Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$462.00
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATH ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$372.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATH ASH SPLIT 14fx55cm ASPC55

Facility

$2,108.00

Hospital Charge Code	270624983
Hospital Revenue Code	272
Min. Negotiated Rate	$316.20
Max. Negotiated Rate	$316.20
Rate for Payer: Qualcare PPO/HMO/WC	$316.20

CATH ASH SPLIT 14fx55cm ASPC55

Facility

$2,108.00

Hospital Charge Code	270624983
Hospital Revenue Code	272
Min. Negotiated Rate	$274.04
Max. Negotiated Rate	$1,054.00
Rate for Payer: Aetna Commercial	$632.40
Rate for Payer: Aetna Medicare Advantage	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$537.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$537.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$537.54
Rate for Payer: Cigna Commercial	$1,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.04
Rate for Payer: Oxford Commercial	$1,054.00
Rate for Payer: Qualcare PPO/HMO/WC	$316.20
Rate for Payer: UnitedHealthcare Commercial	$1,054.00

CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$3,727.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATH ATKIS 12x4 AT75124

Facility

$1,810.45

Hospital Charge Code	270634928
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

CATH ATKIS 12x4 AT75124

Facility

$1,810.45

Hospital Charge Code	270634928
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$543.13
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

CATH ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
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 ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
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 ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
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 ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
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 AVIA PLU 4x20 142 424402W

Facility

$2,500.00

Hospital Charge Code	270639315C
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATH AVIA PLU 4x20 142 424402W

Facility

$2,500.00

Hospital Charge Code	270639315C
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATH AVIATOR PL .14 6X30 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270694130S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.05
Rate for Payer: Cigna Commercial	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

CATH AVIATOR PL .14 6X30 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270694130S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$413.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

CATH AVIATOR PLUS 4x40mm 142cm

Facility

$2,300.00

Hospital Charge Code	270639629C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH AVIATOR PLUS 4x40mm 142cm

Facility

$2,300.00

Hospital Charge Code	270639629C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$690.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH AVIATOR PLUS 5X20MM 142CM

Facility

$2,500.00

Hospital Charge Code	270641370
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATH AVIATOR PLUS 5X20MM 142CM

Facility

$2,500.00

Hospital Charge Code	270641370
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATH AVIATOR PLUS 6x20mm 142cm

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

CATH AVIATOR PLUS 6x20mm 142cm

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

CATH AVIATOR PLUS 6x40mm 142cm

Facility

$2,300.00

Hospital Charge Code	270639864C
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

Know your out-of-pocket cost for care.

All Charges