Heights University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON STERLING 6x20mm 80cm

Facility

$1,493.50

Hospital Charge Code	270637627
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 STERLING 6x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270642538
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 STERLING 6x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270642538
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 STERLING 6x60mm 135cm

Facility

$1,493.50

Hospital Charge Code	270641294
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 STERLING 6x60mm 135cm

Facility

$1,824.50

Hospital Charge Code	270641294C
Hospital Revenue Code	278
Min. Negotiated Rate	$273.68
Max. Negotiated Rate	$912.25
Rate for Payer: Aetna Commercial	$547.35
Rate for Payer: Aetna Medicare Advantage	$547.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.25
Rate for Payer: Cigna Commercial	$912.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.53
Rate for Payer: Qualcare PPO/HMO/WC	$273.68

BALLOON STERLING 6x60mm 135cm

Facility

$1,493.50

Hospital Charge Code	270641294
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 STERLING 6x60mm 135cm

Facility

$1,824.50

Hospital Charge Code	270641294C
Hospital Revenue Code	278
Min. Negotiated Rate	$273.68
Max. Negotiated Rate	$441.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.53
Rate for Payer: Qualcare PPO/HMO/WC	$273.68

BALLOON STERLING 7x20mm 135cm

Facility

$1,493.50

Hospital Charge Code	270639734
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
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

BALLOON STERLING 7x20mm 135cm

Facility

$1,493.50

Hospital Charge Code	270639734
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 STERLING 7x20mm 80cm

Facility

$1,493.50

Hospital Charge Code	270638409
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 STERLING 7x20mm 80cm

Facility

$1,493.50

Hospital Charge Code	270638409
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 STERLING 7x20mm 80cm

Facility

$1,906.50

Hospital Charge Code	270638409C
Hospital Revenue Code	278
Min. Negotiated Rate	$285.98
Max. Negotiated Rate	$461.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.37
Rate for Payer: Qualcare PPO/HMO/WC	$285.98

BALLOON STERLING 7x20mm 80cm

Facility

$1,906.50

Hospital Charge Code	270638409C
Hospital Revenue Code	278
Min. Negotiated Rate	$285.98
Max. Negotiated Rate	$953.25
Rate for Payer: Aetna Commercial	$571.95
Rate for Payer: Aetna Medicare Advantage	$571.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.16
Rate for Payer: Cigna Commercial	$953.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.37
Rate for Payer: Qualcare PPO/HMO/WC	$285.98

BALLOON STERLING 8x20mm 135cm

Facility

$1,493.50

Hospital Charge Code	270639735
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 STERLING 8x20mm 135cm

Facility

$1,493.50

Hospital Charge Code	270639735
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 STERLING OTW 5x150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270673986
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$397.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

BALLOON STERLING OTW 5x150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270673986
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$821.42
Rate for Payer: Aetna Commercial	$492.86
Rate for Payer: Aetna Medicare Advantage	$492.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.93
Rate for Payer: Cigna Commercial	$821.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

BALLOON TREK 1.20MM X 20MM

Facility

$500.00

Hospital Charge Code	270666646
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BALLOON TREK 1.20MM X 20MM

Facility

$500.00

Hospital Charge Code	270666646
Hospital Revenue Code	279
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

BALLOON TREK 2.25mm x06mm

Facility

$500.00

Hospital Charge Code	270645230
Hospital Revenue Code	279
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

BALLOON TREK 2.25mm x06mm

Facility

$500.00

Hospital Charge Code	270645230
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BALLOON TREK 2.25MM X 06MM

Facility

$500.00

Hospital Charge Code	270645231
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BALLOON TREK 2.25MM X 06MM

Facility

$500.00

Hospital Charge Code	270645231
Hospital Revenue Code	279
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

BALLOON TREK 2.25MM X12MM

Facility

$500.00

Hospital Charge Code	270645232
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BALLOON TREK 2.25MM X12MM

Facility

$500.00

Hospital Charge Code	270645232
Hospital Revenue Code	279
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

Know your out-of-pocket cost for care.

All Charges