Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT TAXUS 2 5X24 389682425

Facility

$21,118.75

Hospital Charge Code	270636965
Hospital Revenue Code	278
Min. Negotiated Rate	$3,167.81
Max. Negotiated Rate	$5,110.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,223.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,110.74
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81

STENT TAXUS 2 5X24 389682425

Facility

$21,118.75

Hospital Charge Code	270636965
Hospital Revenue Code	278
Min. Negotiated Rate	$3,167.81
Max. Negotiated Rate	$10,559.38
Rate for Payer: Aetna Commercial	$6,335.62
Rate for Payer: Aetna Medicare Advantage	$6,335.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,385.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,385.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,385.28
Rate for Payer: Cigna Commercial	$10,559.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,110.74
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81

STENT TAXUS EXPRESS 2.75x24mm

Facility

$13,625.00

Hospital Charge Code	270637404
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$4,087.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TAXUS EXPRESS 2.75x24mm

Facility

$13,625.00

Hospital Charge Code	270637404
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TRACH CVRD 17FR 12x30mm

Facility

$15,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270673159
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 17FR 12x30mm

Facility

$15,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270673159
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 18FR 14x60mm

Facility

$15,000.00

Hospital Charge Code	270676650
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 18FR 14x60mm

Facility

$15,000.00

Hospital Charge Code	270676650
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 1FR 14x30mm

Facility

$15,000.00

Hospital Charge Code	270676649
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACH CVRD 1FR 14x30mm

Facility

$15,000.00

Hospital Charge Code	270676649
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STENT TRACHEAL SIZE 40 6957

Facility

$8,400.00

Hospital Charge Code	270638727V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$4,200.00
Rate for Payer: Aetna Commercial	$2,520.00
Rate for Payer: Aetna Medicare Advantage	$2,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.00
Rate for Payer: Cigna Commercial	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

STENT TRACHEAL SIZE 40 6957

Facility

$8,400.00

Hospital Charge Code	270638727V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$2,032.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

STENT TRACHEAL SIZE 60

Facility

$8,400.00

Hospital Charge Code	270638729
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$2,032.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

STENT TRACHEAL SIZE 60

Facility

$8,400.00

Hospital Charge Code	270638729
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$4,200.00
Rate for Payer: Aetna Commercial	$2,520.00
Rate for Payer: Aetna Medicare Advantage	$2,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.00
Rate for Payer: Cigna Commercial	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

STENT TRACH P/COVRD 12x40x25MM

Facility

$16,500.00

Service Code	HCPCS C1874
Hospital Charge Code	270676648
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TRACH P/COVRD 12x40x25MM

Facility

$16,500.00

Service Code	HCPCS C1874
Hospital Charge Code	270676648
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$4,950.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TRACH P/COVRD 14x40x40MM

Facility

$16,500.00

Service Code	HCPCS C1874
Hospital Charge Code	270677586
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TRACH P/COVRD 14x40x40MM

Facility

$16,500.00

Service Code	HCPCS C1874
Hospital Charge Code	270677586
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$4,950.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TRACH P/COVRD 16x40x40MM

Facility

$16,500.00

Hospital Charge Code	270677587
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TRACH P/COVRD 16x40x40MM

Facility

$16,500.00

Hospital Charge Code	270677587
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$4,950.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

STENT TREVO 3 X 20 CM

Facility

$39,975.00

Hospital Charge Code	270685068
Hospital Revenue Code	278
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$11,992.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

STENT TREVO 3 X 20 CM

Facility

$39,975.00

Hospital Charge Code	270685068
Hospital Revenue Code	278
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$9,673.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,673.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

STENT TX EXP 2 75X32 389703227

Facility

$13,625.00

Hospital Charge Code	270637365
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$3,297.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TX EXP 2 75X32 389703227

Facility

$13,625.00

Hospital Charge Code	270637365
Hospital Revenue Code	278
Min. Negotiated Rate	$2,043.75
Max. Negotiated Rate	$6,812.50
Rate for Payer: Aetna Commercial	$4,087.50
Rate for Payer: Aetna Medicare Advantage	$4,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,474.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,474.38
Rate for Payer: Cigna Commercial	$6,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,297.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,043.75

STENT TX XPEDITION 2.75X18

Facility

$7,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270658768
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

Know your out-of-pocket cost for care.

All Charges