Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT HERCULINK RX 7X18X80CM

Facility

$4,750.00

Hospital Charge Code	270644563C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT HRCLNK7X15X80 1011504-15

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270646392C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,395.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT HRCLNK7X15X80 1011504-15

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270646392C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT HRCLNK7X15X80 1011504-18

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270646393C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,395.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT HRCLNK7X15X80 1011504-18

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270646393C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT HRK RX 6X18X80 100802018

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270644203C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,395.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT HRK RX 6X18X80 100802018

Facility

$4,650.00

Service Code	HCPCS C1876
Hospital Charge Code	270644203C
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

STENT I CAST 10MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270645521C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 10MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270645521C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$3,630.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 5MMX16MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647292C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 5MMX16MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647292C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$3,630.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 6MMX22MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647293C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$3,630.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 6MMX22MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647293C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I-CAST 6x22MM 120CM

Facility

$12,575.00

Service Code	HCPCS C1874
Hospital Charge Code	270647293
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$6,287.50
Rate for Payer: Aetna Commercial	$3,772.50
Rate for Payer: Aetna Medicare Advantage	$3,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,206.62
Rate for Payer: Cigna Commercial	$6,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I-CAST 6x22MM 120CM

Facility

$12,575.00

Service Code	HCPCS C1874
Hospital Charge Code	270647293
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$3,043.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I-CAST 6x22MM 80CM

Facility

$12,575.00

Hospital Charge Code	270678107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$6,287.50
Rate for Payer: Aetna Commercial	$3,772.50
Rate for Payer: Aetna Medicare Advantage	$3,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,206.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,206.62
Rate for Payer: Cigna Commercial	$6,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I-CAST 6x22MM 80CM

Facility

$12,575.00

Hospital Charge Code	270678107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,886.25
Max. Negotiated Rate	$3,043.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,043.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,886.25

STENT I CAST 7MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647294C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$3,630.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 7MMX38MMX120CM

Facility

$12,100.00

Hospital Charge Code	270647294C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

STENT I CAST 8MMX59MX80CM

Facility

$13,875.00

Hospital Charge Code	270634582C
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 I CAST 8MMX59MX80CM

Facility

$13,875.00

Hospital Charge Code	270634582C
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 ICAST COV 6MMx38MMx80CM

Facility

$13,875.00

Hospital Charge Code	270653399
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 ICAST COV 6MMx38MMx80CM

Facility

$13,875.00

Hospital Charge Code	270653399
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 ICAST COV 7MMx59MMx80CM

Facility

$13,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270653401
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 ICAST COV 7MMx59MMx80CM

Facility

$13,875.00

Service Code	HCPCS C1874
Hospital Charge Code	270653401
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

Know your out-of-pocket cost for care.

All Charges