Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT PROTEGE RX 10/7x40 130cm

Facility

$10,500.00

Hospital Charge Code	270643691
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 10/7x40 135cm

Facility

$10,500.00

Hospital Charge Code	270638619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 10/7x40 135cm

Facility

$10,500.00

Hospital Charge Code	270638619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 7X20 135CM

Facility

$11,250.00

Hospital Charge Code	270640328
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

STENT PROTEGE RX 7X20 135CM

Facility

$11,250.00

Hospital Charge Code	270640328
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

STENT PROTEGE RX 7X30 135CM

Facility

$11,250.00

Hospital Charge Code	270640327
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

STENT PROTEGE RX 7X30 135CM

Facility

$11,250.00

Hospital Charge Code	270640327
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

STENT PROTEGE RX 7X40 135CM

Facility

$10,500.00

Hospital Charge Code	270641658
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 7X40 135CM

Facility

$10,500.00

Hospital Charge Code	270641658
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 8/6x30 135cm

Facility

$10,500.00

Hospital Charge Code	270639757
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 8/6x30 135cm

Facility

$10,500.00

Hospital Charge Code	270639757
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 8x30 135cm

Facility

$10,500.00

Hospital Charge Code	270639015
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE RX 8x30 135cm

Facility

$10,500.00

Hospital Charge Code	270639015
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STENT PROTEGE SERB65-07-60-120

Facility

$7,192.00

Hospital Charge Code	270636205V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,078.80
Max. Negotiated Rate	$3,596.00
Rate for Payer: Aetna Commercial	$2,157.60
Rate for Payer: Aetna Medicare Advantage	$2,157.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,833.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,833.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,438.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,833.96
Rate for Payer: Cigna Commercial	$3,596.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,740.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.80

STENT PROTEGE SERB65-07-60-120

Facility

$7,192.00

Hospital Charge Code	270636205V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,078.80
Max. Negotiated Rate	$1,740.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,438.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,740.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.80

STENT PROTEGE SERB65-07-60-120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636205N
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 PROTEGE SERB65-07-60-120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636205N
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

STENT PROTEGE SERB65-07-60-120

Facility

$1,395.00

Hospital Charge Code	270636205
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 PROTEGE SERB65-07-60-120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636205S
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 PROTEGE SERB65-07-60-120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636205S
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

STENT PROTEGE SERB65-07-60-120

Facility

$1,395.00

Hospital Charge Code	270636205
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

STENT PROTEG PRB-35-07-100-120

Facility

$7,500.00

Hospital Charge Code	270638088V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

STENT PROTEG PRB-35-07-100-120

Facility

$7,500.00

Hospital Charge Code	270638088V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

STENTPROTEGVERFLEX6FR8/060/120

Facility

$6,975.00

Hospital Charge Code	2709003217
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

STENTPROTEGVERFLEX6FR8/060/120

Facility

$6,975.00

Hospital Charge Code	2709003217
Hospital Revenue Code	272
Min. Negotiated Rate	$906.75
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) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$906.75
Rate for Payer: Oxford Commercial	$3,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$3,487.50

Know your out-of-pocket cost for care.

All Charges