Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEAD FINELINE II PASSIVE 53

Facility

$5,325.00

Hospital Charge Code	270666558
Hospital Revenue Code	275
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$1,288.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

LEAD FINELIN II PASS 52CM 4456

Facility

$3,000.00

Hospital Charge Code	270640192
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 FINELIN II PASS 52CM 4456

Facility

$3,000.00

Hospital Charge Code	270640192
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 FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270661941
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$979.50
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270667006
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$790.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270661941
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$790.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

LEAD FPA BI SIL ATR STER US

Facility

$3,265.00

Hospital Charge Code	270667006
Hospital Revenue Code	275
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$979.50
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$790.13
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7742 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677539N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7742 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677539
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7742 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677539
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI 7742 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677539N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI IS-1 52CM

Facility

$4,000.00

Hospital Charge Code	270677289
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD INGEVITY MRI IS-1 52CM

Facility

$4,000.00

Hospital Charge Code	270677289
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Know your out-of-pocket cost for care.

All Charges