Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH CRD BRIT TIP 8F 401823M

Facility

$206.45

Hospital Charge Code	270623511
Hospital Revenue Code	272
Min. Negotiated Rate	$30.97
Max. Negotiated Rate	$30.97
Rate for Payer: Qualcare PPO/HMO/WC	$30.97

SHEATH CRD BRIT TIP 8F 401890M

Facility

$323.25

Hospital Charge Code	270624311
Hospital Revenue Code	272
Min. Negotiated Rate	$42.02
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$96.97
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.02
Rate for Payer: Oxford Commercial	$161.62
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$161.62

SHEATH CRD BRIT TIP 8F 401890M

Facility

$323.25

Hospital Charge Code	270624311
Hospital Revenue Code	272
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

SHEATH DESILETS-HOFFMAN SET

Facility

$324.45

Service Code	HCPCS C1894
Hospital Charge Code	270659157
Hospital Revenue Code	272
Min. Negotiated Rate	$42.18
Max. Negotiated Rate	$162.22
Rate for Payer: Aetna Commercial	$97.33
Rate for Payer: Aetna Medicare Advantage	$97.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.73
Rate for Payer: Cigna Commercial	$162.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.18
Rate for Payer: Oxford Commercial	$162.22
Rate for Payer: Qualcare PPO/HMO/WC	$48.67
Rate for Payer: UnitedHealthcare Commercial	$162.22

SHEATH DESILETS-HOFFMAN SET

Facility

$324.45

Service Code	HCPCS C1894
Hospital Charge Code	270659157
Hospital Revenue Code	272
Min. Negotiated Rate	$48.67
Max. Negotiated Rate	$48.67
Rate for Payer: Qualcare PPO/HMO/WC	$48.67

SHEATH DRYSEAL 12FR

Facility

$1,250.00

Hospital Charge Code	207645161
Hospital Revenue Code	271
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SHEATH DRYSEAL 12FR

Facility

$1,250.00

Hospital Charge Code	207645161
Hospital Revenue Code	271
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

SHEATH EDS BIP 4.6 EC714501

Facility

$1,312.85

Hospital Charge Code	270628753
Hospital Revenue Code	272
Min. Negotiated Rate	$196.93
Max. Negotiated Rate	$196.93
Rate for Payer: Qualcare PPO/HMO/WC	$196.93

SHEATH EDS BIP 4.6 EC714501

Facility

$1,312.85

Hospital Charge Code	270628753
Hospital Revenue Code	272
Min. Negotiated Rate	$170.67
Max. Negotiated Rate	$656.42
Rate for Payer: Aetna Commercial	$393.86
Rate for Payer: Aetna Medicare Advantage	$393.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.78
Rate for Payer: Cigna Commercial	$656.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.67
Rate for Payer: Oxford Commercial	$656.42
Rate for Payer: Qualcare PPO/HMO/WC	$196.93
Rate for Payer: UnitedHealthcare Commercial	$656.42

SHEATH FLEX DRYSEAL 12X4 GORE

Facility

$3,450.00

Service Code	HCPCS C1894
Hospital Charge Code	270687577
Hospital Revenue Code	272
Min. Negotiated Rate	$448.50
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,035.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.50
Rate for Payer: Oxford Commercial	$1,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.50
Rate for Payer: UnitedHealthcare Commercial	$1,725.00

SHEATH FLEX DRYSEAL 12X4 GORE

Facility

$3,450.00

Service Code	HCPCS C1894
Hospital Charge Code	270687577
Hospital Revenue Code	272
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$517.50
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$649.00

Hospital Charge Code	270647885
Hospital Revenue Code	272
Min. Negotiated Rate	$97.35
Max. Negotiated Rate	$97.35
Rate for Payer: Qualcare PPO/HMO/WC	$97.35

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$589.20

Hospital Charge Code	270478885
Hospital Revenue Code	271
Min. Negotiated Rate	$76.60
Max. Negotiated Rate	$294.60
Rate for Payer: Aetna Commercial	$176.76
Rate for Payer: Aetna Medicare Advantage	$176.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.25
Rate for Payer: Cigna Commercial	$294.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.60
Rate for Payer: Oxford Commercial	$294.60
Rate for Payer: Qualcare PPO/HMO/WC	$88.38
Rate for Payer: UnitedHealthcare Commercial	$294.60

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$649.00

Hospital Charge Code	270647885
Hospital Revenue Code	272
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$324.50
Rate for Payer: Aetna Commercial	$194.70
Rate for Payer: Aetna Medicare Advantage	$194.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.50
Rate for Payer: Cigna Commercial	$324.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.37
Rate for Payer: Oxford Commercial	$324.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.35
Rate for Payer: UnitedHealthcare Commercial	$324.50

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$589.20

Hospital Charge Code	270478885
Hospital Revenue Code	271
Min. Negotiated Rate	$88.38
Max. Negotiated Rate	$88.38
Rate for Payer: Qualcare PPO/HMO/WC	$88.38

SHEATH FLEXOR ANSEL GUIDING

Facility

$375.00

Hospital Charge Code	270660259
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

SHEATH FLEXOR ANSEL GUIDING

Facility

$375.00

Hospital Charge Code	270660259
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270662215
Hospital Revenue Code	272
Min. Negotiated Rate	$48.10
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) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$185.00

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$450.00

Hospital Charge Code	270662215N
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$450.00

Hospital Charge Code	270662215N
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Hospital Charge Code	270662215S
Hospital Revenue Code	272
Min. Negotiated Rate	$48.10
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) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$185.00

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270662215
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Hospital Charge Code	270662215S
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH FOR HDR 3.5x20cm 30-00

Facility

$1.35

Hospital Charge Code	270636674
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

SHEATH FOR HDR 3.5x20cm 30-00

Facility

$1.35

Hospital Charge Code	270636674
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.68
Rate for Payer: Aetna Commercial	$0.41
Rate for Payer: Aetna Medicare Advantage	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.34
Rate for Payer: Cigna Commercial	$0.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.18
Rate for Payer: Oxford Commercial	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.68

Know your out-of-pocket cost for care.

All Charges