Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$6,076.00
Rate for Payer: Aetna Commercial	$3,645.60
Rate for Payer: Aetna Medicare Advantage	$3,645.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,098.76
Rate for Payer: Cigna Commercial	$6,076.00
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	270634584V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,822.80
Max. Negotiated Rate	$6,076.00
Rate for Payer: Aetna Commercial	$3,645.60
Rate for Payer: Aetna Medicare Advantage	$3,645.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,098.76
Rate for Payer: Cigna Commercial	$6,076.00
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 7x50 120 85415

Facility

$13,144.00

Hospital Charge Code	270634391V
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 7x50 120 85415

Facility

$13,144.00

Hospital Charge Code	270634391
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 7x50 120 85415

Facility

$13,144.00

Hospital Charge Code	270634391
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 7x50 120 85415

Facility

$13,144.00

Hospital Charge Code	270634391V
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 8x59 120 85417

Facility

$13,144.00

Hospital Charge Code	270634395
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 8x59 120 85417

Facility

$13,144.00

Hospital Charge Code	270634395V
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 8x59 120 85417

Facility

$13,144.00

Hospital Charge Code	270634395
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 8x59 120 85417

Facility

$13,144.00

Hospital Charge Code	270634395V
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 8x59 80 85407

Facility

$13,875.00

Hospital Charge Code	270634582V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$3,357.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

STENT CAST COVD 8x59 80 85407

Facility

$13,144.00

Hospital Charge Code	270634582
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 8x59 80 85407

Facility

$13,144.00

Hospital Charge Code	270634582
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 8x59 80 85407

Facility

$13,875.00

Hospital Charge Code	270634582V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$6,937.50
Rate for Payer: Aetna Commercial	$4,162.50
Rate for Payer: Aetna Medicare Advantage	$4,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,538.12
Rate for Payer: Cigna Commercial	$6,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

STENT CAST COVD 9x59 120 85419

Facility

$13,144.00

Hospital Charge Code	270634396
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 9x59 120 85419

Facility

$13,144.00

Hospital Charge Code	270634396V
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 9x59 120 85419

Facility

$13,144.00

Hospital Charge Code	270634396V
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 9x59 120 85419

Facility

$13,144.00

Hospital Charge Code	270634396
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 CENTER BEND STR SZ 10-5

Facility

$266.50

Hospital Charge Code	270673446
Hospital Revenue Code	278
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$133.25
Rate for Payer: Aetna Commercial	$79.95
Rate for Payer: Aetna Medicare Advantage	$79.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.96
Rate for Payer: Cigna Commercial	$133.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.49
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

STENT CENTER BEND STR SZ 10-5

Facility

$266.50

Hospital Charge Code	270673446
Hospital Revenue Code	278
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$64.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.49
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

STENT CENTER BEND STR SZ 7-9

Facility

$266.50

Hospital Charge Code	270673445
Hospital Revenue Code	278
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$64.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.49
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

STENT CENTER BEND STR SZ 7-9

Facility

$266.50

Hospital Charge Code	270673445
Hospital Revenue Code	278
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$133.25
Rate for Payer: Aetna Commercial	$79.95
Rate for Payer: Aetna Medicare Advantage	$79.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.96
Rate for Payer: Cigna Commercial	$133.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.49
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

STENT CENTRAL DIALYS SEG ADDON

Facility

$1,034.20

Service Code	HCPCS 36908
Hospital Charge Code	5100842
Hospital Revenue Code	361
Min. Negotiated Rate	$134.45
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$310.26
Rate for Payer: Aetna Medicare Advantage	$310.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.72
Rate for Payer: Cigna Commercial	$195.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.45
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.13
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

STENT CENTRAL DIALYS SEG ADDON

Facility

$1,034.20

Service Code	HCPCS 36908
Hospital Charge Code	321036908
Hospital Revenue Code	361
Min. Negotiated Rate	$134.45
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$310.26
Rate for Payer: Aetna Medicare Advantage	$310.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.72
Rate for Payer: Cigna Commercial	$195.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.45
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.13
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

STENT CENTRAL DIALYS SEG ADDON

Facility

$1,034.20

Service Code	HCPCS 36908
Hospital Charge Code	2709029
Hospital Revenue Code	361
Min. Negotiated Rate	$155.13
Max. Negotiated Rate	$155.13
Rate for Payer: Qualcare PPO/HMO/WC	$155.13

Know your out-of-pocket cost for care.

All Charges