Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHBALLOONHIGHPRESS 8X40X120

Facility

$975.00

Hospital Charge Code	2709006527
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X40X80

Facility

$975.00

Hospital Charge Code	2709006526
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

CATHBALLOONHIGHPRESS 8X40X80

Facility

$975.00

Hospital Charge Code	2709006526
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X60X120

Facility

$975.00

Hospital Charge Code	2709006529
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X60X120

Facility

$975.00

Hospital Charge Code	2709006529
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

CATHBALLOONHIGHPRESS 8X60X80

Facility

$975.00

Hospital Charge Code	2709006528
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X60X80

Facility

$975.00

Hospital Charge Code	2709006528
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

CATHBALLOONHIGHPRESS 8X80X120

Facility

$975.00

Hospital Charge Code	2709006531
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHBALLOONHIGHPRESS 8X80X120

Facility

$975.00

Hospital Charge Code	2709006531
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

CATH BALLOON INFLATION 7FR

Facility

$1,166.60

Hospital Charge Code	270661557
Hospital Revenue Code	278
Min. Negotiated Rate	$174.99
Max. Negotiated Rate	$583.30
Rate for Payer: Aetna Commercial	$349.98
Rate for Payer: Aetna Medicare Advantage	$349.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.48
Rate for Payer: Cigna Commercial	$583.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.32
Rate for Payer: Qualcare PPO/HMO/WC	$174.99

CATH BALLOON INFLATION 7FR

Facility

$1,166.60

Hospital Charge Code	270661557
Hospital Revenue Code	278
Min. Negotiated Rate	$174.99
Max. Negotiated Rate	$282.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.32
Rate for Payer: Qualcare PPO/HMO/WC	$174.99

CATH BALLOON OCCLUSION SCEPTER

Facility

$16,975.00

Service Code	HCPCS C2628
Hospital Charge Code	270699202S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$5,092.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH BALLOON OCCLUSION SCEPTER

Facility

$16,975.00

Service Code	HCPCS C2628
Hospital Charge Code	270699202S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH BALLOON POLAR 4x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634517
Hospital Revenue Code	278
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$720.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

CATH BALLOON POLAR 4x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634517
Hospital Revenue Code	278
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$892.80
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

CATH BALLOON POLAR 6x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634519
Hospital Revenue Code	278
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$720.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

CATH BALLOON POLAR 6x60 120cm

Facility

$2,976.00

Hospital Charge Code	270634519
Hospital Revenue Code	278
Min. Negotiated Rate	$446.40
Max. Negotiated Rate	$1,488.00
Rate for Payer: Aetna Commercial	$892.80
Rate for Payer: Aetna Medicare Advantage	$892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.88
Rate for Payer: Cigna Commercial	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.40

CATH BALLOON SAVVY 3x2 110c

Facility

$1,810.45

Hospital Charge Code	270634860
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 BALLOON SAVVY 3x2 110c

Facility

$1,810.45

Hospital Charge Code	270634860
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 BALLOON SLALOM 4385020S

Facility

$1,900.00

Hospital Charge Code	270625415V
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

CATH BALLOON SLALOM 4385020S

Facility

$1,237.65

Hospital Charge Code	270625415
Hospital Revenue Code	272
Min. Negotiated Rate	$185.65
Max. Negotiated Rate	$185.65
Rate for Payer: Qualcare PPO/HMO/WC	$185.65

CATH BALLOON SLALOM 4385020S

Facility

$1,900.00

Hospital Charge Code	270625415V
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

CATH BALLOON SLALOM 4385020S

Facility

$1,237.65

Hospital Charge Code	270625415
Hospital Revenue Code	272
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$618.83
Rate for Payer: Aetna Commercial	$371.30
Rate for Payer: Aetna Medicare Advantage	$371.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.60
Rate for Payer: Cigna Commercial	$618.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.89
Rate for Payer: Oxford Commercial	$618.83
Rate for Payer: Qualcare PPO/HMO/WC	$185.65
Rate for Payer: UnitedHealthcare Commercial	$618.83

CATH BALLOON SLALOM 438-5040X

Facility

$1,900.00

Hospital Charge Code	270626422V
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

CATH BALLOON SLALOM 438-5040X

Facility

$1,884.85

Hospital Charge Code	270626422
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$942.42
Rate for Payer: Aetna Commercial	$565.46
Rate for Payer: Aetna Medicare Advantage	$565.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.64
Rate for Payer: Cigna Commercial	$942.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

Know your out-of-pocket cost for care.

All Charges