Heights University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER XT SR AZURE SURESCAN

Facility

$21,725.00

Service Code	HCPCS C1785
Hospital Charge Code	270681678C
Hospital Revenue Code	278
Min. Negotiated Rate	$3,258.75
Max. Negotiated Rate	$10,862.50
Rate for Payer: Aetna Commercial	$6,517.50
Rate for Payer: Aetna Medicare Advantage	$6,517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,539.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,539.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,539.88
Rate for Payer: Cigna Commercial	$10,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,258.75

PACEMAKER XT SR AZURE SURESCAN

Facility

$18,683.50

Service Code	HCPCS C1785
Hospital Charge Code	270681678
Hospital Revenue Code	278
Min. Negotiated Rate	$2,802.53
Max. Negotiated Rate	$9,341.75
Rate for Payer: Aetna Commercial	$5,605.05
Rate for Payer: Aetna Medicare Advantage	$5,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,764.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,764.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,736.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,764.29
Rate for Payer: Cigna Commercial	$9,341.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,521.41
Rate for Payer: Qualcare PPO/HMO/WC	$2,802.53

PACEMAKER ZEPHYR SR SSIR 5620

Facility

$28,475.00

Hospital Charge Code	270642137
Hospital Revenue Code	275
Min. Negotiated Rate	$4,271.25
Max. Negotiated Rate	$14,237.50
Rate for Payer: Aetna Commercial	$8,542.50
Rate for Payer: Aetna Medicare Advantage	$8,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,261.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,261.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,261.12
Rate for Payer: Cigna Commercial	$14,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,890.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,271.25

PACEMAKER ZEPHYR SR SSIR 5620

Facility

$28,475.00

Hospital Charge Code	270642137
Hospital Revenue Code	275
Min. Negotiated Rate	$4,271.25
Max. Negotiated Rate	$6,890.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,890.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,271.25

PACEMAKER ZEPHYR XLSR SIR 5626

Facility

$30,210.00

Service Code	HCPCS C1786
Hospital Charge Code	270645677N
Hospital Revenue Code	275
Min. Negotiated Rate	$4,531.50
Max. Negotiated Rate	$15,105.00
Rate for Payer: Aetna Commercial	$9,063.00
Rate for Payer: Aetna Medicare Advantage	$9,063.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,703.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,703.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,703.55
Rate for Payer: Cigna Commercial	$15,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,310.82
Rate for Payer: Qualcare PPO/HMO/WC	$4,531.50

PACEMAKER ZEPHYR XLSR SIR 5626

Facility

$25,175.00

Service Code	HCPCS C1786
Hospital Charge Code	270645677C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,776.25
Max. Negotiated Rate	$6,092.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,092.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,776.25

PACEMAKER ZEPHYR XLSR SIR 5626

Facility

$25,175.00

Service Code	HCPCS C1786
Hospital Charge Code	270645677C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,776.25
Max. Negotiated Rate	$12,587.50
Rate for Payer: Aetna Commercial	$7,552.50
Rate for Payer: Aetna Medicare Advantage	$7,552.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,419.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,419.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,419.62
Rate for Payer: Cigna Commercial	$12,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,092.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,776.25

PACEMAKER ZEPHYR XLSR SIR 5626

Facility

$30,210.00

Service Code	HCPCS C1786
Hospital Charge Code	270645677N
Hospital Revenue Code	275
Min. Negotiated Rate	$4,531.50
Max. Negotiated Rate	$7,310.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,042.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,310.82
Rate for Payer: Qualcare PPO/HMO/WC	$4,531.50

PACEMKR ALTRA 60SSIR IS-1 S601

Facility

$22,500.00

Hospital Charge Code	270644194
Hospital Revenue Code	275
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

PACEMKR ALTRA 60SSIR IS-1 S601

Facility

$22,500.00

Hospital Charge Code	270644194
Hospital Revenue Code	275
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

PACEMKR ENPUL DUL CHAMB E2DRO3

Facility

$30,504.00

Hospital Charge Code	270633746C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,575.60
Max. Negotiated Rate	$15,252.00
Rate for Payer: Aetna Commercial	$9,151.20
Rate for Payer: Aetna Medicare Advantage	$9,151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,778.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,778.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,778.52
Rate for Payer: Cigna Commercial	$15,252.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.60

