Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT DRUG-ELUT PERIPH 6x80MM

Facility

$8,975.00

Hospital Charge Code	270667654
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT EMBOL PIPLINE 4X12MM

Facility

$89,300.00

Service Code	HCPCS C1884
Hospital Charge Code	270696541S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT EMBOL PIPLINE 4X12MM

Facility

$89,300.00

Service Code	HCPCS C1884
Hospital Charge Code	270696541S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT ENDOMAXX 23MM 120 MM

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688794
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$4,200.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STENT ENDOMAXX 23MM 120 MM

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688794
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STENT ENDOMAXX 23MM 150 MM

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688795
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STENT ENDOMAXX 23MM 150 MM

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688795
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$4,200.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STENT ENDOPROSTH GFT 8X7.6MM

Facility

$19,230.00

Service Code	HCPCS C1874
Hospital Charge Code	270689581S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,884.50
Max. Negotiated Rate	$4,653.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,653.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,884.50

STENT ENDOPROSTH GFT 8X7.6MM

Facility

$19,230.00

Service Code	HCPCS C1874
Hospital Charge Code	270689581S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,884.50
Max. Negotiated Rate	$9,615.00
Rate for Payer: Aetna Commercial	$5,769.00
Rate for Payer: Aetna Medicare Advantage	$5,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,903.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,903.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,903.65
Rate for Payer: Cigna Commercial	$9,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,653.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,884.50

STENT ENDOPYELOTOMY RETROMAX

Facility

$990.00

Hospital Charge Code	270655402
Hospital Revenue Code	278
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$239.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$148.50

STENT ENDOPYELOTOMY RETROMAX

Facility

$990.00

Hospital Charge Code	270655402
Hospital Revenue Code	278
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$495.00
Rate for Payer: Aetna Commercial	$297.00
Rate for Payer: Aetna Medicare Advantage	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.45
Rate for Payer: Cigna Commercial	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$148.50

STENT ENDOVASCU G48432

Facility

$42,290.00

Hospital Charge Code	270647928C
Hospital Revenue Code	278
Min. Negotiated Rate	$6,343.50
Max. Negotiated Rate	$21,145.00
Rate for Payer: Aetna Commercial	$12,687.00
Rate for Payer: Aetna Medicare Advantage	$12,687.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,783.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,783.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,458.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,783.95
Rate for Payer: Cigna Commercial	$21,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,234.18
Rate for Payer: Qualcare PPO/HMO/WC	$6,343.50

STENT ENDOVASCU G48432

Facility

$42,290.00

Hospital Charge Code	270647928C
Hospital Revenue Code	278
Min. Negotiated Rate	$6,343.50
Max. Negotiated Rate	$10,234.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,458.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,234.18
Rate for Payer: Qualcare PPO/HMO/WC	$6,343.50

STENT EPIC VASC 6FR 8x60x75

Facility

$6,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270677594N
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STENT EPIC VASC 6FR 8x60x75

Facility

$6,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270677594N
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STENT EPIC VASC 6FR 8x60x75

Facility

$5,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677594
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

STENT EPIC VASC 6FR 8x60x75

Facility

$5,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677594
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

STENT ESOPHAGEAL 23x18x90 1430

Facility

$9,176.00

Hospital Charge Code	270632323
Hospital Revenue Code	278
Min. Negotiated Rate	$1,376.40
Max. Negotiated Rate	$2,220.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,835.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,220.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,376.40

STENT ESOPHAGEAL 23x18x90 1430

Facility

$9,176.00

Hospital Charge Code	270632323
Hospital Revenue Code	278
Min. Negotiated Rate	$1,376.40
Max. Negotiated Rate	$4,588.00
Rate for Payer: Aetna Commercial	$2,752.80
Rate for Payer: Aetna Medicare Advantage	$2,752.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,339.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,339.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,835.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,339.88
Rate for Payer: Cigna Commercial	$4,588.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,220.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,376.40

STENT ESOPHAGEAL POLYFLEX 1430

Facility

$14,337.50

Hospital Charge Code	270637105
Hospital Revenue Code	278
Min. Negotiated Rate	$2,150.62
Max. Negotiated Rate	$7,168.75
Rate for Payer: Aetna Commercial	$4,301.25
Rate for Payer: Aetna Medicare Advantage	$4,301.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,656.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,656.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,867.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,656.06
Rate for Payer: Cigna Commercial	$7,168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,469.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,150.62

STENT ESOPHAGEAL POLYFLEX 1430

Facility

$14,337.50

Hospital Charge Code	270637105
Hospital Revenue Code	278
Min. Negotiated Rate	$2,150.62
Max. Negotiated Rate	$3,469.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,469.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,150.62

STENT ESOPHAGEAL POLYFLEX 1431

Facility

$14,337.50

Hospital Charge Code	270637104
Hospital Revenue Code	278
Min. Negotiated Rate	$2,150.62
Max. Negotiated Rate	$3,469.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,469.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,150.62

STENT ESOPHAGEAL POLYFLEX 1431

Facility

$14,337.50

Hospital Charge Code	270637104
Hospital Revenue Code	278
Min. Negotiated Rate	$2,150.62
Max. Negotiated Rate	$7,168.75
Rate for Payer: Aetna Commercial	$4,301.25
Rate for Payer: Aetna Medicare Advantage	$4,301.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,656.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,656.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,867.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,656.06
Rate for Payer: Cigna Commercial	$7,168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,469.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,150.62

STENT ESOPHAGEAL WALLFLEX

Facility

$12,500.00

Hospital Charge Code	270659234
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STENT ESOPHAGEAL WALLFLEX

Facility

$12,500.00

Hospital Charge Code	270659234
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

Know your out-of-pocket cost for care.

All Charges