Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEAD ADAPTER MEDTRONIC

Facility

$2,575.00

Service Code	HCPCS C1779
Hospital Charge Code	270681603N
Hospital Revenue Code	275
Min. Negotiated Rate	$386.25
Max. Negotiated Rate	$1,287.50
Rate for Payer: Aetna Commercial	$772.50
Rate for Payer: Aetna Medicare Advantage	$772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.62
Rate for Payer: Cigna Commercial	$1,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.15
Rate for Payer: Qualcare PPO/HMO/WC	$386.25

LEAD, ADULT, ANY SOURCE

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001799
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

LEAD, ADULT, ANY SOURCE

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001799
Hospital Revenue Code	301
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.24
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$12.11
Rate for Payer: Cigna Medicare Advantage	$6.05
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.84
Rate for Payer: Wellcare Medicare Advantage	$12.11

LEAD ATRIAL 4524-53

Facility

$2,976.00

Hospital Charge Code	270627551
Hospital Revenue Code	275
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$720.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

LEAD ATRIAL 4524-53

Facility

$2,976.00

Hospital Charge Code	270627551
Hospital Revenue Code	275
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$892.80
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

LEAD ATRIAL 45CM FOR PACEMAKER

Facility

$4,965.00

Hospital Charge Code	270645705
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD ATRIAL 45CM FOR PACEMAKER

Facility

$4,965.00

Hospital Charge Code	270645705
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,489.50
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD ATRIAL 45CM FOR PM 508645

Facility

$4,965.00

Hospital Charge Code	270645705C
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD ATRIAL 45CM FOR PM 508645

Facility

$4,965.00

Hospital Charge Code	270645705C
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,489.50
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD BIPOLAR ENDOCARDIA 52CM

Facility

$3,000.00

Hospital Charge Code	270662925
Hospital Revenue Code	275
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD BIPOLAR ENDOCARDIA 52CM

Facility

$3,000.00

Hospital Charge Code	270662925
Hospital Revenue Code	275
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.24
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$12.11
Rate for Payer: Cigna Medicare Advantage	$6.05
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.84
Rate for Payer: Wellcare Medicare Advantage	$12.11

LEAD (BLOOD)***

Facility

$50.00

Hospital Charge Code	3011798
Hospital Revenue Code	309
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

LEAD (BLOOD)***

Facility

$50.00

Hospital Charge Code	3011798
Hospital Revenue Code	309
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.24
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$12.11
Rate for Payer: Cigna Medicare Advantage	$6.05
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.84
Rate for Payer: Wellcare Medicare Advantage	$12.11

LEAD CAPSURE

Facility

$3,080.00

Hospital Charge Code	270657301
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$745.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAD CAPSURE

Facility

$3,080.00

Hospital Charge Code	270657301
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$1,540.00
Rate for Payer: Aetna Commercial	$924.00
Rate for Payer: Aetna Medicare Advantage	$924.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.40
Rate for Payer: Cigna Commercial	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAD C APSURE ATRIAL SP BIPOLA

Facility

$4,025.00

Hospital Charge Code	270656094
Hospital Revenue Code	278
Min. Negotiated Rate	$603.75
Max. Negotiated Rate	$2,012.50
Rate for Payer: Aetna Commercial	$1,207.50
Rate for Payer: Aetna Medicare Advantage	$1,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,026.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,026.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,026.38
Rate for Payer: Cigna Commercial	$2,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.05
Rate for Payer: Qualcare PPO/HMO/WC	$603.75

LEAD C APSURE ATRIAL SP BIPOLA

Facility

$4,025.00

Hospital Charge Code	270656094
Hospital Revenue Code	278
Min. Negotiated Rate	$603.75
Max. Negotiated Rate	$974.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.05
Rate for Payer: Qualcare PPO/HMO/WC	$603.75

LEAD CAPSUREFIX MRI

Facility

$4,230.00

Service Code	HCPCS C1898
Hospital Charge Code	270673835
Hospital Revenue Code	278
Min. Negotiated Rate	$634.50
Max. Negotiated Rate	$1,023.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.66
Rate for Payer: Qualcare PPO/HMO/WC	$634.50

LEAD CAPSUREFIX MRI

Facility

$4,230.00

Service Code	HCPCS C1898
Hospital Charge Code	270673835
Hospital Revenue Code	278
Min. Negotiated Rate	$634.50
Max. Negotiated Rate	$2,115.00
Rate for Payer: Aetna Commercial	$1,269.00
Rate for Payer: Aetna Medicare Advantage	$1,269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,078.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,078.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,078.65
Rate for Payer: Cigna Commercial	$2,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.66
Rate for Payer: Qualcare PPO/HMO/WC	$634.50

LEAD CAPSUREFIX NOVUS

Facility

$3,630.00

Hospital Charge Code	270657302
Hospital Revenue Code	278
Min. Negotiated Rate	$544.50
Max. Negotiated Rate	$1,815.00
Rate for Payer: Aetna Commercial	$1,089.00
Rate for Payer: Aetna Medicare Advantage	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.65
Rate for Payer: Cigna Commercial	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$878.46
Rate for Payer: Qualcare PPO/HMO/WC	$544.50

LEAD CAPSUREFIX NOVUS

Facility

$3,630.00

Hospital Charge Code	270657302
Hospital Revenue Code	278
Min. Negotiated Rate	$544.50
Max. Negotiated Rate	$878.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$726.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$878.46
Rate for Payer: Qualcare PPO/HMO/WC	$544.50

Know your out-of-pocket cost for care.

All Charges