Heights University Hospital

All Charges

Charge

Type

Setting

Price

STENT XPERT 8X60X120MM

Facility

$8,625.00

Hospital Charge Code	270644529C
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 ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$1,554.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$3,211.62
Rate for Payer: Aetna Commercial	$1,926.97
Rate for Payer: Aetna Medicare Advantage	$1,926.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.93
Rate for Payer: Cigna Commercial	$3,211.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797V
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$3,211.62
Rate for Payer: Aetna Commercial	$1,926.97
Rate for Payer: Aetna Medicare Advantage	$1,926.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,637.93
Rate for Payer: Cigna Commercial	$3,211.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER BILI 10x60 265218

Facility

$6,423.25

Hospital Charge Code	270631797V
Hospital Revenue Code	278
Min. Negotiated Rate	$963.49
Max. Negotiated Rate	$1,554.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,284.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.43
Rate for Payer: Qualcare PPO/HMO/WC	$963.49

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$3,592.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$3,592.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6MM X 140

Facility

$11,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270683859
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

STENT ZILVER DES PTX 6x100x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677114N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$2,692.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZILVER DES PTX 6x100x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677114
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZILVER DES PTX 6x100x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677114N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZILVER DES PTX 6x100x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677114
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$2,692.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZILVER DES PTX 6x120x125

Facility

$9,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677115N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

STENT ZILVER DES PTX 6x120x125

Facility

$9,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677115
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

STENT ZILVER DES PTX 6x120x125

Facility

$9,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677115
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

STENT ZILVER DES PTX 6x120x125

Facility

$9,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677115N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$1,762.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111N
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111N
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$1,762.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,212.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,212.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

Know your out-of-pocket cost for care.

All Charges