Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT SUPERA 6.5x40x120 6F

Facility

$8,137.50

Hospital Charge Code	270705288
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 6.5x40x120 6F

Facility

$8,137.50

Hospital Charge Code	270705288
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 6.5x80MM 120CM

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270675915
Hospital Revenue Code	278
Min. Negotiated Rate	$1,220.62
Max. Negotiated Rate	$1,969.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,969.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62

STENT SUPERA 6.5x80MM 120CM

Facility

$8,137.50

Service Code	HCPCS C1876
Hospital Charge Code	270675915
Hospital Revenue Code	278
Min. Negotiated Rate	$1,220.62
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) NJ Health	$1,627.50
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	$1,969.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,220.62

STENT SUPERA 6X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644887
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 6X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644887C
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 6X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644887C
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 6X100MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644887
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 6X120MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644889
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 6X120MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644889
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 6X40MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644883C
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 6X40MM 120CM

Facility

$8,250.00

Hospital Charge Code	270644883C
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 7.5x40x120 6F

Facility

$8,137.50

Hospital Charge Code	270705290
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 7.5x40x120 6F

Facility

$8,137.50

Hospital Charge Code	270705290
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 7.5x60x120 6F

Facility

$8,137.50

Hospital Charge Code	270705291
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 7.5x60x120 6F

Facility

$8,137.50

Hospital Charge Code	270705291
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 7.5x80x120 6F

Facility

$8,137.50

Hospital Charge Code	270705292
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 7.5x80x120 6F

Facility

$8,137.50

Hospital Charge Code	270705292
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 7x60x120 6F

Facility

$8,137.50

Hospital Charge Code	270705289
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 7x60x120 6F

Facility

$8,137.50

Hospital Charge Code	270705289
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 PERIPH 4.5x100MM

Facility

$8,805.00

Service Code	HCPCS C1875
Hospital Charge Code	270672353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,320.75
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) NJ Health	$1,761.00
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	$2,130.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.75

STENT SUPERA PERIPH 4.5x100MM

Facility

$7,750.00

Service Code	HCPCS C1875
Hospital Charge Code	270672353N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT SUPERA PERIPH 4.5x100MM

Facility

$8,805.00

Service Code	HCPCS C1875
Hospital Charge Code	270672353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,320.75
Max. Negotiated Rate	$2,130.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,761.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,130.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.75

STENT SUPERA PERIPH 4.5x100MM

Facility

$7,750.00

Service Code	HCPCS C1875
Hospital Charge Code	270672353N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,325.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

STENT SUPRA 5.5 60 MM

Facility

$7,750.00

Service Code	HCPCS C1876
Hospital Charge Code	270668265O
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,325.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

Know your out-of-pocket cost for care.

All Charges