Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238V
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 ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238V
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 ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238
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 ABSOL 6x80x135 101056480

Facility

$6,448.00

Hospital Charge Code	270635238
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 ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678
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 ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678V
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 ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678
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 ABSOL 8x80x035 101056680

Facility

$6,448.00

Hospital Charge Code	270633678V
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 ABSOLUTE 6x60mm 135cm

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647807
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 ABSOLUTE 6x60mm 135cm

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647807
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 ACCLK 6.5X190 1011649-65

Facility

$7,750.00

Hospital Charge Code	270635737
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT ACCLK 6.5X190 1011649-65

Facility

$7,750.00

Hospital Charge Code	270635737
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,325.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT ACULK 7-10x30 1011344-30

Facility

$11,160.00

Hospital Charge Code	270636416V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,580.00
Rate for Payer: Aetna Commercial	$3,348.00
Rate for Payer: Aetna Medicare Advantage	$3,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,845.80
Rate for Payer: Cigna Commercial	$5,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x30 1011344-30

Facility

$11,160.00

Hospital Charge Code	270636416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$2,700.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x30 1011344-30

Facility

$11,160.00

Hospital Charge Code	270636416V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$2,700.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x30 1011344-30

Facility

$11,160.00

Hospital Charge Code	270636416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,580.00
Rate for Payer: Aetna Commercial	$3,348.00
Rate for Payer: Aetna Medicare Advantage	$3,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,845.80
Rate for Payer: Cigna Commercial	$5,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x40 1011344-40

Facility

$11,160.00

Hospital Charge Code	270635410V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,580.00
Rate for Payer: Aetna Commercial	$3,348.00
Rate for Payer: Aetna Medicare Advantage	$3,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,845.80
Rate for Payer: Cigna Commercial	$5,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x40 1011344-40

Facility

$11,160.00

Hospital Charge Code	270635410V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$2,700.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x40 1011344-40

Facility

$11,160.00

Hospital Charge Code	270635410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$5,580.00
Rate for Payer: Aetna Commercial	$3,348.00
Rate for Payer: Aetna Medicare Advantage	$3,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,845.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,845.80
Rate for Payer: Cigna Commercial	$5,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ACULK 7-10x40 1011344-40

Facility

$11,160.00

Hospital Charge Code	270635410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.00
Max. Negotiated Rate	$2,700.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,674.00

STENT ADVANIX BILIARY 10FR12cm

Facility

$651.90

Hospital Charge Code	270675944
Hospital Revenue Code	278
Min. Negotiated Rate	$97.78
Max. Negotiated Rate	$157.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.76
Rate for Payer: Qualcare PPO/HMO/WC	$97.78

STENT ADVANIX BILIARY 10FR12cm

Facility

$651.90

Hospital Charge Code	270675944
Hospital Revenue Code	278
Min. Negotiated Rate	$97.78
Max. Negotiated Rate	$325.95
Rate for Payer: Aetna Commercial	$195.57
Rate for Payer: Aetna Medicare Advantage	$195.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.23
Rate for Payer: Cigna Commercial	$325.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.76
Rate for Payer: Qualcare PPO/HMO/WC	$97.78

STENT ADVANIX BILIARY 10FR 5CM

Facility

$661.00

Hospital Charge Code	270675169
Hospital Revenue Code	278
Min. Negotiated Rate	$99.15
Max. Negotiated Rate	$159.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.96
Rate for Payer: Qualcare PPO/HMO/WC	$99.15

STENT ADVANIX BILIARY 10FR 5CM

Facility

$661.00

Hospital Charge Code	270675169
Hospital Revenue Code	278
Min. Negotiated Rate	$99.15
Max. Negotiated Rate	$330.50
Rate for Payer: Aetna Commercial	$198.30
Rate for Payer: Aetna Medicare Advantage	$198.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.56
Rate for Payer: Cigna Commercial	$330.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.96
Rate for Payer: Qualcare PPO/HMO/WC	$99.15

STENT ADVANIX BILIARY 10FR 7CM

Facility

$661.00

Service Code	HCPCS C2625
Hospital Charge Code	270669218
Hospital Revenue Code	278
Min. Negotiated Rate	$99.15
Max. Negotiated Rate	$330.50
Rate for Payer: Aetna Commercial	$198.30
Rate for Payer: Aetna Medicare Advantage	$198.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.56
Rate for Payer: Cigna Commercial	$330.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.96
Rate for Payer: Qualcare PPO/HMO/WC	$99.15

Know your out-of-pocket cost for care.

All Charges