Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISOFLEX VENTRICULAR 58CM

Facility

$4,040.00

Hospital Charge Code	270645678C
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISOFLEX VENTRICULAR 58CM

Facility

$4,040.00

Hospital Charge Code	270645678C
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

LEAD ISOFLEX VETNRICULAR 58cm

Facility

$4,040.00

Hospital Charge Code	270645678
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD ISOFLEX VETNRICULAR 58cm

Facility

$4,040.00

Hospital Charge Code	270645678
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

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

LEAD KIT 50 8 CON LIN SC221850

Facility

$12,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270641627
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

LEAD KIT 50 8 CON LIN SC221850

Facility

$12,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270641627
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$8,712.50
Rate for Payer: Aetna Commercial	$5,227.50
Rate for Payer: Aetna Medicare Advantage	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,443.38
Rate for Payer: Cigna Commercial	$8,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$4,216.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$726.00
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

LEAD MEDT PCEMKER 5092-52CM

Facility

$3,589.65

Hospital Charge Code	270626470C
Hospital Revenue Code	275
Min. Negotiated Rate	$538.45
Max. Negotiated Rate	$1,794.83
Rate for Payer: Aetna Commercial	$1,076.89
Rate for Payer: Aetna Medicare Advantage	$1,076.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$915.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$915.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$717.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$915.36
Rate for Payer: Cigna Commercial	$1,794.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$868.70
Rate for Payer: Qualcare PPO/HMO/WC	$538.45

LEAD MEDT PCEMKER 5092-52CM

Facility

$3,589.65

Hospital Charge Code	270626470C
Hospital Revenue Code	275
Min. Negotiated Rate	$538.45
Max. Negotiated Rate	$868.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$717.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$868.70
Rate for Payer: Qualcare PPO/HMO/WC	$538.45

Know your out-of-pocket cost for care.

All Charges