Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON MAVERICK OTW 2.25x9mm

Facility

$1,280.00

Hospital Charge Code	270637778
Hospital Revenue Code	278
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$640.00
Rate for Payer: Aetna Commercial	$384.00
Rate for Payer: Aetna Medicare Advantage	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.40
Rate for Payer: Cigna Commercial	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.76
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

BALLOON MAVERICK OTW 2.25x9mm

Facility

$1,280.00

Hospital Charge Code	270637778
Hospital Revenue Code	278
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$309.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.76
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

BALLOON MAVERICK OTW 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270639402
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270639402
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.25x12mm

Facility

$1,295.00

Hospital Charge Code	270639404
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.25x12mm

Facility

$1,295.00

Hospital Charge Code	270639404
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.25x9mm

Facility

$1,295.00

Hospital Charge Code	270639403
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.25x9mm

Facility

$1,295.00

Hospital Charge Code	270639403
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270639408
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270639408
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.5x9mm

Facility

$1,295.00

Hospital Charge Code	270639407
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.5x9mm

Facility

$1,295.00

Hospital Charge Code	270639407
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.75x12mm

Facility

$1,295.00

Hospital Charge Code	270639161
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.75x12mm

Facility

$1,295.00

Hospital Charge Code	270639161
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.75x15mm

Facility

$1,295.00

Hospital Charge Code	270639411
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAVERICK OTW 3.75x15mm

Facility

$1,295.00

Hospital Charge Code	270639411
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.75x9mm

Facility

$1,295.00

Hospital Charge Code	270639410
Hospital Revenue Code	272
Min. Negotiated Rate	$168.35
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.35
Rate for Payer: Oxford Commercial	$647.50
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$647.50

BALLOON MAVERICK OTW 3.75x9mm

Facility

$1,295.00

Hospital Charge Code	270639410
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAV MON 3x15 389281530

Facility

$1,036.00

Hospital Charge Code	270638388C
Hospital Revenue Code	272
Min. Negotiated Rate	$134.68
Max. Negotiated Rate	$518.00
Rate for Payer: Aetna Commercial	$310.80
Rate for Payer: Aetna Medicare Advantage	$310.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.18
Rate for Payer: Cigna Commercial	$518.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.68
Rate for Payer: Oxford Commercial	$518.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.40
Rate for Payer: UnitedHealthcare Commercial	$518.00

BALLOON MAV MON 3x15 389281530

Facility

$1,036.00

Hospital Charge Code	270638388C
Hospital Revenue Code	272
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$155.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.40

BALLOON MAV OTW 2x12 206201220

Facility

$1,295.00

Hospital Charge Code	270636612V
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAV OTW 2x12 206201220

Facility

$1,295.00

Hospital Charge Code	270636612V
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON MAV OTW 3x15 206201530

Facility

$1,036.00

Hospital Charge Code	270636765C
Hospital Revenue Code	272
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$155.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.40

BALLOON MAV OTW 3x15 206201530

Facility

$1,036.00

Hospital Charge Code	270636765C
Hospital Revenue Code	272
Min. Negotiated Rate	$134.68
Max. Negotiated Rate	$518.00
Rate for Payer: Aetna Commercial	$310.80
Rate for Payer: Aetna Medicare Advantage	$310.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.18
Rate for Payer: Cigna Commercial	$518.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.68
Rate for Payer: Oxford Commercial	$518.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.40
Rate for Payer: UnitedHealthcare Commercial	$518.00

BALLOON MCV BILI 12F 4MM 6734

Facility

$1,839.25

Hospital Charge Code	270609409
Hospital Revenue Code	272
Min. Negotiated Rate	$275.89
Max. Negotiated Rate	$275.89
Rate for Payer: Qualcare PPO/HMO/WC	$275.89

Know your out-of-pocket cost for care.

All Charges