Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT ST BILI 7x60x80 C07060SB

Facility

$8,225.00

Hospital Charge Code	270632503V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75

STENT ST BILI 7x80x80 C07080SB

Facility

$9,875.00

Hospital Charge Code	270632504V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$2,962.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

STENT ST BILI 7x80x80 C07080SB

Facility

$9,875.00

Hospital Charge Code	270632504V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

STENT ST BILI 7x80x80 C07080SB

Facility

$9,796.00

Hospital Charge Code	270632504
Hospital Revenue Code	278
Min. Negotiated Rate	$1,469.40
Max. Negotiated Rate	$2,370.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,959.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,370.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,469.40

STENT ST BILI 7x80x80 C07080SB

Facility

$9,796.00

Hospital Charge Code	270632504
Hospital Revenue Code	278
Min. Negotiated Rate	$1,469.40
Max. Negotiated Rate	$4,898.00
Rate for Payer: Aetna Commercial	$2,938.80
Rate for Payer: Aetna Medicare Advantage	$2,938.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,497.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,497.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,959.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,497.98
Rate for Payer: Cigna Commercial	$4,898.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,370.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,469.40

STENT STRAIGHT LEADING 5FRx5CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679133
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

STENT STRAIGHT LEADING 5FRx5CM

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679133
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

STENT STSB BIL 10x60 80 C10060

Facility

$7,316.00

Hospital Charge Code	270631415V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.40
Max. Negotiated Rate	$3,658.00
Rate for Payer: Aetna Commercial	$2,194.80
Rate for Payer: Aetna Medicare Advantage	$2,194.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,865.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,865.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,463.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,865.58
Rate for Payer: Cigna Commercial	$3,658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,097.40

STENT STSB BIL 10x60 80 C10060

Facility

$7,316.00

Hospital Charge Code	270631415V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.40
Max. Negotiated Rate	$1,770.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,463.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,097.40

STENT STSB BIL 10x60 80 C10060

Facility

$7,316.00

Hospital Charge Code	270631415
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.40
Max. Negotiated Rate	$3,658.00
Rate for Payer: Aetna Commercial	$2,194.80
Rate for Payer: Aetna Medicare Advantage	$2,194.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,865.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,865.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,463.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,865.58
Rate for Payer: Cigna Commercial	$3,658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,097.40

STENT STSB BIL 10x60 80 C10060

Facility

$7,316.00

Hospital Charge Code	270631415
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.40
Max. Negotiated Rate	$1,770.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,463.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,097.40

STENT SUP 5X40X120 S05040120G2

Facility

$8,250.00

Hospital Charge Code	270644818C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT SUP 5X40X120 S05040120G2

Facility

$8,250.00

Hospital Charge Code	270644818C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$2,475.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT SUPERA 4.5x100MM

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270671334
Hospital Revenue Code	272
Min. Negotiated Rate	$1,220.62
Max. Negotiated Rate	$1,220.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62

STENT SUPERA 4.5x100MM

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270671334
Hospital Revenue Code	272
Min. Negotiated Rate	$1,057.88
Max. Negotiated Rate	$4,068.75
Rate for Payer: Aetna Commercial	$2,441.25
Rate for Payer: Aetna Medicare Advantage	$2,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,075.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,075.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,075.06
Rate for Payer: Cigna Commercial	$4,068.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,057.88
Rate for Payer: Oxford Commercial	$4,068.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62
Rate for Payer: UnitedHealthcare Commercial	$4,068.75

STENT SUPERA 4.5x120mm 6F

Facility

$8,805.00

Hospital Charge Code	270705282
Hospital Revenue Code	272
Min. Negotiated Rate	$1,144.65
Max. Negotiated Rate	$4,402.50
Rate for Payer: Aetna Commercial	$2,641.50
Rate for Payer: Aetna Medicare Advantage	$2,641.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,245.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,245.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,245.28
Rate for Payer: Cigna Commercial	$4,402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,144.65
Rate for Payer: Oxford Commercial	$4,402.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.75
Rate for Payer: UnitedHealthcare Commercial	$4,402.50

STENT SUPERA 4.5x120mm 6F

Facility

$9,945.00

Service Code	HCPCS C1876
Hospital Charge Code	270672069
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.75
Max. Negotiated Rate	$4,972.50
Rate for Payer: Aetna Commercial	$2,983.50
Rate for Payer: Aetna Medicare Advantage	$2,983.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.97
Rate for Payer: Cigna Commercial	$4,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.75

STENT SUPERA 4.5x120mm 6F

Facility

$8,805.00

Hospital Charge Code	270705282
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 SUPERA 4.5x120mm 6F

Facility

$9,945.00

Service Code	HCPCS C1876
Hospital Charge Code	270672069
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.75
Max. Negotiated Rate	$2,406.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,989.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.75

STENT SUPERA 4.5x60mm 120cm 6F

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270670960
Hospital Revenue Code	272
Min. Negotiated Rate	$1,057.88
Max. Negotiated Rate	$4,068.75
Rate for Payer: Aetna Commercial	$2,441.25
Rate for Payer: Aetna Medicare Advantage	$2,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,075.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,075.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,075.06
Rate for Payer: Cigna Commercial	$4,068.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,057.88
Rate for Payer: Oxford Commercial	$4,068.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62
Rate for Payer: UnitedHealthcare Commercial	$4,068.75

STENT SUPERA 4.5x60mm 120cm 6F

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270670960
Hospital Revenue Code	272
Min. Negotiated Rate	$1,220.62
Max. Negotiated Rate	$1,220.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62

STENT SUPERA 4X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644886C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$2,475.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT SUPERA 4X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644886C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT SUPERA 4X120MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644888C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

STENT SUPERA 4X120MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644888C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$2,475.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

Know your out-of-pocket cost for care.

All Charges