Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON QTM OTW 4x12 380811240

Facility

$1,036.00

Hospital Charge Code	270637789C
Hospital Revenue Code	272
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$155.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.40

BALLOON QUANTUM MONO 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270640735
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270640735
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 QUANTUM MONO 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270640733
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 QUANTUM MONO 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270640733
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 4.0x20mm

Facility

$1,295.00

Hospital Charge Code	270640728
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 4.0x20mm

Facility

$1,295.00

Hospital Charge Code	270640728
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 QUANTUM MONO 4.5x12mm

Facility

$1,295.00

Hospital Charge Code	270640730
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 4.5x12mm

Facility

$1,295.00

Hospital Charge Code	270640730
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 QUANTUM MONO 4.5x8mm

Facility

$1,295.00

Hospital Charge Code	270640729
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 4.5x8mm

Facility

$1,295.00

Hospital Charge Code	270640729
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 QUANTUM MONO 5.0x12mm

Facility

$1,295.00

Hospital Charge Code	270640732
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM MONO 5.0x12mm

Facility

$1,295.00

Hospital Charge Code	270640732
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 QUANTUM MONO 5.0X8MM

Facility

$1,295.00

Hospital Charge Code	270940731
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 QUANTUM MONO 5.0X8MM

Facility

$1,295.00

Hospital Charge Code	270940731
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 QUANTUM OTW 2.5x20mm

Facility

$1,875.00

Hospital Charge Code	270629660
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.75
Rate for Payer: Oxford Commercial	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Commercial	$937.50

BALLOON QUANTUM OTW 2.5x20mm

Facility

$1,875.00

Hospital Charge Code	270629660
Hospital Revenue Code	272
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$281.25
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

BALLOON QUANTUM OTW 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270639417
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 QUANTUM OTW 3.0x20mm

Facility

$1,295.00

Hospital Charge Code	270639417
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM OTW 3.5x15mm

Facility

$1,295.00

Hospital Charge Code	270638918
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 QUANTUM OTW 3.5x15mm

Facility

$1,295.00

Hospital Charge Code	270638918
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BALLOON QUANTUM OTW 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270639415
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 QUANTUM OTW 3.5x20mm

Facility

$1,295.00

Hospital Charge Code	270639415
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 RAIDE 10-11 MM

Facility

$535.00

Hospital Charge Code	270700220
Hospital Revenue Code	272
Min. Negotiated Rate	$69.55
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$160.50
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.55
Rate for Payer: Oxford Commercial	$267.50
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Commercial	$267.50

BALLOON RAIDE 10-11 MM

Facility

$535.00

Hospital Charge Code	270700220
Hospital Revenue Code	272
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

Know your out-of-pocket cost for care.

All Charges