Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON E FLEXIBLE ENDOSCOPIC

Facility

$145.20

Hospital Charge Code	270677312
Hospital Revenue Code	272
Min. Negotiated Rate	$21.78
Max. Negotiated Rate	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$21.78

BALLOON E FLEXIBLE ENDOSCOPIC

Facility

$145.20

Hospital Charge Code	270677312
Hospital Revenue Code	272
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$72.60
Rate for Payer: Aetna Commercial	$43.56
Rate for Payer: Aetna Medicare Advantage	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.03
Rate for Payer: Cigna Commercial	$72.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.88
Rate for Payer: Oxford Commercial	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.78
Rate for Payer: UnitedHealthcare Commercial	$72.60

BALLOON ENDOCAVITY 2x14CM NSLF

Facility

$171.00

Hospital Charge Code	270640972
Hospital Revenue Code	272
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

BALLOON ENDOCAVITY 2x14CM NSLF

Facility

$171.00

Hospital Charge Code	270640972
Hospital Revenue Code	272
Min. Negotiated Rate	$22.23
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$85.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$85.50

BALLOON EQUALIZER 7FR 65cm

Facility

$1,236.00

Hospital Charge Code	270623289
Hospital Revenue Code	278
Min. Negotiated Rate	$185.40
Max. Negotiated Rate	$618.00
Rate for Payer: Aetna Commercial	$370.80
Rate for Payer: Aetna Medicare Advantage	$370.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.18
Rate for Payer: Cigna Commercial	$618.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.11
Rate for Payer: Qualcare PPO/HMO/WC	$185.40

BALLOON EQUALIZER 7FR 65cm

Facility

$1,236.00

Hospital Charge Code	270623289
Hospital Revenue Code	278
Min. Negotiated Rate	$185.40
Max. Negotiated Rate	$299.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.11
Rate for Payer: Qualcare PPO/HMO/WC	$185.40

BALLOON EQUILIZER

Facility

$1,493.50

Hospital Charge Code	270655409
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

BALLOON EQUILIZER

Facility

$1,493.50

Hospital Charge Code	270655409
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$746.75
Rate for Payer: Aetna Commercial	$448.05
Rate for Payer: Aetna Medicare Advantage	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.84
Rate for Payer: Cigna Commercial	$746.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

BALLOON EUPHORA 1.5X10MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694587
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X10MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694587S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X10MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694587S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X10MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694587
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X12MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694510
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X12MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694510S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X12MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694510
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X12MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694510S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X15MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694588
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X15MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694588S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X15MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694588
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X15MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694588S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X20MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694592S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X20MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694592
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X20MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694592S
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X20MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694592
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BALLOON EUPHORA 1.5X6MM

Facility

$475.00

Service Code	HCPCS C1725
Hospital Charge Code	270694586
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

Know your out-of-pocket cost for care.

All Charges