Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON PC RAPTOR 3.5x15

Facility

$1,433.75

Hospital Charge Code	270633347
Hospital Revenue Code	272
Min. Negotiated Rate	$186.39
Max. Negotiated Rate	$716.88
Rate for Payer: Aetna Commercial	$430.12
Rate for Payer: Aetna Medicare Advantage	$430.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.61
Rate for Payer: Cigna Commercial	$716.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.39
Rate for Payer: Oxford Commercial	$716.88
Rate for Payer: Qualcare PPO/HMO/WC	$215.06
Rate for Payer: UnitedHealthcare Commercial	$716.88

BALLOON PC RAPTOR 3.5x15

Facility

$1,433.75

Hospital Charge Code	270633347
Hospital Revenue Code	272
Min. Negotiated Rate	$215.06
Max. Negotiated Rate	$215.06
Rate for Payer: Qualcare PPO/HMO/WC	$215.06

BALLOON PFLEX CR 80cm 4208040S

Facility

$1,237.65

Hospital Charge Code	270625419
Hospital Revenue Code	272
Min. Negotiated Rate	$185.65
Max. Negotiated Rate	$185.65
Rate for Payer: Qualcare PPO/HMO/WC	$185.65

BALLOON PFLEX CR 80cm 4208040S

Facility

$1,237.65

Hospital Charge Code	270625419
Hospital Revenue Code	272
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$618.83
Rate for Payer: Aetna Commercial	$371.30
Rate for Payer: Aetna Medicare Advantage	$371.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.60
Rate for Payer: Cigna Commercial	$618.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.89
Rate for Payer: Oxford Commercial	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$185.65
Rate for Payer: UnitedHealthcare Commercial	$618.83

BALLOON POLAR 3.0x100 150cm

Facility

$4,500.00

Hospital Charge Code	270639273
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

BALLOON POLAR 3.0x100 150cm

Facility

$4,500.00

Hospital Charge Code	270639273
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 POWERCROSS PTA 3x100mm

Facility

$1,125.00

Hospital Charge Code	270671660
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 3x100mm

Facility

$1,125.00

Hospital Charge Code	270671660
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 3x120mm

Facility

$1,125.00

Hospital Charge Code	270671661
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 3x120mm

Facility

$1,125.00

Hospital Charge Code	270671661
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x100mm

Facility

$1,125.00

Hospital Charge Code	270671666
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x100mm

Facility

$1,125.00

Hospital Charge Code	270671666
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x120mm

Facility

$1,125.00

Hospital Charge Code	270671667
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x120mm

Facility

$1,125.00

Hospital Charge Code	270671667
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x150mm

Facility

$1,250.00

Hospital Charge Code	270646037C
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 POWERCROSS PTA 4x150mm

Facility

$1,250.00

Hospital Charge Code	270646037C
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 POWERCROSS PTA 4x150mm

Facility

$1,250.00

Hospital Charge Code	270646037
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BALLOON POWERCROSS PTA 4x150mm

Facility

$1,250.00

Hospital Charge Code	270646037
Hospital Revenue Code	272
Min. Negotiated Rate	$162.50
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) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$625.00

BALLOON POWERCROSS PTA 4x20mm

Facility

$1,125.00

Hospital Charge Code	270671662
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x20mm

Facility

$1,125.00

Hospital Charge Code	270671662
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x40mm

Facility

$1,125.00

Hospital Charge Code	270671663
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x40mm

Facility

$1,125.00

Hospital Charge Code	270671663
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x60mm

Facility

$1,125.00

Hospital Charge Code	270671664
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x60mm

Facility

$1,125.00

Hospital Charge Code	270671664
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLOON POWERCROSS PTA 4x80mm

Facility

$1,125.00

Hospital Charge Code	270671665
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

Know your out-of-pocket cost for care.

All Charges