Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT ABRE VEN 035 10x120x90

Facility

$7,975.00

Hospital Charge Code	270705328
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 VEN 035 12x100x90

Facility

$7,975.00

Hospital Charge Code	270705329
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 VEN 035 12x100x90

Facility

$7,975.00

Hospital Charge Code	270705329
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 VEN 035 12x150x90

Facility

$9,125.00

Hospital Charge Code	270705330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,368.75
Max. Negotiated Rate	$1,368.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,368.75

STENT ABRE VEN 035 12x150x90

Facility

$9,125.00

Hospital Charge Code	270705330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,186.25
Max. Negotiated Rate	$4,562.50
Rate for Payer: Aetna Commercial	$2,737.50
Rate for Payer: Aetna Medicare Advantage	$2,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,326.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,326.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,326.88
Rate for Payer: Cigna Commercial	$4,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.25
Rate for Payer: Oxford Commercial	$4,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,368.75
Rate for Payer: UnitedHealthcare Commercial	$4,562.50

STENT ABRE VENOUS035 12x120x90

Facility

$7,975.00

Hospital Charge Code	270705317
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 VENOUS035 12x120x90

Facility

$7,975.00

Hospital Charge Code	270705317
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 VENOUS 18X120MM

Facility

$7,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270697268S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT ABRE VENOUS 18X120MM

Facility

$7,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270697268S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Cigna Commercial	$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) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 6X60 135cm1010564-60

Facility

$6,200.00

Hospital Charge Code	270635611V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921V
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 ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921V
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 ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921
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 ABS 7x100x135 1010565100

Facility

$6,448.00

Hospital Charge Code	270633921
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 ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165
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 ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165
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 ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165V
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 ABS 7x80 135cm 101056580

Facility

$6,448.00

Hospital Charge Code	270635165V
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 ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869V
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

STENT ABS 8x100x035 1010565100

Facility

$6,200.00

Hospital Charge Code	270632869
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

Know your out-of-pocket cost for care.

All Charges