Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON CATH SYNERGY 9-4 75cm

Facility

$1,355.00

Hospital Charge Code	270625143
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 XXL 12-4/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270623292
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-4/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270623292
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-4/5.8/75CM

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270623292C
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-4/5.8/75CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270623292N
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BALLOON CATH XXL 12-4/5.8/75CM

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270623292C
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-4/5.8/75CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270623292N
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885N
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885S
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885N
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 12-6/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270626885S
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 14-2/5.8/75cm

Facility

$1,421.40

Hospital Charge Code	270623530
Hospital Revenue Code	272
Min. Negotiated Rate	$213.21
Max. Negotiated Rate	$213.21
Rate for Payer: Qualcare PPO/HMO/WC	$213.21

BALLOON CATH XXL 14-2/5.8/75cm

Facility

$1,421.40

Hospital Charge Code	270623530
Hospital Revenue Code	272
Min. Negotiated Rate	$184.78
Max. Negotiated Rate	$710.70
Rate for Payer: Aetna Commercial	$426.42
Rate for Payer: Aetna Medicare Advantage	$426.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.46
Rate for Payer: Cigna Commercial	$710.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.78
Rate for Payer: Oxford Commercial	$710.70
Rate for Payer: Qualcare PPO/HMO/WC	$213.21
Rate for Payer: UnitedHealthcare Commercial	$710.70

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270624069
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270624069S
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270624069
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270624069S
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270624069N
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$716.38
Rate for Payer: Aetna Commercial	$429.82
Rate for Payer: Aetna Medicare Advantage	$429.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.35
Rate for Payer: Cigna Commercial	$716.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 14-4/5.8/75cm

Facility

$1,432.75

Service Code	HCPCS C1725
Hospital Charge Code	270624069N
Hospital Revenue Code	278
Min. Negotiated Rate	$214.91
Max. Negotiated Rate	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.73
Rate for Payer: Qualcare PPO/HMO/WC	$214.91

BALLOON CATH XXL 14-6/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270626886
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 14-6/5.8/75cm

Facility

$1,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270626886
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

BALLOON CATH XXL 16-2/5.8/75E

Facility

$1,697.50

Hospital Charge Code	270621572
Hospital Revenue Code	272
Min. Negotiated Rate	$220.68
Max. Negotiated Rate	$848.75
Rate for Payer: Aetna Commercial	$509.25
Rate for Payer: Aetna Medicare Advantage	$509.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.86
Rate for Payer: Cigna Commercial	$848.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.68
Rate for Payer: Oxford Commercial	$848.75
Rate for Payer: Qualcare PPO/HMO/WC	$254.62
Rate for Payer: UnitedHealthcare Commercial	$848.75

BALLOON CATH XXL 16-2/5.8/75E

Facility

$1,697.50

Hospital Charge Code	270621572
Hospital Revenue Code	272
Min. Negotiated Rate	$254.62
Max. Negotiated Rate	$254.62
Rate for Payer: Qualcare PPO/HMO/WC	$254.62

Know your out-of-pocket cost for care.

All Charges