Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT XIENCE SKY P 5.00 X 23

Facility

$3,500.00

Hospital Charge Code	270704420
Hospital Revenue Code	272
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$1,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$1,750.00

STENT XIENCE SKY P 5.00 X 23

Facility

$3,500.00

Hospital Charge Code	270704419
Hospital Revenue Code	272
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$1,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$1,750.00

STENT XIENCE SKY P 5.00 X 33

Facility

$3,500.00

Hospital Charge Code	270704421
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

STENT XIENCE SKY P 5.00 X 33

Facility

$3,500.00

Hospital Charge Code	270704421
Hospital Revenue Code	272
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$1,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$1,750.00

STENT XPERT 3X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644524C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 3X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644524C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 3X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644525C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 3X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644525C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644526C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X20X135MM

Facility

$8,625.00

Hospital Charge Code	270644526C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644527C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X40X135MM

Facility

$8,625.00

Hospital Charge Code	270644527C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X60 82141-01

Facility

$8,625.00

Hospital Charge Code	270644131C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 4X60 82141-01

Facility

$8,625.00

Hospital Charge Code	270644131C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X40X120MM

Facility

$8,625.00

Hospital Charge Code	270644522C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X40X120MM

Facility

$8,625.00

Hospital Charge Code	270644522C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644523C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 5X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644523C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6MM 40MM 1457801

Facility

$8,625.00

Hospital Charge Code	270635237C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6MM 40MM 1457801

Facility

$8,625.00

Hospital Charge Code	270635237C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644528C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 6X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644528C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 8x60x120mm

Facility

$8,625.00

Hospital Charge Code	270644259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 8x60x120mm

Facility

$8,625.00

Hospital Charge Code	270644259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

STENT XPERT 8X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644529C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

Know your out-of-pocket cost for care.

All Charges