Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLN EC 8x20mm AB35W08020080

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270644473C
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$257.25
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLN EC 8X60X80 AB35W08060080

Facility

$725.00

Hospital Charge Code	270644036V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC 8X60X80 AB35W08060080

Facility

$725.00

Hospital Charge Code	270644036V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BALLN EC PT 6x60 AB35W06060135

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270639644C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$204.33
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALLN EC PT 6x60 AB35W06060135

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270639644C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALL NIN OTW 2 5x15 563FX125

Facility

$1,099.45

Hospital Charge Code	270638555C
Hospital Revenue Code	278
Min. Negotiated Rate	$164.92
Max. Negotiated Rate	$549.73
Rate for Payer: Aetna Commercial	$329.83
Rate for Payer: Aetna Medicare Advantage	$329.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.36
Rate for Payer: Cigna Commercial	$549.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.07
Rate for Payer: Qualcare PPO/HMO/WC	$164.92

BALL NIN OTW 2 5x15 563FX125

Facility

$1,099.45

Hospital Charge Code	270638555
Hospital Revenue Code	272
Min. Negotiated Rate	$142.93
Max. Negotiated Rate	$549.73
Rate for Payer: Aetna Commercial	$329.83
Rate for Payer: Aetna Medicare Advantage	$329.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.36
Rate for Payer: Cigna Commercial	$549.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.93
Rate for Payer: Oxford Commercial	$549.73
Rate for Payer: Qualcare PPO/HMO/WC	$164.92
Rate for Payer: UnitedHealthcare Commercial	$549.73

BALL NIN OTW 2 5x15 563FX125

Facility

$1,099.45

Hospital Charge Code	270638555C
Hospital Revenue Code	278
Min. Negotiated Rate	$164.92
Max. Negotiated Rate	$266.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.07
Rate for Payer: Qualcare PPO/HMO/WC	$164.92

BALL NIN OTW 2 5x15 563FX125

Facility

$1,099.45

Hospital Charge Code	270638555
Hospital Revenue Code	272
Min. Negotiated Rate	$164.92
Max. Negotiated Rate	$164.92
Rate for Payer: Qualcare PPO/HMO/WC	$164.92

BALLN MAV MN 2.25x15 389281522

Facility

$1,295.00

Hospital Charge Code	270639395C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLN MAV MN 2.25x15 389281522

Facility

$1,295.00

Hospital Charge Code	270639395C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLN MAV MON 2.75X9 389280927

Facility

$1,475.00

Hospital Charge Code	270639396
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

BALLN MAV MON 2.75X9 389280927

Facility

$1,475.00

Hospital Charge Code	270639396
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

BALLN MAV MON 3.5x20 389282035

Facility

$1,295.00

Hospital Charge Code	270639400C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLN MAV MON 3.5x20 389282035

Facility

$1,295.00

Hospital Charge Code	270639400C
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLN NCR 3x210 AB14W035210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644346C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLN NCR 3x210 AB14W035210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644346C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$555.66
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLN NIN OTW 2 75x15 563FX127

Facility

$1,099.45

Hospital Charge Code	270638319
Hospital Revenue Code	278
Min. Negotiated Rate	$164.92
Max. Negotiated Rate	$549.73
Rate for Payer: Aetna Commercial	$329.83
Rate for Payer: Aetna Medicare Advantage	$329.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.36
Rate for Payer: Cigna Commercial	$549.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.07
Rate for Payer: Qualcare PPO/HMO/WC	$164.92

BALLN NIN OTW 2 75x15 563FX127

Facility

$1,099.45

Hospital Charge Code	270638319
Hospital Revenue Code	278
Min. Negotiated Rate	$164.92
Max. Negotiated Rate	$266.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.07
Rate for Payer: Qualcare PPO/HMO/WC	$164.92

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658
Hospital Revenue Code	278
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$508.43
Rate for Payer: Aetna Commercial	$305.06
Rate for Payer: Aetna Medicare Advantage	$305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.30
Rate for Payer: Cigna Commercial	$508.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658V
Hospital Revenue Code	278
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$508.43
Rate for Payer: Aetna Commercial	$305.06
Rate for Payer: Aetna Medicare Advantage	$305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.30
Rate for Payer: Cigna Commercial	$508.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658
Hospital Revenue Code	278
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$246.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

BALLN OCCLN LG 30 LDOB63510030

Facility

$1,016.85

Hospital Charge Code	270633658V
Hospital Revenue Code	278
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$246.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.08
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$82.88
Max. Negotiated Rate	$276.25
Rate for Payer: Aetna Commercial	$165.75
Rate for Payer: Aetna Medicare Advantage	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.89
Rate for Payer: Cigna Commercial	$276.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: Qualcare PPO/HMO/WC	$82.88

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$82.88
Max. Negotiated Rate	$133.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: Qualcare PPO/HMO/WC	$82.88

Know your out-of-pocket cost for care.

All Charges