Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT BILIARY COTTON CLBS-10-5

Facility

$1,032.85

Hospital Charge Code	270600989
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-7

Facility

$1,032.85

Hospital Charge Code	270601175
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-7

Facility

$1,032.85

Hospital Charge Code	270601175
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$309.86
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-9

Facility

$1,032.85

Hospital Charge Code	270600979
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$249.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-10-9

Facility

$1,032.85

Hospital Charge Code	270600979
Hospital Revenue Code	278
Min. Negotiated Rate	$154.93
Max. Negotiated Rate	$516.42
Rate for Payer: Aetna Commercial	$309.86
Rate for Payer: Aetna Medicare Advantage	$309.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.38
Rate for Payer: Cigna Commercial	$516.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.95
Rate for Payer: Qualcare PPO/HMO/WC	$154.93

STENT BILIARY COTTON CLBS-7-12

Facility

$466.45

Hospital Charge Code	270619606
Hospital Revenue Code	278
Min. Negotiated Rate	$69.97
Max. Negotiated Rate	$112.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.88
Rate for Payer: Qualcare PPO/HMO/WC	$69.97

STENT BILIARY COTTON CLBS-7-12

Facility

$466.45

Hospital Charge Code	270619606
Hospital Revenue Code	278
Min. Negotiated Rate	$69.97
Max. Negotiated Rate	$233.22
Rate for Payer: Aetna Commercial	$139.94
Rate for Payer: Aetna Medicare Advantage	$139.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.94
Rate for Payer: Cigna Commercial	$233.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.88
Rate for Payer: Qualcare PPO/HMO/WC	$69.97

STENT BILIARY MCV 10Fx10c 4562

Facility

$580.40

Hospital Charge Code	270628068
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY MCV 10Fx10c 4562

Facility

$580.40

Hospital Charge Code	270628068
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$174.12
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY MCV 10Fx7c 5461

Facility

$640.00

Service Code	HCPCS C2625
Hospital Charge Code	270628066
Hospital Revenue Code	278
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$154.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.88
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

STENT BILIARY MCV 10Fx7c 5461

Facility

$640.00

Service Code	HCPCS C2625
Hospital Charge Code	270628066
Hospital Revenue Code	278
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$192.00
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.88
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

STENT BILIARY MCV 8 5Fx7c 4566

Facility

$580.40

Hospital Charge Code	270628069
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$174.12
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY MCV 8 5Fx7c 4566

Facility

$580.40

Hospital Charge Code	270628069
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

STENT BILIARY PALMAZ 7x15/80

Facility

$9,031.25

Hospital Charge Code	270635630
Hospital Revenue Code	278
Min. Negotiated Rate	$1,354.69
Max. Negotiated Rate	$2,185.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.69

STENT BILIARY PALMAZ 7x15/80

Facility

$9,031.25

Hospital Charge Code	270635630
Hospital Revenue Code	278
Min. Negotiated Rate	$1,354.69
Max. Negotiated Rate	$4,515.62
Rate for Payer: Aetna Commercial	$2,709.38
Rate for Payer: Aetna Medicare Advantage	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,302.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,302.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,302.97
Rate for Payer: Cigna Commercial	$4,515.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.69

STENT BILIARY PROSTHESIS***

Facility

$494.00

Hospital Charge Code	2300549
Hospital Revenue Code	279
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Qualcare PPO/HMO/WC	$74.10

STENT BILIARY PROSTHESIS***

Facility

$494.00

Hospital Charge Code	2300549
Hospital Revenue Code	279
Min. Negotiated Rate	$64.22
Max. Negotiated Rate	$247.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$148.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.97
Rate for Payer: Cigna Commercial	$247.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$247.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.10
Rate for Payer: UnitedHealthcare Commercial	$247.00

STENT BILIARY RX 7FR 12cm 4558

Facility

$640.00

Service Code	HCPCS C2625
Hospital Charge Code	270636840
Hospital Revenue Code	278
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$154.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.88
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

STENT BILIARY RX 7FR 12cm 4558

Facility

$640.00

Service Code	HCPCS C2625
Hospital Charge Code	270636840
Hospital Revenue Code	278
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$192.00
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.88
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

STENT BILIARY RX 7FR 5CM 4555

Facility

$455.60

Service Code	HCPCS C2625
Hospital Charge Code	270636466
Hospital Revenue Code	278
Min. Negotiated Rate	$68.34
Max. Negotiated Rate	$110.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.26
Rate for Payer: Qualcare PPO/HMO/WC	$68.34

STENT BILIARY RX 7FR 5CM 4555

Facility

$455.60

Service Code	HCPCS C2625
Hospital Charge Code	270636466
Hospital Revenue Code	278
Min. Negotiated Rate	$68.34
Max. Negotiated Rate	$227.80
Rate for Payer: Aetna Commercial	$136.68
Rate for Payer: Aetna Medicare Advantage	$136.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.18
Rate for Payer: Cigna Commercial	$227.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.26
Rate for Payer: Qualcare PPO/HMO/WC	$68.34

STENT BILIARY RX COVER RMV 10X

Facility

$12,999.50

Service Code	HCPCS C2625
Hospital Charge Code	270680141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,949.92
Max. Negotiated Rate	$3,145.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,599.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,145.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,949.92

STENT BILIARY RX COVER RMV 10X

Facility

$12,999.50

Service Code	HCPCS C2625
Hospital Charge Code	270680141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,949.92
Max. Negotiated Rate	$6,499.75
Rate for Payer: Aetna Commercial	$3,899.85
Rate for Payer: Aetna Medicare Advantage	$3,899.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,314.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,314.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,599.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,314.87
Rate for Payer: Cigna Commercial	$6,499.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,145.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,949.92

STENT BILIARY ZEM 7F ZEBD-7-10

Facility

$656.85

Hospital Charge Code	270608988
Hospital Revenue Code	278
Min. Negotiated Rate	$98.53
Max. Negotiated Rate	$328.43
Rate for Payer: Aetna Commercial	$197.06
Rate for Payer: Aetna Medicare Advantage	$197.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.50
Rate for Payer: Cigna Commercial	$328.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.96
Rate for Payer: Qualcare PPO/HMO/WC	$98.53

STENT BILIARY ZEM 7F ZEBD-7-10

Facility

$656.85

Hospital Charge Code	270608988
Hospital Revenue Code	278
Min. Negotiated Rate	$98.53
Max. Negotiated Rate	$158.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.96
Rate for Payer: Qualcare PPO/HMO/WC	$98.53

Know your out-of-pocket cost for care.

All Charges