Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$29.25
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna Medicare Advantage	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.92
Rate for Payer: Cigna Commercial	$29.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.61
Rate for Payer: Oxford Commercial	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.78
Rate for Payer: UnitedHealthcare Commercial	$29.25

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$8.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.78

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$119.38
Rate for Payer: Aetna Commercial	$71.62
Rate for Payer: Aetna Medicare Advantage	$71.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.88
Rate for Payer: Cigna Commercial	$119.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.04
Rate for Payer: Oxford Commercial	$119.38
Rate for Payer: Qualcare PPO/HMO/WC	$35.81
Rate for Payer: UnitedHealthcare Commercial	$119.38

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$35.81
Max. Negotiated Rate	$35.81
Rate for Payer: Qualcare PPO/HMO/WC	$35.81

SHEATH INTRODC PACR 9F 6209-SI

Facility

$609.65

Hospital Charge Code	270607571
Hospital Revenue Code	278
Min. Negotiated Rate	$91.45
Max. Negotiated Rate	$147.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.54
Rate for Payer: Qualcare PPO/HMO/WC	$91.45

SHEATH INTRODC PACR 9F 6209-SI

Facility

$609.65

Hospital Charge Code	270607571
Hospital Revenue Code	278
Min. Negotiated Rate	$91.45
Max. Negotiated Rate	$304.82
Rate for Payer: Aetna Commercial	$182.90
Rate for Payer: Aetna Medicare Advantage	$182.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.46
Rate for Payer: Cigna Commercial	$304.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.54
Rate for Payer: Qualcare PPO/HMO/WC	$91.45

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$47.85
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$47.85
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$47.85
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$49.80
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTROD PINA 6X25 RSB603

Facility

$195.50

Service Code	HCPCS C1766
Hospital Charge Code	270658253N
Hospital Revenue Code	278
Min. Negotiated Rate	$29.32
Max. Negotiated Rate	$97.75
Rate for Payer: Aetna Commercial	$58.65
Rate for Payer: Aetna Medicare Advantage	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.85
Rate for Payer: Cigna Commercial	$97.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.31
Rate for Payer: Qualcare PPO/HMO/WC	$29.32

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$49.80
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTROD PINA 6X25 RSB603

Facility

$195.50

Service Code	HCPCS C1766
Hospital Charge Code	270658253N
Hospital Revenue Code	278
Min. Negotiated Rate	$29.32
Max. Negotiated Rate	$47.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.31
Rate for Payer: Qualcare PPO/HMO/WC	$29.32

SHEATH INTROD PINA 6X25 RSB603

Facility

$166.00

Service Code	HCPCS C1766
Hospital Charge Code	270658253S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

SHEATH INTRODUCER 4 FR 10CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270652526
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$25.86
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

SHEATH INTRODUCER 4 FR 10CM

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270652526
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

SHEATH INTRODUCER 5FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270650595
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$46.35
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 5FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270650595
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 6FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270669990
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 6FR .018

Facility

$154.50

Service Code	HCPCS C1894
Hospital Charge Code	270669990
Hospital Revenue Code	278
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$46.35
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

SHEATH INTRODUCER 7FR 10CM.035

Facility

$700.00

Hospital Charge Code	270689906
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

Know your out-of-pocket cost for care.

All Charges