Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHBALL ADM XTRM.035/9/60/130

Facility

$1,000.00

Hospital Charge Code	2709003731
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.035/9/60/130

Facility

$1,000.00

Hospital Charge Code	2709003731
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

CATH BALL AMPHIRON 2/120/150

Facility

$1,825.00

Hospital Charge Code	2709003761
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALL AMPHIRON 2/120/150

Facility

$1,825.00

Hospital Charge Code	2709003761
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 2.5/120/150

Facility

$1,825.00

Hospital Charge Code	2709003726
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALL AMPHIRON 2.5/120/150

Facility

$1,825.00

Hospital Charge Code	2709003726
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 2.5/40/150

Facility

$1,825.00

Hospital Charge Code	2709003603
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 2.5/40/150

Facility

$1,825.00

Hospital Charge Code	2709003603
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALL AMPHIRON 2.5/80/150

Facility

$1,825.00

Hospital Charge Code	2709003725
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 2.5/80/150

Facility

$1,825.00

Hospital Charge Code	2709003725
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALL AMPHIRON 2/80/150

Facility

$1,825.00

Hospital Charge Code	2709003759
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALL AMPHIRON 2/80/150

Facility

$1,825.00

Hospital Charge Code	2709003759
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 3/40/150

Facility

$1,825.00

Hospital Charge Code	2709003766
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATH BALL AMPHIRON 3/40/150

Facility

$1,825.00

Hospital Charge Code	2709003766
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATH BALLN 5/40/80 050040080

Facility

$700.00

Hospital Charge Code	270661866
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

CATH BALLN 5/40/80 050040080

Facility

$700.00

Hospital Charge Code	270661866
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH BALLN 6/80/80 ADM60080080

Facility

$700.00

Hospital Charge Code	270661863
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$350.00
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

CATH BALLN 6/80/80 ADM60080080

Facility

$700.00

Hospital Charge Code	270661863
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH BALLN 7/4/135 SYN 19398

Facility

$888.00

Hospital Charge Code	270627350
Hospital Revenue Code	272
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$133.20
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

CATH BALLN 7/4/135 SYN 19398

Facility

$888.00

Hospital Charge Code	270627350
Hospital Revenue Code	272
Min. Negotiated Rate	$115.44
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$266.40
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.44
Rate for Payer: Oxford Commercial	$444.00
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Commercial	$444.00

CATH BALLN 9 4 5 8 8/75 16-517

Facility

$1,020.00

Hospital Charge Code	270623524V
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

CATH BALLN 9 4 5 8 8/75 16-517

Facility

$1,020.00

Hospital Charge Code	270623524V
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$306.00
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

CATH BALLN ADM 050250130

Facility

$1,472.50

Hospital Charge Code	270658392
Hospital Revenue Code	272
Min. Negotiated Rate	$220.88
Max. Negotiated Rate	$220.88
Rate for Payer: Qualcare PPO/HMO/WC	$220.88

CATH BALLN ADM 050250130

Facility

$1,472.50

Hospital Charge Code	270658392
Hospital Revenue Code	272
Min. Negotiated Rate	$191.43
Max. Negotiated Rate	$736.25
Rate for Payer: Aetna Commercial	$441.75
Rate for Payer: Aetna Medicare Advantage	$441.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.49
Rate for Payer: Cigna Commercial	$736.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.43
Rate for Payer: Oxford Commercial	$736.25
Rate for Payer: Qualcare PPO/HMO/WC	$220.88
Rate for Payer: UnitedHealthcare Commercial	$736.25

CATH BALLN ADM EXTRM 5/150/130

Facility

$1,092.50

Service Code	HCPCS C1725
Hospital Charge Code	270658390
Hospital Revenue Code	278
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$264.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.38
Rate for Payer: Qualcare PPO/HMO/WC	$163.88

Know your out-of-pocket cost for care.

All Charges