Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON CATH SDS 7FR 9x2 135cm

Facility

$1,080.00

Hospital Charge Code	270635775
Hospital Revenue Code	272
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

BALLOON CATH SDS 7FR 9x2 135cm

Facility

$1,080.00

Hospital Charge Code	270635775
Hospital Revenue Code	272
Min. Negotiated Rate	$140.40
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$324.00
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.40
Rate for Payer: Oxford Commercial	$540.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Commercial	$540.00

BALLOON CATH SL OTW 4x150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270670064
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$821.42
Rate for Payer: Aetna Commercial	$492.86
Rate for Payer: Aetna Medicare Advantage	$492.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.93
Rate for Payer: Cigna Commercial	$821.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

BALLOON CATH SL OTW 4x150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270670064
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$397.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

BALLOON CATH SYNERGY 10-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625144
Hospital Revenue Code	272
Min. Negotiated Rate	$176.15
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$677.50
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$677.50

BALLOON CATH SYNERGY 10-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625144
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

BALLOON CATH SYNERGY 4-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625129
Hospital Revenue Code	272
Min. Negotiated Rate	$176.15
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$677.50
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$677.50

BALLOON CATH SYNERGY 4-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625129
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

BALLOON CATH SYNERGY 4-4 75cm

Facility

$1,355.00

Hospital Charge Code	270625130
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

BALLOON CATH SYNERGY 4-4 75cm

Facility

$1,355.00

Hospital Charge Code	270625130
Hospital Revenue Code	272
Min. Negotiated Rate	$176.15
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$677.50
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$677.50

BALLOON CATH SYNERGY 5-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625131
Hospital Revenue Code	272
Min. Negotiated Rate	$176.15
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$677.50
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$677.50

BALLOON CATH SYNERGY 5-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625131
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

BALLOON CATH SYNERGY 5-4 75cm

Facility

$875.00

Hospital Charge Code	270625133
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

BALLOON CATH SYNERGY 5-4 75cm

Facility

$875.00

Hospital Charge Code	270625133
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BALLOON CATH SYNERGY 6-2 135cm

Facility

$1,430.00

Hospital Charge Code	270625136
Hospital Revenue Code	272
Min. Negotiated Rate	$185.90
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Aetna Commercial	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.90
Rate for Payer: Oxford Commercial	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Commercial	$715.00

BALLOON CATH SYNERGY 6-2 135cm

Facility

$1,430.00

Hospital Charge Code	270625136
Hospital Revenue Code	272
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

BALLOON CATH SYNERGY 6-2 75cm

Facility

$875.00

Hospital Charge Code	270625135
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

BALLOON CATH SYNERGY 6-2 75cm

Facility

$875.00

Hospital Charge Code	270625135
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BALLOON CATH SYNERGY 6-4 135cm

Facility

$1,930.00

Hospital Charge Code	270625138
Hospital Revenue Code	272
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$289.50
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

BALLOON CATH SYNERGY 6-4 135cm

Facility

$1,930.00

Hospital Charge Code	270625138
Hospital Revenue Code	272
Min. Negotiated Rate	$250.90
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$579.00
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.90
Rate for Payer: Oxford Commercial	$965.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.50
Rate for Payer: UnitedHealthcare Commercial	$965.00

BALLOON CATH SYNERGY 7-2 75cm

Facility

$875.00

Hospital Charge Code	270625139
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BALLOON CATH SYNERGY 7-2 75cm

Facility

$875.00

Hospital Charge Code	270625139
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

BALLOON CATH SYNERGY 9-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625142
Hospital Revenue Code	272
Min. Negotiated Rate	$176.15
Max. Negotiated Rate	$677.50
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$406.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$345.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$345.52
Rate for Payer: Cigna Commercial	$677.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.15
Rate for Payer: Oxford Commercial	$677.50
Rate for Payer: Qualcare PPO/HMO/WC	$203.25
Rate for Payer: UnitedHealthcare Commercial	$677.50

BALLOON CATH SYNERGY 9-2 75cm

Facility

$1,355.00

Hospital Charge Code	270625142
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

BALLOON CATH SYNERGY 9-4 75cm

Facility

$1,355.00

Hospital Charge Code	270625143
Hospital Revenue Code	272
Min. Negotiated Rate	$203.25
Max. Negotiated Rate	$203.25
Rate for Payer: Qualcare PPO/HMO/WC	$203.25

Know your out-of-pocket cost for care.

All Charges