Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH BALKIN GUIDING 6.0

Facility

$251.50

Hospital Charge Code	2709003237
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 BALKIN GUIDING 6.0

Facility

$251.50

Hospital Charge Code	2709003237
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH BALKIN GUIDING 7.0

Facility

$251.50

Hospital Charge Code	2709003236
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH BALKIN GUIDING 7.0

Facility

$251.50

Hospital Charge Code	2709003236
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 BIO IFIX TIBL 30 254621

Facility

$925.00

Hospital Charge Code	270635266
Hospital Revenue Code	272
Min. Negotiated Rate	$120.25
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.25
Rate for Payer: Oxford Commercial	$462.50
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$462.50

SHEATH BIO IFIX TIBL 30 254621

Facility

$925.00

Hospital Charge Code	270635266
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

SHEATH BIO INTRAFIX

Facility

$1,140.00

Hospital Charge Code	270640008
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

SHEATH BIO INTRAFIX

Facility

$1,140.00

Hospital Charge Code	270640008
Hospital Revenue Code	272
Min. Negotiated Rate	$148.20
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.20
Rate for Payer: Oxford Commercial	$570.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$570.00

SHEATH BIO INTRAFIX LG 254628

Facility

$1,220.00

Hospital Charge Code	270642094
Hospital Revenue Code	272
Min. Negotiated Rate	$158.60
Max. Negotiated Rate	$610.00
Rate for Payer: Aetna Commercial	$366.00
Rate for Payer: Aetna Medicare Advantage	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.10
Rate for Payer: Cigna Commercial	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Oxford Commercial	$610.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00
Rate for Payer: UnitedHealthcare Commercial	$610.00

SHEATH BIO INTRAFIX LG 254628

Facility

$1,220.00

Hospital Charge Code	270642094
Hospital Revenue Code	272
Min. Negotiated Rate	$183.00
Max. Negotiated Rate	$183.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00

SHEATH BRITE TIP 5F 55 40155M

Facility

$114.15

Hospital Charge Code	270633607
Hospital Revenue Code	272
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$57.08
Rate for Payer: Aetna Commercial	$34.24
Rate for Payer: Aetna Medicare Advantage	$34.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.11
Rate for Payer: Cigna Commercial	$57.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.84
Rate for Payer: Oxford Commercial	$57.08
Rate for Payer: Qualcare PPO/HMO/WC	$17.12
Rate for Payer: UnitedHealthcare Commercial	$57.08

SHEATH BRITE TIP 5F 55 40155M

Facility

$114.15

Hospital Charge Code	270633607
Hospital Revenue Code	272
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$17.12
Rate for Payer: Qualcare PPO/HMO/WC	$17.12

SHEATH CARD INTRODC 8F 501-598

Facility

$136.85

Service Code	HCPCS C2629
Hospital Charge Code	270606061
Hospital Revenue Code	272
Min. Negotiated Rate	$17.79
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$41.05
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$68.42

SHEATH CARD INTRODC 8F 501-598

Facility

$136.85

Service Code	HCPCS C2629
Hospital Charge Code	270606061
Hospital Revenue Code	272
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SHEATH CATH 16F DRYSEAL FLEX

Facility

$3,020.00

Service Code	HCPCS C1894
Hospital Charge Code	270698776S
Hospital Revenue Code	278
Min. Negotiated Rate	$453.00
Max. Negotiated Rate	$730.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$604.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$730.84
Rate for Payer: Qualcare PPO/HMO/WC	$453.00

SHEATH CATH 16F DRYSEAL FLEX

Facility

$3,020.00

Service Code	HCPCS C1894
Hospital Charge Code	270698776S
Hospital Revenue Code	278
Min. Negotiated Rate	$453.00
Max. Negotiated Rate	$1,510.00
Rate for Payer: Aetna Commercial	$906.00
Rate for Payer: Aetna Medicare Advantage	$906.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$770.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$770.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$604.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$770.10
Rate for Payer: Cigna Commercial	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$730.84
Rate for Payer: Qualcare PPO/HMO/WC	$453.00

SHEATH CLEAR RENAL

Facility

$180.00

Hospital Charge Code	270650905
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$90.00

SHEATH CLEAR RENAL

Facility

$180.00

Hospital Charge Code	270650905
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

SHEATH CRD BRIT TIP 7F 401790M

Facility

$322.45

Hospital Charge Code	270624400
Hospital Revenue Code	272
Min. Negotiated Rate	$41.92
Max. Negotiated Rate	$161.22
Rate for Payer: Aetna Commercial	$96.73
Rate for Payer: Aetna Medicare Advantage	$96.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.22
Rate for Payer: Cigna Commercial	$161.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.92
Rate for Payer: Oxford Commercial	$161.22
Rate for Payer: Qualcare PPO/HMO/WC	$48.37
Rate for Payer: UnitedHealthcare Commercial	$161.22

SHEATH CRD BRIT TIP 7F 401790M

Facility

$322.45

Hospital Charge Code	270624400
Hospital Revenue Code	272
Min. Negotiated Rate	$48.37
Max. Negotiated Rate	$48.37
Rate for Payer: Qualcare PPO/HMO/WC	$48.37

SHEATH CRD BRIT TIP 8F 401823M

Facility

$206.45

Hospital Charge Code	270623511
Hospital Revenue Code	272
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$103.22
Rate for Payer: Aetna Commercial	$61.94
Rate for Payer: Aetna Medicare Advantage	$61.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.64
Rate for Payer: Cigna Commercial	$103.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.84
Rate for Payer: Oxford Commercial	$103.22
Rate for Payer: Qualcare PPO/HMO/WC	$30.97
Rate for Payer: UnitedHealthcare Commercial	$103.22

Know your out-of-pocket cost for care.

All Charges