Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT 8X30X135 1012536-30

Facility

$4,750.00

Hospital Charge Code	270647818C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 8X30X135 1012536-30

Facility

$4,750.00

Hospital Charge Code	270647818C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 8X40X135 1012536-40

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647819C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 8X40X135 1012536-40

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647819C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 8X60X135 1012536-60

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647820C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 8X60X135 1012536-60

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647820C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 8X80X135 1012536-80

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647821C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 8X80X135 1012536-80

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647821C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 9.0X30X80 1012531-30

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647799C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 9.0X30X80 1012531-30

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647799C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 9.0X40X80 1012531-40

Facility

$4,750.00

Hospital Charge Code	270647800C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 9.0X40X80 1012531-40

Facility

$4,750.00

Hospital Charge Code	270647800C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 9X60X135 1012537-60

Facility

$4,750.00

Hospital Charge Code	270647823C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 9X60X135 1012537-60

Facility

$4,750.00

Hospital Charge Code	270647823C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 9X60X135 1012537-60

Facility

$4,780.00

Hospital Charge Code	270847823C
Hospital Revenue Code	278
Min. Negotiated Rate	$717.00
Max. Negotiated Rate	$2,390.00
Rate for Payer: Aetna Commercial	$1,434.00
Rate for Payer: Aetna Medicare Advantage	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,218.90
Rate for Payer: Cigna Commercial	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$717.00

STENT 9X60X135 1012537-60

Facility

$4,780.00

Hospital Charge Code	270847823C
Hospital Revenue Code	278
Min. Negotiated Rate	$717.00
Max. Negotiated Rate	$1,156.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$717.00

STENT 9X80X135 1012537-80

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647824C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 9X80X135 1012537-80

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647824C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT AB 6x100 135cm1010564100

Facility

$6,448.00

Hospital Charge Code	270633920V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT AB 6x100 135cm1010564100

Facility

$6,448.00

Hospital Charge Code	270633920
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$1,934.40
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT AB 6x100 135cm1010564100

Facility

$6,448.00

Hospital Charge Code	270633920V
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$1,934.40
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT AB 6x100 135cm1010564100

Facility

$6,448.00

Hospital Charge Code	270633920
Hospital Revenue Code	278
Min. Negotiated Rate	$967.20
Max. Negotiated Rate	$1,560.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: Qualcare PPO/HMO/WC	$967.20

STENT ABRE 14MMX100MMX 90CM

Facility

$7,975.00

Hospital Charge Code	270695849
Hospital Revenue Code	272
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,196.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT ABRE 14MMX100MMX 90CM

Facility

$7,975.00

Hospital Charge Code	270695849
Hospital Revenue Code	272
Min. Negotiated Rate	$1,036.75
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.75
Rate for Payer: Oxford Commercial	$3,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25
Rate for Payer: UnitedHealthcare Commercial	$3,987.50

STENT ABRE 14MMX100MMX90CM

Facility

$0.01

Service Code	HCPCS C1876
Hospital Charge Code	270695849Z
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges