Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH BALLOON AGILTRAC 8x30 135

Facility

$2,250.00

Hospital Charge Code	270653150
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 8x30 135

Facility

$2,250.00

Hospital Charge Code	270653150
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 8x40 135

Facility

$2,250.00

Hospital Charge Code	270653151
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 8x40 135

Facility

$2,250.00

Hospital Charge Code	270653151
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 8x40 55

Facility

$1,750.00

Hospital Charge Code	270653189
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CATH BALLOON AGILTRAC 8x40 55

Facility

$1,750.00

Hospital Charge Code	270653189
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH BALLOON AGILTRAC 8x60 135

Facility

$2,250.00

Hospital Charge Code	270653152
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 8x60 135

Facility

$2,250.00

Hospital Charge Code	270653152
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 8x60 55

Facility

$1,750.00

Hospital Charge Code	270653190
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CATH BALLOON AGILTRAC 8x60 55

Facility

$1,750.00

Hospital Charge Code	270653190
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH BALLOON AGILTRAC 8x80 55

Facility

$1,750.00

Hospital Charge Code	270653191
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CATH BALLOON AGILTRAC 8x80 55

Facility

$1,750.00

Hospital Charge Code	270653191
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH BALLOON AGILTRAC 9x20 135

Facility

$2,250.00

Hospital Charge Code	270653153
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 9x20 135

Facility

$2,250.00

Hospital Charge Code	270653153
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 9x20 55

Facility

$1,750.00

Hospital Charge Code	270653192
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CATH BALLOON AGILTRAC 9x20 55

Facility

$1,750.00

Hospital Charge Code	270653192
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH BALLOON AGILTRAC 9x30 135

Facility

$2,250.00

Hospital Charge Code	270653154
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 9x30 135

Facility

$2,250.00

Hospital Charge Code	270653154
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 9x40 135

Facility

$2,250.00

Hospital Charge Code	270653155
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 9x40 135

Facility

$2,250.00

Hospital Charge Code	270653155
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 9x40 55

Facility

$1,750.00

Hospital Charge Code	270653193
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH BALLOON AGILTRAC 9x40 55

Facility

$1,750.00

Hospital Charge Code	270653193
Hospital Revenue Code	272
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

CATH BALLOON AGILTRAC 9x60 135

Facility

$2,250.00

Hospital Charge Code	270653156
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CATH BALLOON AGILTRAC 9x60 135

Facility

$2,250.00

Hospital Charge Code	270653156
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

CATH BALLOON AGILTRAC 9x60 55

Facility

$1,750.00

Hospital Charge Code	270653194
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

Know your out-of-pocket cost for care.

All Charges