Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH 6 F MPA 1

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636331S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6F MPA2 533642

Facility

$42.25

Hospital Charge Code	270604410
Hospital Revenue Code	272
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$21.12
Rate for Payer: Aetna Commercial	$12.68
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.77
Rate for Payer: Cigna Commercial	$21.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.49
Rate for Payer: Oxford Commercial	$21.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$21.12

CATH 6F MPA2 533642

Facility

$42.25

Hospital Charge Code	270604410
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

CATH 6FR 100CML LEFT 7501-21

Facility

$475.00

Hospital Charge Code	270647848C
Hospital Revenue Code	272
Min. Negotiated Rate	$61.75
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.75
Rate for Payer: Oxford Commercial	$237.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$237.50

CATH 6FR 100CML LEFT 7501-21

Facility

$475.00

Hospital Charge Code	270647848C
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$2,385.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$2,385.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$2,385.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR AL 2.0 SH

Facility

$230.00

Hospital Charge Code	270644740
Hospital Revenue Code	272
Min. Negotiated Rate	$29.90
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$115.00

CATH 6FR AL 2.0 SH

Facility

$230.00

Hospital Charge Code	270644740
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

CATH 6FR AL2 SH

Facility

$255.00

Hospital Charge Code	270640091
Hospital Revenue Code	272
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.15
Rate for Payer: Oxford Commercial	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$127.50

CATH 6FR AL2 SH

Facility

$255.00

Hospital Charge Code	270640091
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR INFINITI PROPAC

Facility

$182.50

Hospital Charge Code	270645134
Hospital Revenue Code	272
Min. Negotiated Rate	$27.38
Max. Negotiated Rate	$27.38
Rate for Payer: Qualcare PPO/HMO/WC	$27.38

CATH 6FR INFINITI PROPAC

Facility

$182.50

Hospital Charge Code	270645134
Hospital Revenue Code	272
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$91.25
Rate for Payer: Aetna Commercial	$54.75
Rate for Payer: Aetna Medicare Advantage	$54.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.54
Rate for Payer: Cigna Commercial	$91.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.73
Rate for Payer: Oxford Commercial	$91.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.38
Rate for Payer: UnitedHealthcare Commercial	$91.25

CATH 6FR INFINITI TLMPA2 100CM

Facility

$45.25

Hospital Charge Code	270640096
Hospital Revenue Code	272
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$22.62
Rate for Payer: Aetna Commercial	$13.57
Rate for Payer: Aetna Medicare Advantage	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.54
Rate for Payer: Cigna Commercial	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.88
Rate for Payer: Oxford Commercial	$22.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.79
Rate for Payer: UnitedHealthcare Commercial	$22.62

CATH 6FR INFINITI TLMPA2 100CM

Facility

$45.25

Hospital Charge Code	270640096
Hospital Revenue Code	272
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.79

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299N
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$120.00

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299N
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

Know your out-of-pocket cost for care.

All Charges