Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEAD INGEVITY MRI IS 45CM

Facility

$4,750.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229S
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LEAD INGEVITY MRI IS 45CM

Facility

$4,750.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229S
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LEAD INGEVITY MRI IS 45CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229N
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 45CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229N
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 45 CM

Facility

$4,750.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LEAD INGEVITY MRI IS 45 CM

Facility

$4,750.00

Service Code	HCPCS C1898
Hospital Charge Code	270682229
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LEAD INGEVITY MRI IS 59CM

Facility

$4,000.00

Hospital Charge Code	270677288
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 59CM

Facility

$4,000.00

Hospital Charge Code	270677288
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 PACING 45CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803
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 PACING 45CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803
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 INTRODUCER

Facility

$80.00

Hospital Charge Code	270335658
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

LEAD INTRODUCER

Facility

$80.00

Hospital Charge Code	270335658
Hospital Revenue Code	272
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$40.00

LEAD INTRODUCER 7fr 6207-S1

Facility

$272.85

Hospital Charge Code	270626471C
Hospital Revenue Code	275
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$66.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.03
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

LEAD INTRODUCER 7fr 6207-S1

Facility

$272.85

Hospital Charge Code	270626471
Hospital Revenue Code	275
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$66.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.03
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

LEAD INTRODUCER 7fr 6207-S1

Facility

$272.85

Hospital Charge Code	270626471C
Hospital Revenue Code	275
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$136.43
Rate for Payer: Aetna Commercial	$81.86
Rate for Payer: Aetna Medicare Advantage	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.58
Rate for Payer: Cigna Commercial	$136.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.03
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

LEAD INTRODUCER 7fr 6207-S1

Facility

$272.85

Hospital Charge Code	270626471
Hospital Revenue Code	275
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$136.43
Rate for Payer: Aetna Commercial	$81.86
Rate for Payer: Aetna Medicare Advantage	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.58
Rate for Payer: Cigna Commercial	$136.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.03
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

LEAD INTRODUCER KIT

Facility

$1,400.00

Hospital Charge Code	270671692
Hospital Revenue Code	272
Min. Negotiated Rate	$182.00
Max. Negotiated Rate	$700.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$700.00

LEAD INTRODUCER KIT

Facility

$1,400.00

Hospital Charge Code	270671692
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

LEAD ISOFLEX OPTIM LV 1948/

Facility

$4,395.00

Hospital Charge Code	270655929
Hospital Revenue Code	275
Min. Negotiated Rate	$659.25
Max. Negotiated Rate	$2,197.50
Rate for Payer: Aetna Commercial	$1,318.50
Rate for Payer: Aetna Medicare Advantage	$1,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,120.72
Rate for Payer: Cigna Commercial	$2,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: Qualcare PPO/HMO/WC	$659.25

LEAD ISOFLEX OPTIM LV 1948/

Facility

$4,395.00

Hospital Charge Code	270655929
Hospital Revenue Code	275
Min. Negotiated Rate	$659.25
Max. Negotiated Rate	$1,063.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: Qualcare PPO/HMO/WC	$659.25

LEAD ISOFLEX OPTIM LV 1948/52

Facility

$4,395.00

Hospital Charge Code	270655929C
Hospital Revenue Code	275
Min. Negotiated Rate	$659.25
Max. Negotiated Rate	$1,063.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: Qualcare PPO/HMO/WC	$659.25

LEAD ISOFLEX OPTIM LV 1948/52

Facility

$4,395.00

Hospital Charge Code	270655929C
Hospital Revenue Code	275
Min. Negotiated Rate	$659.25
Max. Negotiated Rate	$2,197.50
Rate for Payer: Aetna Commercial	$1,318.50
Rate for Payer: Aetna Medicare Advantage	$1,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,120.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,120.72
Rate for Payer: Cigna Commercial	$2,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.59
Rate for Payer: Qualcare PPO/HMO/WC	$659.25

LEAD ISOFLEX VENT 52cm 1646T

Facility

$3,875.00

Hospital Charge Code	270642138
Hospital Revenue Code	275
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LEAD ISOFLEX VENT 52cm 1646T

Facility

$3,875.00

Hospital Charge Code	270642138
Hospital Revenue Code	275
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LEAD ISOFLEX VENT 52CM 1646T

Facility

$4,040.00

Hospital Charge Code	270642138C
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,212.00
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

Know your out-of-pocket cost for care.

All Charges