Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT PIPELINESHIELD 4.25X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699009S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699274S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699274S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699630S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699630S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4X10MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699005S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4X10MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699005S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4x14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699008S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4x14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699008S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$26,790.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	366837218
Hospital Revenue Code	361
Min. Negotiated Rate	$562.64
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,298.40
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$802.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.64
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	366837218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$562.64
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,298.40
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$802.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.64
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

STENT PLACEMT RETRO CAROTID

Facility

$20,000.00

Service Code	HCPCS 37217
Hospital Charge Code	411037217
Hospital Revenue Code	360
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

STENT PLACEMT RETRO CAROTID

Facility

$20,000.00

Service Code	HCPCS 37217
Hospital Charge Code	411037217
Hospital Revenue Code	360
Min. Negotiated Rate	$1,056.20
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$1,056.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

STENT PLASTIC 7 X12

Facility

$670.00

Service Code	HCPCS C2625
Hospital Charge Code	270663632
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

STENT PLASTIC 7 X12

Facility

$670.00

Service Code	HCPCS C2625
Hospital Charge Code	270663632
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$201.00
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

STENT PM RX 2.75x12 100954012B

Facility

$10,250.00

Hospital Charge Code	270642159C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT PM RX 2.75x12 100954012B

Facility

$10,250.00

Hospital Charge Code	270642159C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT PR 6F 8X60 SERB650860120

Facility

$6,000.00

Hospital Charge Code	270636798V
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STENT PR 6F 8X60 SERB650860120

Facility

$6,000.00

Hospital Charge Code	270636798V
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STENT PRECISE BILI 6x30 N630SB

Facility

$9,672.00

Hospital Charge Code	270628402
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.80
Max. Negotiated Rate	$2,340.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80

STENT PRECISE BILI 6x30 N630SB

Facility

$9,672.00

Hospital Charge Code	270628402
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.80
Max. Negotiated Rate	$4,836.00
Rate for Payer: Aetna Commercial	$2,901.60
Rate for Payer: Aetna Medicare Advantage	$2,901.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,466.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,466.36
Rate for Payer: Cigna Commercial	$4,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.80

STENT PRECISE BILI 6x30 N630SB

Facility

$9,750.00

Hospital Charge Code	270628402V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

STENT PRECISE BILI 6x30 N630SB

Facility

$9,750.00

Hospital Charge Code	270628402V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

Know your out-of-pocket cost for care.

All Charges