Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT MCV CONTOR 6X22 18022101

Facility

$1,149.65

Hospital Charge Code	270615912
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV CONTOR 6X22 18022101

Facility

$1,149.65

Hospital Charge Code	270615912
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$344.89
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV CONTOR 6X24 18022201

Facility

$1,149.65

Service Code	HCPCS C1876
Hospital Charge Code	270615913
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV CONTOR 6X24 18022201

Facility

$1,149.65

Service Code	HCPCS C1876
Hospital Charge Code	270615913
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$344.89
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV CONTOR 6X26 18022301

Facility

$1,149.65

Hospital Charge Code	270615914
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV CONTOR 6X26 18022301

Facility

$1,149.65

Hospital Charge Code	270615914
Hospital Revenue Code	278
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$344.89
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

STENT MCV ESOPH 16F 1310

Facility

$5,443.25

Hospital Charge Code	270617890
Hospital Revenue Code	278
Min. Negotiated Rate	$816.49
Max. Negotiated Rate	$1,317.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,088.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,317.27
Rate for Payer: Qualcare PPO/HMO/WC	$816.49

STENT MCV ESOPH 16F 1310

Facility

$5,443.25

Hospital Charge Code	270617890
Hospital Revenue Code	278
Min. Negotiated Rate	$816.49
Max. Negotiated Rate	$2,721.62
Rate for Payer: Aetna Commercial	$1,632.97
Rate for Payer: Aetna Medicare Advantage	$1,632.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,388.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,388.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,088.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,388.03
Rate for Payer: Cigna Commercial	$2,721.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,317.27
Rate for Payer: Qualcare PPO/HMO/WC	$816.49

STENT MCV PERC 6 80 160-205

Facility

$960.00

Hospital Charge Code	270626530
Hospital Revenue Code	278
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$232.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

STENT MCV PERC 6 80 160-205

Facility

$960.00

Hospital Charge Code	270626530
Hospital Revenue Code	278
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$480.00
Rate for Payer: Aetna Commercial	$288.00
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

STENT MCV PERC 7 24 175-272

Facility

$693.65

Hospital Charge Code	270626138
Hospital Revenue Code	278
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$346.82
Rate for Payer: Aetna Commercial	$208.09
Rate for Payer: Aetna Medicare Advantage	$208.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.88
Rate for Payer: Cigna Commercial	$346.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.86
Rate for Payer: Qualcare PPO/HMO/WC	$104.05

STENT MCV PERC 7 24 175-272

Facility

$693.65

Hospital Charge Code	270626138
Hospital Revenue Code	278
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$167.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.86
Rate for Payer: Qualcare PPO/HMO/WC	$104.05

STENT MCV WALL 10 22 60 6558

Facility

$9,135.25

Hospital Charge Code	270629356
Hospital Revenue Code	278
Min. Negotiated Rate	$1,370.29
Max. Negotiated Rate	$4,567.62
Rate for Payer: Aetna Commercial	$2,740.57
Rate for Payer: Aetna Medicare Advantage	$2,740.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,329.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,329.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,827.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,329.49
Rate for Payer: Cigna Commercial	$4,567.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,370.29

STENT MCV WALL 10 22 60 6558

Facility

$9,135.25

Hospital Charge Code	270629356
Hospital Revenue Code	278
Min. Negotiated Rate	$1,370.29
Max. Negotiated Rate	$2,210.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,827.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,370.29

STENT MDT FEM ILIAC YR1R1485

Facility

$8,971.25

Hospital Charge Code	270623301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,345.69
Max. Negotiated Rate	$4,485.62
Rate for Payer: Aetna Commercial	$2,691.38
Rate for Payer: Aetna Medicare Advantage	$2,691.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,287.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,287.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,287.67
Rate for Payer: Cigna Commercial	$4,485.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.69

STENT MDT FEM ILIAC YR1R1485

Facility

$8,971.25

Hospital Charge Code	270623301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,345.69
Max. Negotiated Rate	$2,171.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,794.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.69

STENT MDT FEM ILIAC YRIR14115

Facility

$9,777.65

Hospital Charge Code	270623300
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.65
Max. Negotiated Rate	$2,366.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,366.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.65

STENT MDT FEM ILIAC YRIR14115

Facility

$9,777.65

Hospital Charge Code	270623300
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.65
Max. Negotiated Rate	$4,888.82
Rate for Payer: Aetna Commercial	$2,933.30
Rate for Payer: Aetna Medicare Advantage	$2,933.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,493.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,493.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,493.30
Rate for Payer: Cigna Commercial	$4,888.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,366.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.65

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$6,421.23
Rate for Payer: Aetna Commercial	$3,852.74
Rate for Payer: Aetna Medicare Advantage	$3,852.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,274.82
Rate for Payer: Cigna Commercial	$6,421.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$3,107.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$3,107.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT MEDT ILIAC 16 11.5 16115

Facility

$12,842.45

Hospital Charge Code	270629597V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.37
Max. Negotiated Rate	$6,421.23
Rate for Payer: Aetna Commercial	$3,852.74
Rate for Payer: Aetna Medicare Advantage	$3,852.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,274.82
Rate for Payer: Cigna Commercial	$6,421.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.37

STENT METALLIC URETERAL 20CM

Facility

$4,770.00

Hospital Charge Code	270674320
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,431.00
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 20CM

Facility

$4,770.00

Hospital Charge Code	270674320
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$1,154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

STENT METALLIC URETERAL 22CM

Facility

$4,770.00

Service Code	HCPCS C2617
Hospital Charge Code	270674321
Hospital Revenue Code	278
Min. Negotiated Rate	$715.50
Max. Negotiated Rate	$2,385.00
Rate for Payer: Aetna Commercial	$1,431.00
Rate for Payer: Aetna Medicare Advantage	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,216.35
Rate for Payer: Cigna Commercial	$2,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.34
Rate for Payer: Qualcare PPO/HMO/WC	$715.50

Know your out-of-pocket cost for care.

All Charges