Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT FULLY COVERD 100

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270678265
Hospital Revenue Code	272
Min. Negotiated Rate	$1,820.00
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) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,820.00
Rate for Payer: Oxford Commercial	$7,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Commercial	$7,000.00

STENT FULLY COVERD 100

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270678265
Hospital Revenue Code	272
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STENT FULLY COVERED .035 X 100

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688581
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 FULLY COVERED .035 X 100

Facility

$14,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270688581
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 GEENEN PANCRE 5X7 GEPD57

Facility

$572.30

Hospital Charge Code	270637519
Hospital Revenue Code	278
Min. Negotiated Rate	$85.84
Max. Negotiated Rate	$286.15
Rate for Payer: Aetna Commercial	$171.69
Rate for Payer: Aetna Medicare Advantage	$171.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.94
Rate for Payer: Cigna Commercial	$286.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.50
Rate for Payer: Qualcare PPO/HMO/WC	$85.84

STENT GEENEN PANCRE 5X7 GEPD57

Facility

$572.30

Hospital Charge Code	270637519
Hospital Revenue Code	278
Min. Negotiated Rate	$85.84
Max. Negotiated Rate	$138.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.50
Rate for Payer: Qualcare PPO/HMO/WC	$85.84

STENT GEN 6x15 135cm PG1560BAX

Facility

$7,375.00

Hospital Charge Code	270637225C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,212.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT GEN 6x15 135cm PG1560BAX

Facility

$7,375.00

Hospital Charge Code	270637225C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT GEN 6X18 80 PG1860BSS

Facility

$6,944.00

Hospital Charge Code	270624012
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,083.20
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GEN 6X18 80 PG1860BSS

Facility

$6,944.00

Hospital Charge Code	270624012
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GEN 6X18 80 PG1860BSS

Facility

$6,944.00

Hospital Charge Code	270624012V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GEN 6X18 80 PG1860BSS

Facility

$6,944.00

Hospital Charge Code	270624012V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,083.20
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GEN 6X24 80 PG2460BXX

Facility

$7,056.00

Hospital Charge Code	270624013
Hospital Revenue Code	278
Min. Negotiated Rate	$1,058.40
Max. Negotiated Rate	$3,528.00
Rate for Payer: Aetna Commercial	$2,116.80
Rate for Payer: Aetna Medicare Advantage	$2,116.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,799.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,799.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,411.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,799.28
Rate for Payer: Cigna Commercial	$3,528.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,707.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,058.40

STENT GEN 6X24 80 PG2460BXX

Facility

$7,056.00

Hospital Charge Code	270624013
Hospital Revenue Code	278
Min. Negotiated Rate	$1,058.40
Max. Negotiated Rate	$1,707.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,411.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,707.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,058.40

STENT GEN 7F 9x29m PG2990BPX

Facility

$6,658.45

Hospital Charge Code	270624396
Hospital Revenue Code	278
Min. Negotiated Rate	$998.77
Max. Negotiated Rate	$1,611.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,331.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.34
Rate for Payer: Qualcare PPO/HMO/WC	$998.77

STENT GEN 7F 9x29m PG2990BPX

Facility

$6,725.00

Hospital Charge Code	270624396V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,008.75
Max. Negotiated Rate	$3,362.50
Rate for Payer: Aetna Commercial	$2,017.50
Rate for Payer: Aetna Medicare Advantage	$2,017.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.88
Rate for Payer: Cigna Commercial	$3,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,627.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,008.75

STENT GEN 7F 9x29m PG2990BPX

Facility

$6,658.45

Hospital Charge Code	270624396
Hospital Revenue Code	278
Min. Negotiated Rate	$998.77
Max. Negotiated Rate	$3,329.22
Rate for Payer: Aetna Commercial	$1,997.54
Rate for Payer: Aetna Medicare Advantage	$1,997.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,697.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,697.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,331.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,697.90
Rate for Payer: Cigna Commercial	$3,329.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.34
Rate for Payer: Qualcare PPO/HMO/WC	$998.77

STENT GEN 7F 9x29m PG2990BPX

Facility

$6,725.00

Hospital Charge Code	270624396V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,008.75
Max. Negotiated Rate	$1,627.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,627.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,008.75

STENT GENESI 7x15x80 PG1570BSS

Facility

$6,820.00

Hospital Charge Code	270631552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$3,410.00
Rate for Payer: Aetna Commercial	$2,046.00
Rate for Payer: Aetna Medicare Advantage	$2,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.10
Rate for Payer: Cigna Commercial	$3,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

STENT GENESI 7x15x80 PG1570BSS

Facility

$6,820.00

Hospital Charge Code	270631552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$1,650.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

STENT GENESIS 135CM PG2980BPX

Facility

$6,944.00

Hospital Charge Code	270625416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$3,472.00
Rate for Payer: Aetna Commercial	$2,083.20
Rate for Payer: Aetna Medicare Advantage	$2,083.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,770.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,770.72
Rate for Payer: Cigna Commercial	$3,472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GENESIS 135CM PG2980BPX

Facility

$6,944.00

Hospital Charge Code	270625416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.60
Max. Negotiated Rate	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,680.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.60

STENT GENESIS 4x18 135cm

Facility

$7,375.00

Hospital Charge Code	270635357
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,212.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT GENESIS 4x18 135cm

Facility

$7,375.00

Hospital Charge Code	270635357
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT GENESIS 5x15 135cm

Facility

$7,375.00

Hospital Charge Code	270635767
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

Know your out-of-pocket cost for care.

All Charges