Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLN VOY NC 5.0x12 101176012

Facility

$1,275.00

Hospital Charge Code	270643185C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY NC 5.0x12 101176012

Facility

$1,275.00

Hospital Charge Code	270643185V
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY NC 5.0x12 101176012

Facility

$1,275.00

Hospital Charge Code	270643185V
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY NC 5.0x12 101176012

Facility

$1,275.00

Hospital Charge Code	270643185C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 1.5x15 100943815

Facility

$1,275.00

Hospital Charge Code	270643790C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 1.5x15 100943815

Facility

$1,275.00

Hospital Charge Code	270643790C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x12 100943912

Facility

$1,275.00

Hospital Charge Code	270642994V
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x12 100943912

Facility

$1,275.00

Hospital Charge Code	270642994V
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x15 100943915

Facility

$1,275.00

Hospital Charge Code	270643414C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x15 100943915

Facility

$1,275.00

Hospital Charge Code	270643414C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x8 100943908

Facility

$1,275.00

Hospital Charge Code	270643794C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 2.0x8 100943908

Facility

$1,275.00

Hospital Charge Code	270643794C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 4.0x15 100944715

Facility

$1,275.00

Hospital Charge Code	270643415C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY OTW 4.0x15 100944715

Facility

$1,275.00

Hospital Charge Code	270643415C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.0x15M 101139215

Facility

$1,275.00

Hospital Charge Code	270643122C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.0x15M 101139215

Facility

$1,275.00

Hospital Charge Code	270643122C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.25x15 101139315

Facility

$1,275.00

Hospital Charge Code	270643198C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.25x15 101139315

Facility

$1,275.00

Hospital Charge Code	270643198C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.50X15 100944115

Facility

$1,275.00

Hospital Charge Code	270643388C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.50X15 100944115

Facility

$1,275.00

Hospital Charge Code	270643388C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.75x15 101139515

Facility

$1,275.00

Hospital Charge Code	270643078C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 2.75x15 101139515

Facility

$1,275.00

Hospital Charge Code	270643078C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 3.5x15 101139815

Facility

$1,275.00

Hospital Charge Code	270643211C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLN VOY RX 3.5x15 101139815

Facility

$1,275.00

Hospital Charge Code	270643211C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

BALLONCATHOCCLSCEPTERC4X20MM

Facility

$8,125.00

Service Code	HCPCS C2628
Hospital Charge Code	270693919S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

Know your out-of-pocket cost for care.

All Charges