Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT WALLFLEX 10X40

Facility

$14,995.00

Hospital Charge Code	270648051C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,249.25
Max. Negotiated Rate	$3,628.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,628.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,249.25

STENT WALLFLEX 120MM

Facility

$12,875.00

Hospital Charge Code	270662150
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT WALLFLEX 120MM

Facility

$12,875.00

Hospital Charge Code	270662150
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$3,862.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT WALLFLEX 23X10.5

Facility

$12,047.05

Service Code	HCPCS C1876
Hospital Charge Code	270643744
Hospital Revenue Code	278
Min. Negotiated Rate	$1,807.06
Max. Negotiated Rate	$6,023.52
Rate for Payer: Aetna Commercial	$3,614.11
Rate for Payer: Aetna Medicare Advantage	$3,614.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,072.00
Rate for Payer: Cigna Commercial	$6,023.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,915.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,807.06

STENT WALLFLEX 23X10.5

Facility

$12,047.05

Service Code	HCPCS C1876
Hospital Charge Code	270643744
Hospital Revenue Code	278
Min. Negotiated Rate	$1,807.06
Max. Negotiated Rate	$2,915.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,915.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,807.06

STENT WALLFLEX 27/22X 10 60 CM

Facility

$12,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270663057
Hospital Revenue Code	278
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$3,139.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

STENT WALLFLEX 27/22X 10 60 CM

Facility

$12,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270663057
Hospital Revenue Code	278
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$3,892.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

STENT WALLFLEX 27/22X 12 230CM

Facility

$12,975.00

Hospital Charge Code	270648012
Hospital Revenue Code	278
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$6,487.50
Rate for Payer: Aetna Commercial	$3,892.50
Rate for Payer: Aetna Medicare Advantage	$3,892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,308.62
Rate for Payer: Cigna Commercial	$6,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

STENT WALLFLEX 27/22X 12 230CM

Facility

$12,975.00

Hospital Charge Code	270648012
Hospital Revenue Code	278
Min. Negotiated Rate	$1,946.25
Max. Negotiated Rate	$3,139.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,139.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.25

STENT WALLFLEX 60MM

Facility

$12,875.00

Hospital Charge Code	270662148
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT WALLFLEX 60MM

Facility

$12,875.00

Hospital Charge Code	270662148
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$3,862.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

STENT WALLFLEX 8MM X 8FR

Facility

$8,470.00

Service Code	HCPCS C1876
Hospital Charge Code	270688376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,270.50
Max. Negotiated Rate	$2,049.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,694.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,049.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,270.50

STENT WALLFLEX 8MM X 8FR

Facility

$8,470.00

Service Code	HCPCS C1876
Hospital Charge Code	270688376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,270.50
Max. Negotiated Rate	$4,235.00
Rate for Payer: Aetna Commercial	$2,541.00
Rate for Payer: Aetna Medicare Advantage	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,159.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,159.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,159.85
Rate for Payer: Cigna Commercial	$4,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,049.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,270.50

STENT WALLFLEX BILI 10x60 7053

Facility

$12,999.50

Service Code	HCPCS C1876
Hospital Charge Code	270642716
Hospital Revenue Code	278
Min. Negotiated Rate	$1,949.92
Max. Negotiated Rate	$3,145.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,599.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,145.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,949.92

STENT WALLFLEX BILI 10x60 7053

Facility

$12,999.50

Service Code	HCPCS C1876
Hospital Charge Code	270642716
Hospital Revenue Code	278
Min. Negotiated Rate	$1,949.92
Max. Negotiated Rate	$6,499.75
Rate for Payer: Aetna Commercial	$3,899.85
Rate for Payer: Aetna Medicare Advantage	$3,899.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,314.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,314.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,599.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,314.87
Rate for Payer: Cigna Commercial	$6,499.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,145.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,949.92

STENT WALLFLEX BILI 10X60 7053

Facility

$14,175.00

Hospital Charge Code	270642716C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILI 10X60 7053

Facility

$14,175.00

Hospital Charge Code	270642716C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$7,087.50
Rate for Payer: Aetna Commercial	$4,252.50
Rate for Payer: Aetna Medicare Advantage	$4,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,614.62
Rate for Payer: Cigna Commercial	$7,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILI 10X60 7478

Facility

$15,000.00

Hospital Charge Code	270648050C
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 WALLFLEX BILI 10X60 7478

Facility

$15,000.00

Hospital Charge Code	270648050C
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 WALLFLEX BILI 8X60 7050

Facility

$14,175.00

Hospital Charge Code	270645387C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$7,087.50
Rate for Payer: Aetna Commercial	$4,252.50
Rate for Payer: Aetna Medicare Advantage	$4,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,614.62
Rate for Payer: Cigna Commercial	$7,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILI 8X60 7050

Facility

$14,175.00

Hospital Charge Code	270645387C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILIARY 10*60MM

Facility

$14,175.00

Hospital Charge Code	270664732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILIARY 10*60MM

Facility

$14,175.00

Hospital Charge Code	270664732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$7,087.50
Rate for Payer: Aetna Commercial	$4,252.50
Rate for Payer: Aetna Medicare Advantage	$4,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,614.62
Rate for Payer: Cigna Commercial	$7,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILIARY 10x40

Facility

$14,175.00

Hospital Charge Code	270644762
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

STENT WALLFLEX BILIARY 10x40

Facility

$14,175.00

Hospital Charge Code	270644762
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$7,087.50
Rate for Payer: Aetna Commercial	$4,252.50
Rate for Payer: Aetna Medicare Advantage	$4,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,614.62
Rate for Payer: Cigna Commercial	$7,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

Know your out-of-pocket cost for care.

All Charges