Heights University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER REPLACE PULSE GEN***

Facility

$517.00

Service Code	HCPCS 33212
Hospital Charge Code	5100197
Hospital Revenue Code	489
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

PACEMAKER REPLACE PULSE GEN***

Facility

$517.00

Service Code	HCPCS 33212
Hospital Charge Code	5100197
Hospital Revenue Code	489
Min. Negotiated Rate	$67.21
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$155.10
Rate for Payer: Aetna Medicare Advantage	$155.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.84
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.21
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

PACEMAKER REPLC PUL GEN DUAL

Facility

$49,497.70

Service Code	HCPCS 33213
Hospital Charge Code	5100290
Hospital Revenue Code	361
Min. Negotiated Rate	$7,424.65
Max. Negotiated Rate	$7,424.65
Rate for Payer: Qualcare PPO/HMO/WC	$7,424.65

PACEMAKER REPLC PUL GEN DUAL

Facility

$49,497.70

Service Code	HCPCS 33213
Hospital Charge Code	74110032
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$14,849.31
Rate for Payer: Aetna Medicare Advantage	$14,849.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,621.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,621.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,621.91
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,434.70
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,424.65
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,790.24

PACEMAKER REPLC PUL GEN DUAL

Facility

$49,497.70

Service Code	HCPCS 33213
Hospital Charge Code	5100290
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$14,849.31
Rate for Payer: Aetna Medicare Advantage	$14,849.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,621.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,621.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,621.91
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,434.70
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,424.65
Rate for Payer: UnitedHealthcare Commercial	$10,997.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,790.24

PACEMAKER REPLC PUL GEN DUAL

Facility

$49,497.70

Service Code	HCPCS 33213
Hospital Charge Code	74110032
Hospital Revenue Code	361
Min. Negotiated Rate	$7,424.65
Max. Negotiated Rate	$7,424.65
Rate for Payer: Qualcare PPO/HMO/WC	$7,424.65

PACEMAKER REPLC PUL GEN SNGL

Facility

$43,734.25

Service Code	HCPCS 33212
Hospital Charge Code	5100280
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$13,120.27
Rate for Payer: Aetna Medicare Advantage	$13,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,152.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,152.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,152.23
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,685.45
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,560.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PACEMAKER REPLC PUL GEN SNGL

Facility

$43,734.25

Service Code	HCPCS 33212
Hospital Charge Code	74110031
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$13,120.27
Rate for Payer: Aetna Medicare Advantage	$13,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,152.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,152.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,152.23
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,685.45
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,560.14
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

PACEMAKER REPLC PUL GEN SNGL

Facility

$43,734.25

Service Code	HCPCS 33212
Hospital Charge Code	74110031
Hospital Revenue Code	361
Min. Negotiated Rate	$6,560.14
Max. Negotiated Rate	$6,560.14
Rate for Payer: Qualcare PPO/HMO/WC	$6,560.14

PACEMAKER REPLC PUL GEN SNGL

Facility

$43,734.25

Service Code	HCPCS 33212
Hospital Charge Code	5100280
Hospital Revenue Code	361
Min. Negotiated Rate	$6,560.14
Max. Negotiated Rate	$6,560.14
Rate for Payer: Qualcare PPO/HMO/WC	$6,560.14

PACEMAKER REPROG DUAL

Facility

$222.75

Service Code	HCPCS 93732
Hospital Charge Code	5100270
Hospital Revenue Code	921
Min. Negotiated Rate	$28.96
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$66.83
Rate for Payer: Aetna Medicare Advantage	$66.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.80
Rate for Payer: Cigna Commercial	$111.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.96
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.41
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

PACEMAKER REPROG DUAL

Facility

$222.75

Service Code	HCPCS 93732
Hospital Charge Code	5100270
Hospital Revenue Code	921
Min. Negotiated Rate	$33.41
Max. Negotiated Rate	$33.41
Rate for Payer: Qualcare PPO/HMO/WC	$33.41

PACEMAKER REPROG SNGL

Facility

$136.35

Service Code	HCPCS 93735
Hospital Charge Code	5100260
Hospital Revenue Code	921
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$40.91
Rate for Payer: Aetna Medicare Advantage	$40.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.77
Rate for Payer: Cigna Commercial	$68.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.73
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.45
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

PACEMAKER REPROG SNGL

Facility

$136.35

Service Code	HCPCS 93735
Hospital Charge Code	5100260
Hospital Revenue Code	921
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$20.45
Rate for Payer: Qualcare PPO/HMO/WC	$20.45

