Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH ARMADA PTA 6.0x20MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676838
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676615S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676615S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676615
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676615
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676616C
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676616
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676616C
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676616
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ARMADA PTA 6.0x80MM OTW

Facility

$253.93

Service Code	HCPCS C1725
Hospital Charge Code	270676618
Hospital Revenue Code	278
Min. Negotiated Rate	$38.09
Max. Negotiated Rate	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$38.09

CATH ARMADA PTA 6.0x80MM OTW

Facility

$253.93

Service Code	HCPCS C1725
Hospital Charge Code	270676618
Hospital Revenue Code	278
Min. Negotiated Rate	$38.09
Max. Negotiated Rate	$126.97
Rate for Payer: Aetna Commercial	$76.18
Rate for Payer: Aetna Medicare Advantage	$76.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.75
Rate for Payer: Cigna Commercial	$126.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$38.09

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617
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

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617C
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

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617
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

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617C
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

CATH ARROW RADIAL ARTERY*****

Facility

$51.00

Hospital Charge Code	8003204
Hospital Revenue Code	279
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

CATH ARROW RADIAL ARTERY*****

Facility

$51.00

Hospital Charge Code	8003204
Hospital Revenue Code	279
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290
Hospital Revenue Code	360
Min. Negotiated Rate	$458.65
Max. Negotiated Rate	$458.65
Rate for Payer: Qualcare PPO/HMO/WC	$458.65

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290V
Hospital Revenue Code	761
Min. Negotiated Rate	$397.49
Max. Negotiated Rate	$1,528.83
Rate for Payer: Aetna Commercial	$917.29
Rate for Payer: Aetna Medicare Advantage	$917.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.70
Rate for Payer: Cigna Commercial	$1,528.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.49
Rate for Payer: Oxford Commercial	$1,528.83
Rate for Payer: Qualcare PPO/HMO/WC	$458.65
Rate for Payer: UnitedHealthcare Commercial	$1,528.83

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290
Hospital Revenue Code	360
Min. Negotiated Rate	$397.49
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$917.29
Rate for Payer: Aetna Medicare Advantage	$917.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.70
Rate for Payer: Cigna Commercial	$1,528.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.49
Rate for Payer: Qualcare PPO/HMO/WC	$458.65

CATH ASH SPLIT 14F 32 ASPC32-3

Facility

$3,057.65

Hospital Charge Code	270617290V
Hospital Revenue Code	761
Min. Negotiated Rate	$458.65
Max. Negotiated Rate	$458.65
Rate for Payer: Qualcare PPO/HMO/WC	$458.65

CATH ASH SPLIT 14F 36 ASPC36

Facility

$1,976.00

Hospital Charge Code	270624360V
Hospital Revenue Code	761
Min. Negotiated Rate	$296.40
Max. Negotiated Rate	$296.40
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

CATH ASH SPLIT 14F 36 ASPC36

Facility

$1,976.00

Hospital Charge Code	270624360V
Hospital Revenue Code	761
Min. Negotiated Rate	$256.88
Max. Negotiated Rate	$988.00
Rate for Payer: Aetna Commercial	$592.80
Rate for Payer: Aetna Medicare Advantage	$592.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.88
Rate for Payer: Cigna Commercial	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.88
Rate for Payer: Oxford Commercial	$988.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.40
Rate for Payer: UnitedHealthcare Commercial	$988.00

CATH ASH SPLIT 14F 36 ASPC36-3

Facility

$1,976.00

Hospital Charge Code	270624360
Hospital Revenue Code	360
Min. Negotiated Rate	$256.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$592.80
Rate for Payer: Aetna Medicare Advantage	$592.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.88
Rate for Payer: Cigna Commercial	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.88
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

CATH ASH SPLIT 14F 36 ASPC36-3

Facility

$1,976.00

Hospital Charge Code	270624360
Hospital Revenue Code	360
Min. Negotiated Rate	$296.40
Max. Negotiated Rate	$296.40
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

Know your out-of-pocket cost for care.

All Charges