Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT PERIPHERAL 5x100x120 6F

Facility

$8,805.00

Hospital Charge Code	270705281
Hospital Revenue Code	272
Min. Negotiated Rate	$1,320.75
Max. Negotiated Rate	$1,320.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.75

STENT PERMALUME 10X40 6970

Facility

$7,775.00

Hospital Charge Code	270638527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.25
Max. Negotiated Rate	$1,881.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,881.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.25

STENT PERMALUME 10X40 6970

Facility

$7,775.00

Hospital Charge Code	270638527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.25
Max. Negotiated Rate	$3,887.50
Rate for Payer: Aetna Commercial	$2,332.50
Rate for Payer: Aetna Medicare Advantage	$2,332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,982.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,982.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,982.62
Rate for Payer: Cigna Commercial	$3,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,881.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.25

STENTP EVERFLX6FR BL 7X30X120

Facility

$6,975.00

Service Code	HCPCS C2617
Hospital Charge Code	270644086S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

STENTP EVERFLX6FR BL 7X30X120

Facility

$4,500.00

Service Code	HCPCS C2617
Hospital Charge Code	270644086
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENTP EVERFLX6FR BL 7X30X120

Facility

$4,500.00

Service Code	HCPCS C2617
Hospital Charge Code	270644086
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

STENTP EVERFLX6FR BL 7X30X120

Facility

$6,975.00

Service Code	HCPCS C2617
Hospital Charge Code	270644086S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

STENTP EVERFLX6FR BL 8X120X120

Facility

$8,350.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

STENTP EVERFLX6FR BL 8X120X120

Facility

$1,695.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523N
Hospital Revenue Code	278
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$847.50
Rate for Payer: Aetna Commercial	$508.50
Rate for Payer: Aetna Medicare Advantage	$508.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.23
Rate for Payer: Cigna Commercial	$847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.19
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

STENTP EVERFLX6FR BL 8X120X120

Facility

$1,695.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523S
Hospital Revenue Code	278
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$410.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.19
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

STENTP EVERFLX6FR BL 8X120X120

Facility

$1,695.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523S
Hospital Revenue Code	278
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$847.50
Rate for Payer: Aetna Commercial	$508.50
Rate for Payer: Aetna Medicare Advantage	$508.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.23
Rate for Payer: Cigna Commercial	$847.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.19
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

STENTP EVERFLX6FR BL 8X120X120

Facility

$8,350.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$2,505.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

STENTP EVERFLX6FR BL 8X120X120

Facility

$1,695.00

Service Code	HCPCS C2617
Hospital Charge Code	270635523N
Hospital Revenue Code	278
Min. Negotiated Rate	$254.25
Max. Negotiated Rate	$410.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.19
Rate for Payer: Qualcare PPO/HMO/WC	$254.25

STENTP EVERFLX6FR BL 8X60X120

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270635763
Hospital Revenue Code	278
Min. Negotiated Rate	$993.72
Max. Negotiated Rate	$1,603.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: Qualcare PPO/HMO/WC	$993.72

STENTP EVERFLX6FR BL 8X60X120

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270635763
Hospital Revenue Code	278
Min. Negotiated Rate	$993.72
Max. Negotiated Rate	$3,312.40
Rate for Payer: Aetna Commercial	$1,987.44
Rate for Payer: Aetna Medicare Advantage	$1,987.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.32
Rate for Payer: Cigna Commercial	$3,312.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: Qualcare PPO/HMO/WC	$993.72

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763N
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$418.50
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763N
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763S
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763S
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$418.50
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENT P GPS 8x120SERB650812012

Facility

$9,176.00

Hospital Charge Code	270635523V
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 P GPS 8x120SERB650812012

Facility

$9,176.00

Hospital Charge Code	270635523V
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 P GPS SERB6506120120

Facility

$9,176.00

Hospital Charge Code	270635521V
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 P GPS SERB6506120120

Facility

$9,176.00

Hospital Charge Code	270635521
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 P GPS SERB6506120120

Facility

$9,176.00

Hospital Charge Code	270635521V
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 P GPS SERB6506120120

Facility

$9,176.00

Hospital Charge Code	270635521
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

Know your out-of-pocket cost for care.

All Charges