Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316S
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 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316
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 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316
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 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316S
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 PLUX 5X20MM 142

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270641370S
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 PLUX 5X20MM 142

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270641370S
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 BAKER JEJUNOSTOMY 16FR

Facility

$694.45

Hospital Charge Code	270679142
Hospital Revenue Code	272
Min. Negotiated Rate	$90.28
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$208.34
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.28
Rate for Payer: Oxford Commercial	$347.23
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Commercial	$347.23

CATH BAKER JEJUNOSTOMY 16FR

Facility

$694.45

Hospital Charge Code	270679142
Hospital Revenue Code	272
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

CATH BAL 2.5x40x135 T254013501

Facility

$3,968.00

Hospital Charge Code	270635038
Hospital Revenue Code	278
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$960.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$793.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.26
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

CATH BAL 2.5x40x135 T254013501

Facility

$4,960.00

Hospital Charge Code	270634038
Hospital Revenue Code	272
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$744.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

CATH BAL 2.5x40x135 T254013501

Facility

$3,968.00

Hospital Charge Code	270635038
Hospital Revenue Code	278
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$1,984.00
Rate for Payer: Aetna Commercial	$1,190.40
Rate for Payer: Aetna Medicare Advantage	$1,190.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$793.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,011.84
Rate for Payer: Cigna Commercial	$1,984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.26
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

CATH BAL 2.5x40x135 T254013501

Facility

$4,232.25

Hospital Charge Code	270635038V
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,269.67
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

CATH BAL 2.5x40x135 T254013501

Facility

$4,960.00

Hospital Charge Code	270634038
Hospital Revenue Code	272
Min. Negotiated Rate	$644.80
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,488.00
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$644.80
Rate for Payer: Oxford Commercial	$2,480.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Commercial	$2,480.00

CATH BAL 2.5x40x135 T254013501

Facility

$4,232.25

Hospital Charge Code	270635038V
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20

CATH BAL 3.5x40x135 T354013501

Facility

$3,968.00

Hospital Charge Code	270635040
Hospital Revenue Code	278
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$960.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$793.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.26
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

CATH BAL 3.5x40x135 T354013501

Facility

$4,232.25

Hospital Charge Code	270635040V
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,269.67
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

CATH BAL 3.5x40x135 T354013501

Facility

$3,968.00

Hospital Charge Code	270635040
Hospital Revenue Code	278
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$1,984.00
Rate for Payer: Aetna Commercial	$1,190.40
Rate for Payer: Aetna Medicare Advantage	$1,190.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$793.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,011.84
Rate for Payer: Cigna Commercial	$1,984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.26
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

CATH BAL 3.5x40x135 T354013501

Facility

$4,232.25

Hospital Charge Code	270635040V
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

CATHBALL ADM XTRM.035/4/40/130

Facility

$900.00

Hospital Charge Code	2709003598
Hospital Revenue Code	272
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$450.00

CATHBALL ADM XTRM.035/4/40/130

Facility

$900.00

Hospital Charge Code	2709003598
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CATHBALL ADM XTRM.035/7/20/130

Facility

$1,000.00

Hospital Charge Code	2709003729
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHBALL ADM XTRM.035/7/20/130

Facility

$1,000.00

Hospital Charge Code	2709003729
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CATHBALL ADM XTRM.035/8/80/130

Facility

$1,000.00

Hospital Charge Code	2709003730
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHBALL ADM XTRM.035/8/80/130

Facility

$1,000.00

Hospital Charge Code	2709003730
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

Know your out-of-pocket cost for care.

All Charges