Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 438-5040X

Facility

$1,884.85

Hospital Charge Code	270626422
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423V
Hospital Revenue Code	278
Min. Negotiated Rate	$282.73
Max. Negotiated Rate	$456.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.13
Rate for Payer: Qualcare PPO/HMO/WC	$282.73

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423
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

CATH BALLOON SLALOM 438-6040X

Facility

$1,884.85

Hospital Charge Code	270626423V
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

CATHBALLOONUT/SDS OTW10/2/75

Facility

$271.00

Hospital Charge Code	270653620
Hospital Revenue Code	278
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$81.30
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

CATHBALLOONUT/SDS OTW10/2/75

Facility

$271.00

Hospital Charge Code	270653620
Hospital Revenue Code	278
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$65.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.58
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

CATH BALLOON UT/SDS OTW 6/8/75

Facility

$857.50

Hospital Charge Code	270653610
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$257.25
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

CATH BALLOON UT/SDS OTW 6/8/75

Facility

$857.50

Hospital Charge Code	270653610
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

CATHBALLOONVOYAGERRXCOMP1.5X12

Facility

$850.00

Hospital Charge Code	2709001127
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATHBALLOONVOYAGERRXCOMP1.5X12

Facility

$850.00

Hospital Charge Code	2709001127
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP3.0X20

Facility

$850.00

Hospital Charge Code	2709001134
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP3.0X20

Facility

$850.00

Hospital Charge Code	2709001134
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATHBALLOONVOYAGERRXCOMP3.5X12

Facility

$1,275.00

Hospital Charge Code	2709001131
Hospital Revenue Code	272
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$191.25
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

CATHBALLOONVOYAGERRXCOMP3.5X12

Facility

$1,275.00

Hospital Charge Code	2709001131
Hospital Revenue Code	272
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$382.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.75
Rate for Payer: Oxford Commercial	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Commercial	$637.50

CATHBALLOONVOYAGERRXCOMP3.5X20

Facility

$850.00

Hospital Charge Code	2709001135
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP3.5X20

Facility

$850.00

Hospital Charge Code	2709001135
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATHBALLOONVOYAGERRXCOMP4.0X12

Facility

$850.00

Hospital Charge Code	2709001132
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

CATHBALLOONVOYAGERRXCOMP4.0X12

Facility

$850.00

Hospital Charge Code	2709001132
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

CATH BALL UT/SDS OTW 10/4/75

Facility

$1,020.00

Hospital Charge Code	2709003632
Hospital Revenue Code	272
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$153.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

CATH BALL UT/SDS OTW 10/4/75

Facility

$1,020.00

Hospital Charge Code	2709003632
Hospital Revenue Code	272
Min. Negotiated Rate	$132.60
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) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.60
Rate for Payer: Oxford Commercial	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Commercial	$510.00

CATH BALM SLAM 3x2x80 4383020S

Facility

$1,884.85

Hospital Charge Code	270629623
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

CATH BALM SLAM 3x2x80 4383020S

Facility

$1,900.00

Hospital Charge Code	270629623V
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 BALM SLAM 3x2x80 4383020S

Facility

$1,900.00

Hospital Charge Code	270629623V
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

Know your out-of-pocket cost for care.

All Charges