Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH 14 FR

Facility

$2,235.00

Service Code	HCPCS C1894
Hospital Charge Code	270681916
Hospital Revenue Code	278
Min. Negotiated Rate	$335.25
Max. Negotiated Rate	$540.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$447.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.87
Rate for Payer: Qualcare PPO/HMO/WC	$335.25

SHEATH 14 FR

Facility

$2,235.00

Service Code	HCPCS C1894
Hospital Charge Code	270681916
Hospital Revenue Code	278
Min. Negotiated Rate	$335.25
Max. Negotiated Rate	$1,117.50
Rate for Payer: Aetna Commercial	$670.50
Rate for Payer: Aetna Medicare Advantage	$670.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.92
Rate for Payer: Cigna Commercial	$1,117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.87
Rate for Payer: Qualcare PPO/HMO/WC	$335.25

SHEATH 18FR ONAL MCVS118 *****

Facility

$360.00

Hospital Charge Code	1608363
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

SHEATH 18FR ONAL MCVS118 *****

Facility

$360.00

Hospital Charge Code	1608363
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

SHEATH 18FR PG183000

Facility

$615.00

Hospital Charge Code	270635530
Hospital Revenue Code	272
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

SHEATH 18FR PG183000

Facility

$615.00

Hospital Charge Code	270635530
Hospital Revenue Code	272
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$184.50
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.95
Rate for Payer: Oxford Commercial	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Commercial	$307.50

SHEATH 21FR SACHSE URETHROTOME

Facility

$5,360.00

Hospital Charge Code	270644827
Hospital Revenue Code	272
Min. Negotiated Rate	$696.80
Max. Negotiated Rate	$2,680.00
Rate for Payer: Aetna Commercial	$1,608.00
Rate for Payer: Aetna Medicare Advantage	$1,608.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,366.80
Rate for Payer: Cigna Commercial	$2,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$696.80
Rate for Payer: Oxford Commercial	$2,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$804.00
Rate for Payer: UnitedHealthcare Commercial	$2,680.00

SHEATH 21FR SACHSE URETHROTOME

Facility

$5,360.00

Hospital Charge Code	270644827
Hospital Revenue Code	272
Min. Negotiated Rate	$804.00
Max. Negotiated Rate	$804.00
Rate for Payer: Qualcare PPO/HMO/WC	$804.00

SHEATH 33mm ENDOSCOPIC STAPLER

Facility

$1,422.65

Hospital Charge Code	270630330
Hospital Revenue Code	272
Min. Negotiated Rate	$184.94
Max. Negotiated Rate	$711.33
Rate for Payer: Aetna Commercial	$426.80
Rate for Payer: Aetna Medicare Advantage	$426.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.78
Rate for Payer: Cigna Commercial	$711.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.94
Rate for Payer: Oxford Commercial	$711.33
Rate for Payer: Qualcare PPO/HMO/WC	$213.40
Rate for Payer: UnitedHealthcare Commercial	$711.33

SHEATH 33mm ENDOSCOPIC STAPLER

Facility

$1,422.65

Hospital Charge Code	270630330
Hospital Revenue Code	272
Min. Negotiated Rate	$213.40
Max. Negotiated Rate	$213.40
Rate for Payer: Qualcare PPO/HMO/WC	$213.40

SHEATH 6.5FR 12CM 0.038 50CM

Facility

$40.00

Hospital Charge Code	270661685
Hospital Revenue Code	272
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$20.00

SHEATH 6.5FR 12CM 0.038 50CM

Facility

$40.00

Hospital Charge Code	270661685
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

SHEATH 6F 088 NEURON MAX LONG

Facility

$2,475.00

Hospital Charge Code	270684222
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

SHEATH 6F 088 NEURON MAX LONG

Facility

$2,475.00

Hospital Charge Code	270684222
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6FR 45CM

Facility

$251.50

Hospital Charge Code	270667642S
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH 6FR 45CM

Facility

$251.50

Hospital Charge Code	270667642S
Hospital Revenue Code	272
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$125.75
Rate for Payer: Aetna Commercial	$75.45
Rate for Payer: Aetna Medicare Advantage	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.13
Rate for Payer: Cigna Commercial	$125.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.70
Rate for Payer: Oxford Commercial	$125.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.73
Rate for Payer: UnitedHealthcare Commercial	$125.75

SHEATH 6FR 45CM

Facility

$251.50

Hospital Charge Code	270667642
Hospital Revenue Code	272
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$125.75
Rate for Payer: Aetna Commercial	$75.45
Rate for Payer: Aetna Medicare Advantage	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.13
Rate for Payer: Cigna Commercial	$125.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.70
Rate for Payer: Oxford Commercial	$125.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.73
Rate for Payer: UnitedHealthcare Commercial	$125.75

SHEATH 6FR 45CM

Facility

$350.00

Hospital Charge Code	270667642N
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SHEATH 6FR 45CM

Facility

$251.50

Hospital Charge Code	270667642
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH 6FR 45CM

Facility

$350.00

Hospital Charge Code	270667642N
Hospital Revenue Code	272
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$175.00

SHEATH 6 FR NEURON 80 STR

Facility

$2,475.00

Service Code	HCPCS C1894
Hospital Charge Code	270685061
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6 FR NEURON 80 STR

Facility

$2,475.00

Service Code	HCPCS C1894
Hospital Charge Code	270685061
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6 FR NEURON 90 MP

Facility

$2,475.00

Service Code	HCPCS C1894
Hospital Charge Code	270685063S
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6 FR NEURON 90 MP

Facility

$2,475.00

Service Code	HCPCS C1894
Hospital Charge Code	270685063S
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6 FR NEURON 90 MP

Facility

$2,475.00

Service Code	HCPCS C1894
Hospital Charge Code	270685063
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

Know your out-of-pocket cost for care.

All Charges