Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH AMPLATZ SAR 1.0 6FR

Facility

$245.00

Hospital Charge Code	270639308
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH AMPLATZ SAR 2.0 6FR

Facility

$245.00

Hospital Charge Code	270639609
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH AMPLATZ SAR 2.0 6FR

Facility

$245.00

Hospital Charge Code	270639609
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH AMPLATZ SHT LEFT 1.0

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270640496
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SHT LEFT 1.0

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270640496
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SHT LEFT 1.0 W/SH

Facility

$650.00

Hospital Charge Code	270640497
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH AMPLATZ SHT LEFT 1.0 W/SH

Facility

$650.00

Hospital Charge Code	270640497
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH AMPLATZ SHT LEFT 1.5

Facility

$225.00

Hospital Charge Code	270640498
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SHT LEFT 1.5

Facility

$225.00

Hospital Charge Code	270640498
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SHT LEFT 2.0

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270640499
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SHT LEFT 2.0

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270640499
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMP R1.0 6FR SHO LA6SAR10

Facility

$650.00

Hospital Charge Code	270639608C
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH AMP R1.0 6FR SHO LA6SAR10

Facility

$650.00

Hospital Charge Code	270639608C
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CATH ANGIO 4FR .035 150cm

Facility

$325.00

Hospital Charge Code	270636641
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

CATH ANGIO 4FR .035 150cm

Facility

$325.00

Hospital Charge Code	270636641
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

CATH ANGIO 5F100CM LEGATO

Facility

$950.00

Hospital Charge Code	270700331S
Hospital Revenue Code	272
Min. Negotiated Rate	$123.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Commercial	$475.00

CATH ANGIO 5F100CM LEGATO

Facility

$950.00

Hospital Charge Code	270700331S
Hospital Revenue Code	272
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

CATH ANGIO 5fx90x038 10709110

Facility

$99.25

Service Code	HCPCS C1887
Hospital Charge Code	270626621
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

CATH ANGIO 5fx90x038 10709110

Facility

$99.25

Service Code	HCPCS C1887
Hospital Charge Code	270626621
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$24.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

CATH ANGIO BALLOON SV/5.0

Facility

$1,493.50

Hospital Charge Code	270655403
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

CATH ANGIO BALLOON SV/5.0

Facility

$1,493.50

Hospital Charge Code	270655403
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$746.75
Rate for Payer: Aetna Commercial	$448.05
Rate for Payer: Aetna Medicare Advantage	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.84
Rate for Payer: Cigna Commercial	$746.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

CATH ANGIO DXT 6F 100CM UL40

Facility

$1,125.00

Service Code	HCPCS C1887
Hospital Charge Code	270695283S
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

CATH ANGIO DXT 6F 100CM UL40

Facility

$1,125.00

Service Code	HCPCS C1887
Hospital Charge Code	270695283S
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
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) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.25
Rate for Payer: Oxford Commercial	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$562.50

CATH ANGIOGR 6F POSTR 0864151

Facility

$45.00

Service Code	HCPCS C1887
Hospital Charge Code	270633183
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATH ANGIOGR 6F POSTR 0864151

Facility

$45.00

Service Code	HCPCS C1887
Hospital Charge Code	270633183
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

Know your out-of-pocket cost for care.

All Charges