Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT BIOMIM 3D SWIR FLW 6x125

Facility

$5,750.00

Hospital Charge Code	270705371
Hospital Revenue Code	279
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

STENT BIOMIM 3D SWIR FLW 6x150

Facility

$5,750.00

Hospital Charge Code	270705440
Hospital Revenue Code	279
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

STENT BIOMIM 3D SWIR FLW 6x150

Facility

$5,750.00

Hospital Charge Code	270705440
Hospital Revenue Code	279
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

STENT BIOMIM 3D SWIR FLW 6x60

Facility

$5,250.00

Hospital Charge Code	270705377
Hospital Revenue Code	279
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$2,625.00

STENT BIOMIM 3D SWIR FLW 6x60

Facility

$5,250.00

Hospital Charge Code	270705373
Hospital Revenue Code	279
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT BIOMIM 3D SWIR FLW 6x60

Facility

$5,250.00

Hospital Charge Code	270705377
Hospital Revenue Code	279
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT BIOMIM 3D SWIR FLW 6x60

Facility

$5,250.00

Hospital Charge Code	270705373
Hospital Revenue Code	279
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$2,625.00

STENT BIOMIM 3D SWIR FLW 6x80

Facility

$5,250.00

Hospital Charge Code	270705374
Hospital Revenue Code	279
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT BIOMIM 3D SWIR FLW 6x80

Facility

$5,250.00

Hospital Charge Code	270705374
Hospital Revenue Code	279
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$2,625.00

STENT BIOMIM 3D SWIR FLW 7x100

Facility

$5,750.00

Hospital Charge Code	270705375
Hospital Revenue Code	279
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

STENT BIOMIM 3D SWIR FLW 7x100

Facility

$5,750.00

Hospital Charge Code	270705375
Hospital Revenue Code	279
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

STENT BIOMIM 3D SWIR FLW 7x150

Facility

$5,750.00

Hospital Charge Code	270705376
Hospital Revenue Code	279
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

STENT BIOMIM 3D SWIR FLW 7x150

Facility

$5,750.00

Hospital Charge Code	270705376
Hospital Revenue Code	279
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

STENT BIOMIM 3D SWIR FLW 7x80

Facility

$5,250.00

Hospital Charge Code	270705378
Hospital Revenue Code	279
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$2,625.00

STENT BIOMIM 3D SWIR FLW 7x80

Facility

$5,250.00

Hospital Charge Code	270705378
Hospital Revenue Code	279
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT CAST COV.9MM X 38MMX80CM

Facility

$12,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270653404N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT CAST COV.9MM X 38MMX80CM

Facility

$12,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270653404
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT CAST COV.9MM X 38MMX80CM

Facility

$12,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270653404
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$3,862.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT CAST COV.9MM X 38MMX80CM

Facility

$12,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270653404N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$3,862.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT CAST COVD 10x59 80 85421

Facility

$13,144.00

Hospital Charge Code	270634583
Hospital Revenue Code	278
Min. Negotiated Rate	$1,971.60
Max. Negotiated Rate	$3,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,628.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,180.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,971.60

STENT CAST COVD 10x59 80 85421

Facility

$13,144.00

Hospital Charge Code	270634583
Hospital Revenue Code	278
Min. Negotiated Rate	$1,971.60
Max. Negotiated Rate	$6,572.00
Rate for Payer: Aetna Commercial	$3,943.20
Rate for Payer: Aetna Medicare Advantage	$3,943.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,351.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,351.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,628.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,351.72
Rate for Payer: Cigna Commercial	$6,572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,180.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,971.60

STENT CAST COVD 10x59 80 85421

Facility

$13,144.00

Hospital Charge Code	270634583V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,971.60
Max. Negotiated Rate	$6,572.00
Rate for Payer: Aetna Commercial	$3,943.20
Rate for Payer: Aetna Medicare Advantage	$3,943.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,351.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,351.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,628.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,351.72
Rate for Payer: Cigna Commercial	$6,572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,180.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,971.60

STENT CAST COVD 10x59 80 85421

Facility

$13,144.00

Hospital Charge Code	270634583V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,971.60
Max. Negotiated Rate	$3,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,628.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,180.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,971.60

STENT CAST COVD 12x38 80 85422

Facility

$12,152.00

Hospital Charge Code	270634584V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,822.80
Max. Negotiated Rate	$2,940.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,940.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,822.80

STENT CAST COVD 12x38 80 85422

Facility

$12,152.00

Hospital Charge Code	270634584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,822.80
Max. Negotiated Rate	$2,940.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,940.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,822.80

Know your out-of-pocket cost for care.

All Charges