Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781S
Hospital Revenue Code	278
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$643.75
Rate for Payer: Aetna Commercial	$386.25
Rate for Payer: Aetna Medicare Advantage	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.31
Rate for Payer: Cigna Commercial	$643.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$311.50
Rate for Payer: Aetna Commercial	$186.90
Rate for Payer: Aetna Medicare Advantage	$186.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.87
Rate for Payer: Cigna Commercial	$311.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: Qualcare PPO/HMO/WC	$93.45

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$150.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: Qualcare PPO/HMO/WC	$93.45

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$730.31
Max. Negotiated Rate	$730.31
Rate for Payer: Qualcare PPO/HMO/WC	$730.31

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$632.94
Max. Negotiated Rate	$2,434.38
Rate for Payer: Aetna Commercial	$1,460.62
Rate for Payer: Aetna Medicare Advantage	$1,460.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,241.53
Rate for Payer: Cigna Commercial	$2,434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.94
Rate for Payer: Oxford Commercial	$2,434.38
Rate for Payer: Qualcare PPO/HMO/WC	$730.31
Rate for Payer: UnitedHealthcare Commercial	$2,434.38

INTRODUCER SYSTEM OSTEO T24A

Facility

$5,750.00

Hospital Charge Code	270637757
Hospital Revenue Code	272
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

INTRODUCER SYSTEM OSTEO T24A

Facility

$5,750.00

Hospital Charge Code	270637757
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$22.38
Rate for Payer: Aetna Commercial	$13.43
Rate for Payer: Aetna Medicare Advantage	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.41
Rate for Payer: Cigna Commercial	$22.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709002917
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709006916
Hospital Revenue Code	272
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709002917
Hospital Revenue Code	272
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

INTRODUCER TRANSRADIAL PRELUDE

Facility

$160.00

Hospital Charge Code	2709006916
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

INTRODUCER VIS 7f 55c 4037553H

Facility

$281.85

Hospital Charge Code	270629332
Hospital Revenue Code	272
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$84.56
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.64
Rate for Payer: Oxford Commercial	$140.93
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Commercial	$140.93

INTRODUCER VIS 7f 55c 4037553H

Facility

$281.85

Hospital Charge Code	270629332
Hospital Revenue Code	272
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRODUCER V-STICK 5FR STD

Facility

$90.00

Hospital Charge Code	270676898
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

INTRODUCER V-STICK 5FR STD

Facility

$90.00

Hospital Charge Code	270676898
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

INTRODUCER W/STYLET 407253

Facility

$550.00

Hospital Charge Code	270641739
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

INTRODUCER W/STYLET 407253

Facility

$550.00

Hospital Charge Code	270641739
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

INTRODUCE SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664837
Hospital Revenue Code	270
Min. Negotiated Rate	$632.94
Max. Negotiated Rate	$2,434.38
Rate for Payer: Aetna Commercial	$1,460.62
Rate for Payer: Aetna Medicare Advantage	$1,460.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,241.53
Rate for Payer: Cigna Commercial	$2,434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.94
Rate for Payer: Oxford Commercial	$2,434.38
Rate for Payer: Qualcare PPO/HMO/WC	$730.31
Rate for Payer: UnitedHealthcare Commercial	$2,434.38

INTRODUCE SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664837
Hospital Revenue Code	270
Min. Negotiated Rate	$730.31
Max. Negotiated Rate	$730.31
Rate for Payer: Qualcare PPO/HMO/WC	$730.31

Know your out-of-pocket cost for care.

All Charges