Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT MULTI-LINK RX 4.5X18MM

Facility

$3,325.00

Hospital Charge Code	270646285C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI-LINK RX 4.5X18MM

Facility

$3,325.00

Hospital Charge Code	270646285C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI LINK RX 5 0x18mm

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270646286
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI LINK RX 5 0x18mm

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270646286
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI-LINK RX 5.0X18MM

Facility

$3,325.00

Service Code	HCPCS C1876
Hospital Charge Code	270646286C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI-LINK RX 5.0X18MM

Facility

$3,325.00

Service Code	HCPCS C1876
Hospital Charge Code	270646286C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI-LINK RX 5.0x28mm

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270646287
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI-LINK RX 5.0x28mm

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270646287
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI-LINK RX 5.0X28MM

Facility

$3,325.00

Hospital Charge Code	270646287C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI-LINK RX 5.0X28MM

Facility

$3,325.00

Hospital Charge Code	270646287C
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

STENT MULTI MI 2.5X23 10078223

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643419C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI MI 2.5X23 10078223

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643419C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTIRX 3.0X18 100784818

Facility

$4,875.00

Hospital Charge Code	270643616C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MULTIRX 3.0X18 100784818

Facility

$4,875.00

Hospital Charge Code	270643616C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MULTI RX 30x28 10078428

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643618
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI RX 30x28 10078428

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643618
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI RX 3.0X8 100784808

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643613C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULTI RX 3.0X8 100784808

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643613C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULT-LK 2.5X18 100782318

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643367C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULT-LK 2.5X18 100782318

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643367C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULT RX 2.75X8 100784708

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270643417C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MULT RX 2.75X8 100784708

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270643417C
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

STENT MULT RX 3.0X28 100784828

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643618C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULT RX 3.0X28 100784828

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643618C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STENT MULT UL 5.0X13 100338213

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270643935N
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

Know your out-of-pocket cost for care.

All Charges