Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x40x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673707
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x60x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673624
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x60x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673624
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6X60X130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673624S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6X60X130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673624S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623O
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623O
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 6x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673623
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x60x130

Facility

$7,050.00

Hospital Charge Code	270673877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x60x130

Facility

$7,050.00

Hospital Charge Code	270673877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673871S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673871S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673871
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$3,525.00
Rate for Payer: Aetna Commercial	$2,115.00
Rate for Payer: Aetna Medicare Advantage	$2,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,797.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,797.75
Rate for Payer: Cigna Commercial	$3,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673871
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

BALLOON ADMIRAL INP 7x80x130

Facility

$7,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270673871N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,057.50
Max. Negotiated Rate	$1,706.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,057.50

Know your out-of-pocket cost for care.

All Charges