Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOONCRE WG 12-15mm 240cm

Facility

$1,070.00

Hospital Charge Code	270664036
Hospital Revenue Code	272
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOONCRE WG 12-15mm 240cm

Facility

$1,070.00

Hospital Charge Code	270664036
Hospital Revenue Code	272
Min. Negotiated Rate	$139.10
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$321.00
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.10
Rate for Payer: Oxford Commercial	$535.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Commercial	$535.00

BALLOONCRE WG 6-8mm240cm

Facility

$1,070.00

Hospital Charge Code	270654307
Hospital Revenue Code	272
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOONCRE WG 6-8mm240cm

Facility

$1,070.00

Hospital Charge Code	270654307
Hospital Revenue Code	272
Min. Negotiated Rate	$139.10
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$321.00
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.10
Rate for Payer: Oxford Commercial	$535.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Commercial	$535.00

BALLOON CRE WG 8-10mm

Facility

$1,070.00

Service Code	HCPCS C1725
Hospital Charge Code	270627706
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$258.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOON CRE WG 8-10mm

Facility

$1,070.00

Service Code	HCPCS C1725
Hospital Charge Code	270627706
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$321.00
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOONCRE WG 8-10Mm 240cm

Facility

$1,070.00

Hospital Charge Code	270658593
Hospital Revenue Code	272
Min. Negotiated Rate	$139.10
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$321.00
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.10
Rate for Payer: Oxford Commercial	$535.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Commercial	$535.00

BALLOONCRE WG 8-10Mm 240cm

Facility

$1,070.00

Hospital Charge Code	270658593
Hospital Revenue Code	272
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOON CRE WG COLONIC 18-20MM

Facility

$1,195.00

Service Code	HCPCS C1729
Hospital Charge Code	270654316
Hospital Revenue Code	278
Min. Negotiated Rate	$179.25
Max. Negotiated Rate	$289.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$239.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.19
Rate for Payer: Qualcare PPO/HMO/WC	$179.25

BALLOON CRE WG COLONIC 18-20MM

Facility

$1,195.00

Service Code	HCPCS C1729
Hospital Charge Code	270654316
Hospital Revenue Code	278
Min. Negotiated Rate	$179.25
Max. Negotiated Rate	$597.50
Rate for Payer: Aetna Commercial	$358.50
Rate for Payer: Aetna Medicare Advantage	$358.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$304.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$304.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$239.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$304.73
Rate for Payer: Cigna Commercial	$597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.19
Rate for Payer: Qualcare PPO/HMO/WC	$179.25

BALLOON CRE WG PYLORIC 18-20mm

Facility

$1,070.00

Service Code	HCPCS C1725
Hospital Charge Code	270654304
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$321.00
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOON CRE WG PYLORIC 18-20mm

Facility

$1,070.00

Service Code	HCPCS C1725
Hospital Charge Code	270654304
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$258.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

BALLOON CRYO 4x100

Facility

$4,500.00

Hospital Charge Code	270638597
Hospital Revenue Code	272
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$2,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$2,250.00

BALLOON CRYO 4x100

Facility

$4,500.00

Hospital Charge Code	270638597
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

BALLOON CUTTING 4x1.5x140cm

Facility

$3,517.50

Hospital Charge Code	270642206
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$851.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 4x1.5x140cm

Facility

$4,113.50

Hospital Charge Code	270642206C
Hospital Revenue Code	278
Min. Negotiated Rate	$617.02
Max. Negotiated Rate	$2,056.75
Rate for Payer: Aetna Commercial	$1,234.05
Rate for Payer: Aetna Medicare Advantage	$1,234.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,048.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,048.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,048.94
Rate for Payer: Cigna Commercial	$2,056.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.47
Rate for Payer: Qualcare PPO/HMO/WC	$617.02

BALLOON CUTTING 4x1.5x140cm

Facility

$4,113.50

Hospital Charge Code	270642206C
Hospital Revenue Code	278
Min. Negotiated Rate	$617.02
Max. Negotiated Rate	$995.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.47
Rate for Payer: Qualcare PPO/HMO/WC	$617.02

BALLOON CUTTING 4x1.5x140cm

Facility

$3,517.50

Hospital Charge Code	270642206
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$1,758.75
Rate for Payer: Aetna Commercial	$1,055.25
Rate for Payer: Aetna Medicare Advantage	$1,055.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$896.96
Rate for Payer: Cigna Commercial	$1,758.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 5x2x135cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270642207
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$1,758.75
Rate for Payer: Aetna Commercial	$1,055.25
Rate for Payer: Aetna Medicare Advantage	$1,055.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$896.96
Rate for Payer: Cigna Commercial	$1,758.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 5x2x135cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270642207
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$851.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 6x2x135cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270642209
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$851.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 6x2x135cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270642209
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$1,758.75
Rate for Payer: Aetna Commercial	$1,055.25
Rate for Payer: Aetna Medicare Advantage	$1,055.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$896.96
Rate for Payer: Cigna Commercial	$1,758.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 6x90cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270633879
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$1,758.75
Rate for Payer: Aetna Commercial	$1,055.25
Rate for Payer: Aetna Medicare Advantage	$1,055.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$896.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$896.96
Rate for Payer: Cigna Commercial	$1,758.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 6x90cm

Facility

$3,517.50

Service Code	HCPCS C1725
Hospital Charge Code	270633879
Hospital Revenue Code	278
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$851.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$703.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

BALLOON CUTTING 6X90CM

Facility

$4,330.00

Hospital Charge Code	270633879C
Hospital Revenue Code	278
Min. Negotiated Rate	$649.50
Max. Negotiated Rate	$2,165.00
Rate for Payer: Aetna Commercial	$1,299.00
Rate for Payer: Aetna Medicare Advantage	$1,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.15
Rate for Payer: Cigna Commercial	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.86
Rate for Payer: Qualcare PPO/HMO/WC	$649.50

Know your out-of-pocket cost for care.

All Charges