Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH SUPER W/O GW 4FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270637756
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$14.63
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 5FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270626580
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$14.63
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 5FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270626580
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 5FR 11CM

Facility

$50.00

Hospital Charge Code	270626580C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

SHEATH SUPER W/O GW 5FR 11CM

Facility

$50.00

Hospital Charge Code	270626580C
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

SHEATH SUPER W/O GW 5FR 25cm

Facility

$174.71

Hospital Charge Code	270637586
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$87.36
Rate for Payer: Aetna Commercial	$52.41
Rate for Payer: Aetna Medicare Advantage	$52.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.55
Rate for Payer: Cigna Commercial	$87.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 5FR 25cm

Facility

$174.71

Hospital Charge Code	270637586
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 5FR 25CM

Facility

$184.06

Hospital Charge Code	270637586C
Hospital Revenue Code	272
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$92.03
Rate for Payer: Aetna Commercial	$55.22
Rate for Payer: Aetna Medicare Advantage	$55.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.94
Rate for Payer: Cigna Commercial	$92.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.93
Rate for Payer: Oxford Commercial	$92.03
Rate for Payer: Qualcare PPO/HMO/WC	$27.61
Rate for Payer: UnitedHealthcare Commercial	$92.03

SHEATH SUPER W/O GW 5FR 25CM

Facility

$184.06

Hospital Charge Code	270637586C
Hospital Revenue Code	272
Min. Negotiated Rate	$27.61
Max. Negotiated Rate	$27.61
Rate for Payer: Qualcare PPO/HMO/WC	$27.61

SHEATH SUPER W/O GW 6FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270638086
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$14.63
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 6FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270638086
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 6FR 25cm

Facility

$174.71

Service Code	HCPCS C1894
Hospital Charge Code	270637678
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$87.36
Rate for Payer: Aetna Commercial	$52.41
Rate for Payer: Aetna Medicare Advantage	$52.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.55
Rate for Payer: Cigna Commercial	$87.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 6FR 25cm

Facility

$174.71

Service Code	HCPCS C1894
Hospital Charge Code	270637678
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 6FR 25cm

Facility

$1,840.50

Hospital Charge Code	270637678C
Hospital Revenue Code	272
Min. Negotiated Rate	$276.07
Max. Negotiated Rate	$276.07
Rate for Payer: Qualcare PPO/HMO/WC	$276.07

SHEATH SUPER W/O GW 6FR 25cm

Facility

$1,840.50

Hospital Charge Code	270637678C
Hospital Revenue Code	272
Min. Negotiated Rate	$239.26
Max. Negotiated Rate	$920.25
Rate for Payer: Aetna Commercial	$552.15
Rate for Payer: Aetna Medicare Advantage	$552.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.33
Rate for Payer: Cigna Commercial	$920.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.26
Rate for Payer: Oxford Commercial	$920.25
Rate for Payer: Qualcare PPO/HMO/WC	$276.07
Rate for Payer: UnitedHealthcare Commercial	$920.25

SHEATH SUPER W/O GW 7FR 11cm

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270641355
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 SUPER W/O GW 7FR 11cm

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624071
Hospital Revenue Code	278
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.59

SHEATH SUPER W/O GW 7FR 11cm

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270641355
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 SUPER W/O GW 7FR 11cm

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624071
Hospital Revenue Code	278
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$28.62
Rate for Payer: Aetna Commercial	$17.18
Rate for Payer: Aetna Medicare Advantage	$17.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.60
Rate for Payer: Cigna Commercial	$28.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.59

SHEATH SUPER W/O GW 7FR 25cm

Facility

$125.00

Service Code	HCPCS C1894
Hospital Charge Code	270625247
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SHEATH SUPER W/O GW 7FR 25cm

Facility

$125.00

Service Code	HCPCS C1894
Hospital Charge Code	270625247
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SHEATH SUPER W/O GW 7FR 25CM

Facility

$180.27

Hospital Charge Code	270625247C
Hospital Revenue Code	272
Min. Negotiated Rate	$27.04
Max. Negotiated Rate	$27.04
Rate for Payer: Qualcare PPO/HMO/WC	$27.04

SHEATH SUPER W/O GW 7FR 25CM

Facility

$180.27

Hospital Charge Code	270625247C
Hospital Revenue Code	272
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$90.14
Rate for Payer: Aetna Commercial	$54.08
Rate for Payer: Aetna Medicare Advantage	$54.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.97
Rate for Payer: Cigna Commercial	$90.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.44
Rate for Payer: Oxford Commercial	$90.14
Rate for Payer: Qualcare PPO/HMO/WC	$27.04
Rate for Payer: UnitedHealthcare Commercial	$90.14

SHEATH SUPER WO GW 8F 11 1596B

Facility

$139.50

Hospital Charge Code	270637587C
Hospital Revenue Code	272
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$20.93
Rate for Payer: Qualcare PPO/HMO/WC	$20.93

SHEATH SUPER WO GW 8F 11 1596B

Facility

$139.50

Hospital Charge Code	270637587C
Hospital Revenue Code	272
Min. Negotiated Rate	$18.14
Max. Negotiated Rate	$69.75
Rate for Payer: Aetna Commercial	$41.85
Rate for Payer: Aetna Medicare Advantage	$41.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.57
Rate for Payer: Cigna Commercial	$69.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.14
Rate for Payer: Oxford Commercial	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.93
Rate for Payer: UnitedHealthcare Commercial	$69.75

Know your out-of-pocket cost for care.

All Charges