Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEAD PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
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 PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
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 PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
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 PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
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 PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
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 PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
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 PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
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 PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
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 PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

LEAD PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

LEAD PASVE ATRIAL BIPOLAR 4592

Facility

$3,348.00

Hospital Charge Code	270629894
Hospital Revenue Code	275
Min. Negotiated Rate	$502.20
Max. Negotiated Rate	$1,674.00
Rate for Payer: Aetna Commercial	$1,004.40
Rate for Payer: Aetna Medicare Advantage	$1,004.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$853.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$853.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$669.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$853.74
Rate for Payer: Cigna Commercial	$1,674.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.22
Rate for Payer: Qualcare PPO/HMO/WC	$502.20

LEAD PASVE ATRIAL BIPOLAR 4592

Facility

$3,348.00

Hospital Charge Code	270629894
Hospital Revenue Code	275
Min. Negotiated Rate	$502.20
Max. Negotiated Rate	$810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$669.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.22
Rate for Payer: Qualcare PPO/HMO/WC	$502.20

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,224.00

Service Code	HCPCS C1779
Hospital Charge Code	270633849
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,465.00

Hospital Charge Code	270633849C
Hospital Revenue Code	275
Min. Negotiated Rate	$519.75
Max. Negotiated Rate	$1,732.50
Rate for Payer: Aetna Commercial	$1,039.50
Rate for Payer: Aetna Medicare Advantage	$1,039.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$883.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$883.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$693.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$883.58
Rate for Payer: Cigna Commercial	$1,732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.53
Rate for Payer: Qualcare PPO/HMO/WC	$519.75

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,224.00

Service Code	HCPCS C1779
Hospital Charge Code	270633849
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$967.20
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PCEMAKER VENTRICLE 407658

Facility

$3,465.00

Hospital Charge Code	270633849C
Hospital Revenue Code	275
Min. Negotiated Rate	$519.75
Max. Negotiated Rate	$838.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$693.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.53
Rate for Payer: Qualcare PPO/HMO/WC	$519.75

LEAD PCEMKR 5024M-58****

Facility

$1,875.00

Hospital Charge Code	270608506
Hospital Revenue Code	275
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

LEAD PCEMKR 5024M-58****

Facility

$1,875.00

Hospital Charge Code	270608506
Hospital Revenue Code	275
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

LEAD PCEMKR CPSRE NVUS 6092-58

Facility

$2,940.00

Hospital Charge Code	270647014C
Hospital Revenue Code	275
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$711.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.48
Rate for Payer: Qualcare PPO/HMO/WC	$441.00

LEAD PCEMKR CPSRE NVUS 6092-58

Facility

$2,940.00

Hospital Charge Code	270647014C
Hospital Revenue Code	275
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$1,470.00
Rate for Payer: Aetna Commercial	$882.00
Rate for Payer: Aetna Medicare Advantage	$882.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.70
Rate for Payer: Cigna Commercial	$1,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.48
Rate for Payer: Qualcare PPO/HMO/WC	$441.00

LEAD PEDIATRIC

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001770
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

LEAD PEDIATRIC

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001770
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 PENTA 3228

Facility

$39,250.00

Service Code	HCPCS C1778
Hospital Charge Code	270693177
Hospital Revenue Code	278
Min. Negotiated Rate	$5,887.50
Max. Negotiated Rate	$9,498.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,498.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,887.50

LEAD PENTA 3228

Facility

$39,250.00

Service Code	HCPCS C1778
Hospital Charge Code	270693177
Hospital Revenue Code	278
Min. Negotiated Rate	$5,887.50
Max. Negotiated Rate	$19,625.00
Rate for Payer: Aetna Commercial	$11,775.00
Rate for Payer: Aetna Medicare Advantage	$11,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,008.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,008.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,008.75
Rate for Payer: Cigna Commercial	$19,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,498.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,887.50

LEAD PISCES QD COMP 33c 388733

Facility

$6,646.45

Hospital Charge Code	270631618
Hospital Revenue Code	275
Min. Negotiated Rate	$996.97
Max. Negotiated Rate	$1,608.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.44
Rate for Payer: Qualcare PPO/HMO/WC	$996.97

Know your out-of-pocket cost for care.

All Charges