Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH ANGIOGR WRC 6FR 0864150

Facility

$45.00

Service Code	HCPCS C1887
Hospital Charge Code	270633182
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 WRC 6FR 0864150

Facility

$45.00

Service Code	HCPCS C1887
Hospital Charge Code	270633182
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

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH ANGIOPL LUT 6X300MMX100CM

Facility

$13,750.00

Service Code	HCPCS C2623
Hospital Charge Code	270695613
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH APEX MONORAIL15MMX1.5MM

Facility

$245.00

Hospital Charge Code	270659098
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH APEX MONORAIL15MMX1.5MM

Facility

$245.00

Hospital Charge Code	270659098
Hospital Revenue Code	272
Min. Negotiated Rate	$31.85
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) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$122.50

CATH APEX MONORAIL 15mmx2.50mm

Facility

$1,225.00

Hospital Charge Code	2709007374
Hospital Revenue Code	272
Min. Negotiated Rate	$159.25
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$367.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$612.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$612.50

CATH APEX MONORAIL 15mmx2.50mm

Facility

$1,225.00

Hospital Charge Code	2709007374
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

CATH APEX MONORAIL15MMX2MM

Facility

$245.00

Hospital Charge Code	270659100
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CATH APEX MONORAIL15MMX2MM

Facility

$245.00

Hospital Charge Code	270659100
Hospital Revenue Code	272
Min. Negotiated Rate	$31.85
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) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$122.50

CATH APEX MONORAIL 15mmx3.00mm

Facility

$1,225.00

Hospital Charge Code	2709007376
Hospital Revenue Code	272
Min. Negotiated Rate	$159.25
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$367.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$612.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$612.50

CATH APEX MONORAIL 15mmx3.00mm

Facility

$1,225.00

Hospital Charge Code	2709007376
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

CATH APEX MONORAIL 15X2 5

Facility

$245.00

Hospital Charge Code	270653670
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 APEX MONORAIL 15X2 5

Facility

$245.00

Hospital Charge Code	270653670
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 APEX MONORAIL 15X3

Facility

$245.00

Hospital Charge Code	270653672
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 APEX MONORAIL 15X3

Facility

$1,225.00

Hospital Charge Code	272653672
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

CATH APEX MONORAIL 15X3

Facility

$1,225.00

Hospital Charge Code	661184
Hospital Revenue Code	272
Min. Negotiated Rate	$159.25
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$367.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$612.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$612.50

CATH APEX MONORAIL 15X3

Facility

$1,225.00

Hospital Charge Code	272653672
Hospital Revenue Code	272
Min. Negotiated Rate	$159.25
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$367.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$612.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$612.50

CATH APEX MONORAIL 15X3

Facility

$245.00

Hospital Charge Code	270653672
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 APEX MONORAIL 15X3

Facility

$1,225.00

Hospital Charge Code	661184
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

CATH APEX MONORAIL 8mmx2.50mm

Facility

$1,225.00

Hospital Charge Code	2709007373
Hospital Revenue Code	272
Min. Negotiated Rate	$159.25
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$367.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$612.50
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$612.50

Know your out-of-pocket cost for care.

All Charges