	$556.42

ELECTRODE MTK VAPO 2.3 225201

Facility

$1,112.85

Hospital Charge Code	270619166
Hospital Revenue Code	272
Min. Negotiated Rate	$166.93
Max. Negotiated Rate	$166.93
Rate for Payer: Qualcare PPO/HMO/WC	$166.93

ELECTRODE NEUTRAL SELF-ADHESIV

Facility

$130.15

Hospital Charge Code	270650127
Hospital Revenue Code	272
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$65.08
Rate for Payer: Aetna Commercial	$39.05
Rate for Payer: Aetna Medicare Advantage	$39.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.19
Rate for Payer: Cigna Commercial	$65.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.92
Rate for Payer: Oxford Commercial	$65.08
Rate for Payer: Qualcare PPO/HMO/WC	$19.52
Rate for Payer: UnitedHealthcare Commercial	$65.08

ELECTRODE NEUTRAL SELF-ADHESIV

Facility

$130.15

Hospital Charge Code	270650127
Hospital Revenue Code	272
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$19.52
Rate for Payer: Qualcare PPO/HMO/WC	$19.52

ELECTRODE PACING

Facility

$453.65

Hospital Charge Code	270600755
Hospital Revenue Code	270
Min. Negotiated Rate	$58.97
Max. Negotiated Rate	$226.82
Rate for Payer: Aetna Commercial	$136.09
Rate for Payer: Aetna Medicare Advantage	$136.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.68
Rate for Payer: Cigna Commercial	$226.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.97
Rate for Payer: Oxford Commercial	$226.82
Rate for Payer: Qualcare PPO/HMO/WC	$68.05
Rate for Payer: UnitedHealthcare Commercial	$226.82

ELECTRODE PACING

Facility

$453.65

Hospital Charge Code	270600755
Hospital Revenue Code	270
Min. Negotiated Rate	$68.05
Max. Negotiated Rate	$68.05
Rate for Payer: Qualcare PPO/HMO/WC	$68.05

ELECTRODE PACING BI BALLON FLO

Facility

$905.00

Hospital Charge Code	2707400048
Hospital Revenue Code	272
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$135.75
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

ELECTRODE PACING BI BALLON FLO

Facility

$905.00

Hospital Charge Code	2707400048
Hospital Revenue Code	272
Min. Negotiated Rate	$117.65
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$271.50
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: Oxford Commercial	$452.50
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Commercial	$452.50

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PACING BI BALLOON FL

Facility

$905.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417N
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$271.50
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

ELECTRODE PACING BI BALLOON FL

Facility

$905.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417N
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PAIRED 4-CHANNEL

Facility

$445.00

Hospital Charge Code	270678075
Hospital Revenue Code	272
Min. Negotiated Rate	$57.85
Max. Negotiated Rate	$222.50
Rate for Payer: Aetna Commercial	$133.50
Rate for Payer: Aetna Medicare Advantage	$133.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Commercial	$222.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.85
Rate for Payer: Oxford Commercial	$222.50
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Commercial	$222.50

ELECTRODE PAIRED 4-CHANNEL

Facility

$445.00

Hospital Charge Code	270678075
Hospital Revenue Code	272
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$66.75
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

ELECTRODE PEDIATRIC M2248-50

Facility

$42.58

Hospital Charge Code	270649179
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$6.39
Rate for Payer: Qualcare PPO/HMO/WC	$6.39

ELECTRODE PEDIATRIC M2248-50

Facility

$42.58

Hospital Charge Code	270649179
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$21.29
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$12.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.86
Rate for Payer: Cigna Commercial	$21.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.54
Rate for Payer: Oxford Commercial	$21.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.39
Rate for Payer: UnitedHealthcare Commercial	$21.29

ELECTRODE PREWIRED RADIO

Facility

$12.16

Hospital Charge Code	270649795
Hospital Revenue Code	270
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$6.08
Rate for Payer: Aetna Commercial	$3.65
Rate for Payer: Aetna Medicare Advantage	$3.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.10
Rate for Payer: Cigna Commercial	$6.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$6.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.82
Rate for Payer: UnitedHealthcare Commercial	$6.08

ELECTRODE PREWIRED RADIO

Facility

$12.16

Hospital Charge Code	270649795
Hospital Revenue Code	270
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.82

ELECTRODE QUICK COMBO 11996

Facility

$134.45

Hospital Charge Code	270627213
Hospital Revenue Code	270
Min. Negotiated Rate	$17.48
Max. Negotiated Rate	$67.22
Rate for Payer: Aetna Commercial	$40.34
Rate for Payer: Aetna Medicare Advantage	$40.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.28
Rate for Payer: Cigna Commercial	$67.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.48
Rate for Payer: Oxford Commercial	$67.22
Rate for Payer: Qualcare PPO/HMO/WC	$20.17
Rate for Payer: UnitedHealthcare Commercial	$67.22

ELECTRODE QUICK COMBO 11996

Facility

$134.45

Hospital Charge Code	270627213
Hospital Revenue Code	270
Min. Negotiated Rate	$20.17
Max. Negotiated Rate	$20.17
Rate for Payer: Qualcare PPO/HMO/WC	$20.17

ELECTRODE QUICK PACE DISP

Facility

$158.45

Hospital Charge Code	270603375
Hospital Revenue Code	270
Min. Negotiated Rate	$20.60
Max. Negotiated Rate	$79.22
Rate for Payer: Aetna Commercial	$47.53
Rate for Payer: Aetna Medicare Advantage	$47.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.40
Rate for Payer: Cigna Commercial	$79.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.60
Rate for Payer: Oxford Commercial	$79.22
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$79.22

ELECTRODE QUICK PACE DISP

Facility

$158.45

Hospital Charge Code	270603375
Hospital Revenue Code	270
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

ELECTRODE QUICK PACE PACE*****

Facility

$200.00

Hospital Charge Code	8003212
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

Know your out-of-pocket cost for care.

All Charges