PACEMAKER SENSIA DR

Facility

$21,540.00

Service Code	HCPCS C1785
Hospital Charge Code	270637991
Hospital Revenue Code	275
Min. Negotiated Rate	$3,231.00
Max. Negotiated Rate	$10,770.00
Rate for Payer: Aetna Commercial	$6,462.00
Rate for Payer: Aetna Medicare Advantage	$6,462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,492.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,492.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,492.70
Rate for Payer: Cigna Commercial	$10,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,212.68
Rate for Payer: Qualcare PPO/HMO/WC	$3,231.00

PACEMAKER SENSIA DR

Facility

$21,540.00

Service Code	HCPCS C1785
Hospital Charge Code	270637991
Hospital Revenue Code	275
Min. Negotiated Rate	$3,231.00
Max. Negotiated Rate	$5,212.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,212.68
Rate for Payer: Qualcare PPO/HMO/WC	$3,231.00

PACEMAKER SENSIA DR SEDR01

Facility

$28,665.00

Hospital Charge Code	270637991C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,299.75
Max. Negotiated Rate	$14,332.50
Rate for Payer: Aetna Commercial	$8,599.50
Rate for Payer: Aetna Medicare Advantage	$8,599.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,309.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,309.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,733.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,309.57
Rate for Payer: Cigna Commercial	$14,332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.75

PACEMAKER SENSIA DR SEDR01

Facility

$28,665.00

Hospital Charge Code	270637991C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,299.75
Max. Negotiated Rate	$6,936.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,733.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.75

PACEMAKER SENSIA SESR01

Facility

$24,475.00

Hospital Charge Code	270638082C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,671.25
Max. Negotiated Rate	$12,237.50
Rate for Payer: Aetna Commercial	$7,342.50
Rate for Payer: Aetna Medicare Advantage	$7,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,241.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,241.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,241.12
Rate for Payer: Cigna Commercial	$12,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,922.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,671.25

PACEMAKER SENSIA SESR01

Facility

$24,475.00

Hospital Charge Code	270638082C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,671.25
Max. Negotiated Rate	$5,922.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,922.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,671.25

PACEMAKER SENSIA SR

Facility

$15,680.00

Service Code	HCPCS C1786
Hospital Charge Code	270638082
Hospital Revenue Code	275
Min. Negotiated Rate	$2,352.00
Max. Negotiated Rate	$7,840.00
Rate for Payer: Aetna Commercial	$4,704.00
Rate for Payer: Aetna Medicare Advantage	$4,704.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,998.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,998.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,998.40
Rate for Payer: Cigna Commercial	$7,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,794.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,352.00

PACEMAKER SENSIA SR

Facility

$15,680.00

Service Code	HCPCS C1786
Hospital Charge Code	270638082
Hospital Revenue Code	275
Min. Negotiated Rate	$2,352.00
Max. Negotiated Rate	$3,794.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,794.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,352.00

PACEMAKER SINGL CHAMBER KSR903

Facility

$25,742.45

Hospital Charge Code	270625758
Hospital Revenue Code	275
Min. Negotiated Rate	$3,861.37
Max. Negotiated Rate	$12,871.23
Rate for Payer: Aetna Commercial	$7,722.73
Rate for Payer: Aetna Medicare Advantage	$7,722.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,564.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,564.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,148.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,564.32
Rate for Payer: Cigna Commercial	$12,871.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,229.67
Rate for Payer: Qualcare PPO/HMO/WC	$3,861.37

PACEMAKER SINGL CHAMBER KSR903

Facility

$25,742.45

Hospital Charge Code	270625758C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,861.37
Max. Negotiated Rate	$12,871.23
Rate for Payer: Aetna Commercial	$7,722.73
Rate for Payer: Aetna Medicare Advantage	$7,722.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,564.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,564.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,148.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,564.32
Rate for Payer: Cigna Commercial	$12,871.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,229.67
Rate for Payer: Qualcare PPO/HMO/WC	$3,861.37

PACEMAKER SINGL CHAMBER KSR903

Facility

$25,742.45

Hospital Charge Code	270625758
Hospital Revenue Code	275
Min. Negotiated Rate	$3,861.37
Max. Negotiated Rate	$6,229.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,148.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,229.67
Rate for Payer: Qualcare PPO/HMO/WC	$3,861.37

Know your out-of-pocket cost for care.

All Charges