Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT VIABAHN ENDOPRO 7MMx10CM

Facility

$19,270.00

Service Code	HCPCS C1876
Hospital Charge Code	270676102
Hospital Revenue Code	278
Min. Negotiated Rate	$2,890.50
Max. Negotiated Rate	$4,663.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,854.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,663.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,890.50

STENT VIABAHN HEPA 11MMX10CM

Facility

$18,760.00

Service Code	HCPCS C1876
Hospital Charge Code	270687576
Hospital Revenue Code	278
Min. Negotiated Rate	$2,814.00
Max. Negotiated Rate	$9,380.00
Rate for Payer: Aetna Commercial	$5,628.00
Rate for Payer: Aetna Medicare Advantage	$5,628.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,783.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,783.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,783.80
Rate for Payer: Cigna Commercial	$9,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,539.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,814.00

STENT VIABAHN HEPA 11MMX10CM

Facility

$18,760.00

Service Code	HCPCS C1876
Hospital Charge Code	270687576
Hospital Revenue Code	278
Min. Negotiated Rate	$2,814.00
Max. Negotiated Rate	$4,539.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,752.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,539.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,814.00

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$5,488.50
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679850
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$17,850.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,677.50
Max. Negotiated Rate	$4,319.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,319.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,677.50

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679850
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$5,488.50
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$5,488.50
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$18,295.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

STENT VIABAHN VBX

Facility

$17,850.00

Service Code	HCPCS C1876
Hospital Charge Code	270679851N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,677.50
Max. Negotiated Rate	$8,925.00
Rate for Payer: Aetna Commercial	$5,355.00
Rate for Payer: Aetna Medicare Advantage	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,551.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,551.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,551.75
Rate for Payer: Cigna Commercial	$8,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,319.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,677.50

STENT VIABH 13x10x110 VB131002

Facility

$24,242.84

Hospital Charge Code	270635160V
Hospital Revenue Code	278
Min. Negotiated Rate	$3,636.43
Max. Negotiated Rate	$5,866.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,848.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,866.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,636.43

STENT VIABH 13x10x110 VB131002

Facility

$24,242.84

Hospital Charge Code	270635160V
Hospital Revenue Code	278
Min. Negotiated Rate	$3,636.43
Max. Negotiated Rate	$12,121.42
Rate for Payer: Aetna Commercial	$7,272.85
Rate for Payer: Aetna Medicare Advantage	$7,272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,848.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,181.92
Rate for Payer: Cigna Commercial	$12,121.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,866.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,636.43

STENT VIABH 13x10x110 VB131002

Facility

$12,152.00

Hospital Charge Code	270635160
Hospital Revenue Code	278
Min. Negotiated Rate	$1,822.80
Max. Negotiated Rate	$2,940.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,940.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,822.80

STENT VIABH 13x10x110 VB131002

Facility

$12,152.00

Hospital Charge Code	270635160
Hospital Revenue Code	278
Min. Negotiated Rate	$1,822.80
Max. Negotiated Rate	$6,076.00
Rate for Payer: Aetna Commercial	$3,645.60
Rate for Payer: Aetna Medicare Advantage	$3,645.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,098.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,430.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,098.76
Rate for Payer: Cigna Commercial	$6,076.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,940.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,822.80

STENT VIABHAN 13X10 12

Facility

$18,760.00

Service Code	HCPCS C1876
Hospital Charge Code	270692539
Hospital Revenue Code	278
Min. Negotiated Rate	$2,814.00
Max. Negotiated Rate	$9,380.00
Rate for Payer: Aetna Commercial	$5,628.00
Rate for Payer: Aetna Medicare Advantage	$5,628.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,783.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,783.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,783.80
Rate for Payer: Cigna Commercial	$9,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,539.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,814.00

STENT VIABHAN 13X10 12

Facility

$18,760.00

Service Code	HCPCS C1876
Hospital Charge Code	270692539
Hospital Revenue Code	278
Min. Negotiated Rate	$2,814.00
Max. Negotiated Rate	$4,539.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,752.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,539.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,814.00

STENT VIABHN 7FR 5*10 120CM

Facility

$15,850.00

Hospital Charge Code	270646985C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,377.50
Max. Negotiated Rate	$3,835.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,835.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,377.50

STENT VIABHN 7FR 5*10 120CM

Facility

$15,850.00

Hospital Charge Code	270646985C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,377.50
Max. Negotiated Rate	$7,925.00
Rate for Payer: Aetna Commercial	$4,755.00
Rate for Payer: Aetna Medicare Advantage	$4,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,041.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,041.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,041.75
Rate for Payer: Cigna Commercial	$7,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,835.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,377.50

STENT VIABHN 7X5X120 VBJ070502

Facility

$14,710.00

Hospital Charge Code	270648640C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,206.50
Max. Negotiated Rate	$3,559.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50

STENT VIABHN 7X5X120 VBJ070502

Facility

$14,710.00

Hospital Charge Code	270648640C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,206.50
Max. Negotiated Rate	$7,355.00
Rate for Payer: Aetna Commercial	$4,413.00
Rate for Payer: Aetna Medicare Advantage	$4,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,751.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,751.05
Rate for Payer: Cigna Commercial	$7,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,559.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,206.50

STENT VIABN 8F 8X10 VBH081002

Facility

$24,242.84

Hospital Charge Code	270639500C
Hospital Revenue Code	278
Min. Negotiated Rate	$3,636.43
Max. Negotiated Rate	$5,866.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,848.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,866.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,636.43

STENT VIABN 8F 8X10 VBH081002

Facility

$24,242.84

Hospital Charge Code	270639500C
Hospital Revenue Code	278
Min. Negotiated Rate	$3,636.43
Max. Negotiated Rate	$12,121.42
Rate for Payer: Aetna Commercial	$7,272.85
Rate for Payer: Aetna Medicare Advantage	$7,272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,181.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,848.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,181.92
Rate for Payer: Cigna Commercial	$12,121.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,866.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,636.43

STENT VICI 12 MM X 60 MM X 100

Facility

$9,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270688659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

STENT VICI 12 MM X 60 MM X 100

Facility

$9,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270688659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

Know your out-of-pocket cost for care.

All Charges