Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHRT LG SPLNT CLF TO FOOT

Facility

$288.00

Service Code	HCPCS 29515
Hospital Charge Code	94186075
Hospital Revenue Code	361
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

SHRT LG SPLNT CLF TO FOOT

Facility

$777.42

Service Code	HCPCS 29515
Hospital Charge Code	412329515
Hospital Revenue Code	361
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$116.61
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

SHT 1.5m RAP RESOR 851.532.015

Facility

$2,926.45

Service Code	HCPCS C1776
Hospital Charge Code	270635018
Hospital Revenue Code	278
Min. Negotiated Rate	$438.97
Max. Negotiated Rate	$708.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.20
Rate for Payer: Qualcare PPO/HMO/WC	$438.97

SHT 1.5m RAP RESOR 851.532.015

Facility

$2,926.45

Service Code	HCPCS C1776
Hospital Charge Code	270635018
Hospital Revenue Code	278
Min. Negotiated Rate	$438.97
Max. Negotiated Rate	$1,463.22
Rate for Payer: Aetna Commercial	$877.93
Rate for Payer: Aetna Medicare Advantage	$877.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.24
Rate for Payer: Cigna Commercial	$1,463.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.20
Rate for Payer: Qualcare PPO/HMO/WC	$438.97

SHTH GDING PINNCLE7F 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642217S
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$174.00
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GDING PINNCLE7F 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642217
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GDING PINNCLE7F 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642217S
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GDING PINNCLE7F 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642217
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$174.00
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GUIDING PIN 6FR 65X35X2.5

Facility

$722.50

Hospital Charge Code	270642215
Hospital Revenue Code	278
Min. Negotiated Rate	$108.38
Max. Negotiated Rate	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.84
Rate for Payer: Qualcare PPO/HMO/WC	$108.38

SHTH GUIDING PIN 6FR 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642215S
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GUIDING PIN 6FR 65X35X2.5

Facility

$580.00

Service Code	HCPCS C1766
Hospital Charge Code	270642215S
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$174.00
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

SHTH GUIDING PIN 6FR 65X35X2.5

Facility

$722.50

Hospital Charge Code	270642215
Hospital Revenue Code	278
Min. Negotiated Rate	$108.38
Max. Negotiated Rate	$361.25
Rate for Payer: Aetna Commercial	$216.75
Rate for Payer: Aetna Medicare Advantage	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.24
Rate for Payer: Cigna Commercial	$361.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.84
Rate for Payer: Qualcare PPO/HMO/WC	$108.38

SHTH PINNCLE 2 INTROD 6FRx10

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654371S
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

SHTH PINNCLE 2 INTROD 6FRx10

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654371
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

SHTH PINNCLE 2 INTROD 6FRx10

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654371S
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

SHTH PINNCLE 2 INTROD 6FRx10

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654371
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

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$44.55
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252S
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$44.55
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHTH PINNCLE II INTROD 7FRX6

Facility

$29.70

Service Code	HCPCS C1766
Hospital Charge Code	270658252N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$14.85
Rate for Payer: Aetna Commercial	$8.91
Rate for Payer: Aetna Medicare Advantage	$8.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.57
Rate for Payer: Cigna Commercial	$14.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHTH PINNCLE II INTROD 7FRX6

Facility

$29.70

Service Code	HCPCS C1766
Hospital Charge Code	270658252N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$7.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

SHTH PINNCLE II INTROD 7FRX6

Facility

$148.50

Service Code	HCPCS C1766
Hospital Charge Code	270658252S
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SHUNT ARGYLE CAROTID ARTERY

Facility

$288.40

Service Code	HCPCS C1729
Hospital Charge Code	270657594
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$69.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: Qualcare PPO/HMO/WC	$43.26

SHUNT ARGYLE CAROTID ARTERY

Facility

$288.40

Service Code	HCPCS C1729
Hospital Charge Code	270657594
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$144.20
Rate for Payer: Aetna Commercial	$86.52
Rate for Payer: Aetna Medicare Advantage	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.54
Rate for Payer: Cigna Commercial	$144.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.79
Rate for Payer: Qualcare PPO/HMO/WC	$43.26

SHUNT BYPASS JAVID CAROTID

Facility

$5,925.00

Hospital Charge Code	270656013
Hospital Revenue Code	278
Min. Negotiated Rate	$888.75
Max. Negotiated Rate	$1,433.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.85
Rate for Payer: Qualcare PPO/HMO/WC	$888.75

Know your out-of-pocket cost for care.

All Charges