Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT XIENCE 3.5X8 100954208

Facility

$16,294.37

Hospital Charge Code	270640938C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 3.5X8 100954208

Facility

$16,294.37

Hospital Charge Code	270640938C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X12 100954312

Facility

$16,294.37

Hospital Charge Code	270640947C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X12 100954312

Facility

$16,294.37

Hospital Charge Code	270640947C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X15MM

Facility

$16,294.37

Hospital Charge Code	270640948C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X15MM

Facility

$16,294.37

Hospital Charge Code	270640948C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X18M 100954318

Facility

$16,294.37

Hospital Charge Code	270640949C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X18M 100954318

Facility

$16,294.37

Hospital Charge Code	270640949C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X23MM

Facility

$16,294.37

Hospital Charge Code	270640950C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X23MM

Facility

$16,294.37

Hospital Charge Code	270640950C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270643951V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270640951C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270640951V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270640951V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270640951C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x28 100954328

Facility

$16,294.37

Hospital Charge Code	270643951V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x38 10011735

Facility

$16,294.37

Hospital Charge Code	270647340C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0x38 10011735

Facility

$16,294.37

Hospital Charge Code	270647340C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X8MM

Facility

$16,294.37

Hospital Charge Code	270640946C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$8,147.19
Rate for Payer: Aetna Commercial	$4,888.31
Rate for Payer: Aetna Medicare Advantage	$4,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.06
Rate for Payer: Cigna Commercial	$8,147.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE 4.0X8MM

Facility

$16,294.37

Hospital Charge Code	270640946C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.16
Max. Negotiated Rate	$3,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,258.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.16

STENT XIENCE ALPINE 2.25x12MM

Facility

$5,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270675995
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT XIENCE ALPINE 2.25x12MM

Facility

$5,250.00

Service Code	HCPCS C1874
Hospital Charge Code	270675995
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STENT XIENCE ALPINE 2.25x15MM

Facility

$7,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270675996
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

STENT XIENCE ALPINE 2.25x15MM

Facility

$7,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270675996
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

STENT XIENCE ALPINE 2.25x18MM

Facility

$7,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270675997
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