Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLN ADML XTRM ADM040120130

Facility

$6,975.00

Hospital Charge Code	270644094C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

BLN CATH SDS 7F10x6 75 17-741

Facility

$11,220.00

Hospital Charge Code	270639945C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,683.00
Max. Negotiated Rate	$5,610.00
Rate for Payer: Aetna Commercial	$3,366.00
Rate for Payer: Aetna Medicare Advantage	$3,366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,861.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,861.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,861.10
Rate for Payer: Cigna Commercial	$5,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,715.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.00

BLN CATH SDS 7F10x6 75 17-741

Facility

$11,220.00

Hospital Charge Code	270639945C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,683.00
Max. Negotiated Rate	$2,715.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,715.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.00

BLN EVRCRS PTA AB35W06200135

Facility

$813.40

Service Code	HCPCS C1725
Hospital Charge Code	270644148C
Hospital Revenue Code	278
Min. Negotiated Rate	$122.01
Max. Negotiated Rate	$406.70
Rate for Payer: Aetna Commercial	$244.02
Rate for Payer: Aetna Medicare Advantage	$244.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.42
Rate for Payer: Cigna Commercial	$406.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.84
Rate for Payer: Qualcare PPO/HMO/WC	$122.01

BLN EVRCRS PTA AB35W06200135

Facility

$813.40

Service Code	HCPCS C1725
Hospital Charge Code	270644148C
Hospital Revenue Code	278
Min. Negotiated Rate	$122.01
Max. Negotiated Rate	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.84
Rate for Payer: Qualcare PPO/HMO/WC	$122.01

BLN EVRCRS PTA AB35W07135

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644035C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BLN EVRCRS PTA AB35W07135

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644035C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BLN NANOCROSS PTA AB14W0200801

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643956C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BLN NANOCROSS PTA AB14W0200801

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643956C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$461.58
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BLN NCROS PTA AB14W025080150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644144C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BLN NCROS PTA AB14W025080150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644144C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$461.58
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BLN PWFLEX P3 7x4 80c 4207040S

Facility

$1,325.00

Hospital Charge Code	270630472V
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

BLN PWFLEX P3 7x4 80c 4207040S

Facility

$1,325.00

Hospital Charge Code	270630472V
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

BLN PWFLEX P3 7x4 80c 4207040S

Facility

$1,314.45

Hospital Charge Code	270630472
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

BLN PWFLEX P3 7x4 80c 4207040S

Facility

$1,314.45

Hospital Charge Code	270630472
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$394.33
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

BLN PWRCRS PTA AB18W060200150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644149C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BLN PWRCRS PTA AB18W060200150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644149C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BLN STERLING 5x60 39032-50601

Facility

$1,824.50

Hospital Charge Code	270641373C
Hospital Revenue Code	278
Min. Negotiated Rate	$273.68
Max. Negotiated Rate	$912.25
Rate for Payer: Aetna Commercial	$547.35
Rate for Payer: Aetna Medicare Advantage	$547.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.25
Rate for Payer: Cigna Commercial	$912.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.53
Rate for Payer: Qualcare PPO/HMO/WC	$273.68

BLN STERLING 5x60 39032-50601

Facility

$1,824.50

Hospital Charge Code	270641373C
Hospital Revenue Code	278
Min. Negotiated Rate	$273.68
Max. Negotiated Rate	$441.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.53
Rate for Payer: Qualcare PPO/HMO/WC	$273.68

BLN STRL 39031-30601

Facility

$1,909.00

Hospital Charge Code	270644095C
Hospital Revenue Code	278
Min. Negotiated Rate	$286.35
Max. Negotiated Rate	$461.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.98
Rate for Payer: Qualcare PPO/HMO/WC	$286.35

BLN STRL 39031-30601

Facility

$1,909.00

Hospital Charge Code	270644095C
Hospital Revenue Code	278
Min. Negotiated Rate	$286.35
Max. Negotiated Rate	$954.50
Rate for Payer: Aetna Commercial	$572.70
Rate for Payer: Aetna Medicare Advantage	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.80
Rate for Payer: Cigna Commercial	$954.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.98
Rate for Payer: Qualcare PPO/HMO/WC	$286.35

BLN STRLNG 39031-65201

Facility

$2,381.25

Hospital Charge Code	270644096C
Hospital Revenue Code	278
Min. Negotiated Rate	$357.19
Max. Negotiated Rate	$1,190.62
Rate for Payer: Aetna Commercial	$714.38
Rate for Payer: Aetna Medicare Advantage	$714.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$607.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$607.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$607.22
Rate for Payer: Cigna Commercial	$1,190.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.26
Rate for Payer: Qualcare PPO/HMO/WC	$357.19

BLN STRLNG 39031-65201

Facility

$2,381.25

Hospital Charge Code	270644096C
Hospital Revenue Code	278
Min. Negotiated Rate	$357.19
Max. Negotiated Rate	$576.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.26
Rate for Payer: Qualcare PPO/HMO/WC	$357.19

BLN VYGR RX 2.25x12 1011393-12

Facility

$1,175.00

Hospital Charge Code	270643089C
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$352.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

BLN VYGR RX 2.25x12 1011393-12

Facility

$1,175.00

Hospital Charge Code	270643089C
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

Know your out-of-pocket cost for care.

All Charges