PACEMKR ENPUL DUL CHAMB E2DRO3

Facility

$30,504.00

Hospital Charge Code	270633746
Hospital Revenue Code	275
Min. Negotiated Rate	$4,575.60
Max. Negotiated Rate	$15,252.00
Rate for Payer: Aetna Commercial	$9,151.20
Rate for Payer: Aetna Medicare Advantage	$9,151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,778.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,778.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,778.52
Rate for Payer: Cigna Commercial	$15,252.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.60

PACEMKR ENPUL DUL CHAMB E2DRO3

Facility

$30,504.00

Hospital Charge Code	270633746
Hospital Revenue Code	275
Min. Negotiated Rate	$4,575.60
Max. Negotiated Rate	$7,381.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.60

PACEMKR ENPUL DUL CHAMB E2DRO3

Facility

$30,504.00

Hospital Charge Code	270633746C
Hospital Revenue Code	275
Min. Negotiated Rate	$4,575.60
Max. Negotiated Rate	$7,381.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.60

PACEMKR IDENTY ADX XL DR 5386

Facility

$31,223.25

Hospital Charge Code	270633049
Hospital Revenue Code	275
Min. Negotiated Rate	$4,683.49
Max. Negotiated Rate	$15,611.62
Rate for Payer: Aetna Commercial	$9,366.98
Rate for Payer: Aetna Medicare Advantage	$9,366.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,961.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,961.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,244.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,961.93
Rate for Payer: Cigna Commercial	$15,611.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,556.03
Rate for Payer: Qualcare PPO/HMO/WC	$4,683.49

PACEMKR IDENTY ADX XL DR 5386

Facility

$31,223.25

Hospital Charge Code	270633049
Hospital Revenue Code	275
Min. Negotiated Rate	$4,683.49
Max. Negotiated Rate	$7,556.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,244.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,556.03
Rate for Payer: Qualcare PPO/HMO/WC	$4,683.49

PACEMKR KPA S RATE RESP KSR906

Facility

$26,536.00

Hospital Charge Code	270633461
Hospital Revenue Code	275
Min. Negotiated Rate	$3,980.40
Max. Negotiated Rate	$13,268.00
Rate for Payer: Aetna Commercial	$7,960.80
Rate for Payer: Aetna Medicare Advantage	$7,960.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,766.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,766.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,307.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,766.68
Rate for Payer: Cigna Commercial	$13,268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,421.71
Rate for Payer: Qualcare PPO/HMO/WC	$3,980.40

PACEMKR KPA S RATE RESP KSR906

Facility

$26,536.00

Hospital Charge Code	270633461C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,980.40
Max. Negotiated Rate	$6,421.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,307.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,421.71
Rate for Payer: Qualcare PPO/HMO/WC	$3,980.40

PACEMKR KPA S RATE RESP KSR906

Facility

$26,536.00

Hospital Charge Code	270633461
Hospital Revenue Code	275
Min. Negotiated Rate	$3,980.40
Max. Negotiated Rate	$6,421.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,307.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,421.71
Rate for Payer: Qualcare PPO/HMO/WC	$3,980.40

PACEMKR KPA S RATE RESP KSR906

Facility

$26,536.00

Hospital Charge Code	270633461C
Hospital Revenue Code	275
Min. Negotiated Rate	$3,980.40
Max. Negotiated Rate	$13,268.00
Rate for Payer: Aetna Commercial	$7,960.80
Rate for Payer: Aetna Medicare Advantage	$7,960.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,766.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,766.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,307.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,766.68
Rate for Payer: Cigna Commercial	$13,268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,421.71
Rate for Payer: Qualcare PPO/HMO/WC	$3,980.40

PACER TEMP INSERTION

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	5100102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,763.76
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$4,070.22
Rate for Payer: Aetna Medicare Advantage	$4,070.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,459.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,459.69
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	$3,459.69
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,763.76
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PACER TEMP INSERTION

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	74110014
Hospital Revenue Code	361
Min. Negotiated Rate	$1,763.76
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$4,070.22
Rate for Payer: Aetna Medicare Advantage	$4,070.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,459.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,459.69
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	$3,459.69
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,763.76
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PACER TEMP INSERTION

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	5100102
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.11
Max. Negotiated Rate	$2,035.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11

PACER TEMP INSERTION

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	74110014
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.11
Max. Negotiated Rate	$2,035.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11

Pacific Plus 2.5x120x180

Facility

$1,047.40

Service Code	HCPCS C1725
Hospital Charge Code	270683470
Hospital Revenue Code	278
Min. Negotiated Rate	$157.11
Max. Negotiated Rate	$253.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Qualcare PPO/HMO/WC	$157.11

Know your out-of-pocket cost for care.

All Charges