Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH DRN DAW MEUL MAC8.5FX25CM

Facility

$464.65

Service Code	HCPCS C1727
Hospital Charge Code	270700818
Hospital Revenue Code	272
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$69.70
Rate for Payer: Qualcare PPO/HMO/WC	$69.70

CATH DRN DAW MEUL MAC8.5FX25CM

Facility

$464.65

Service Code	HCPCS C1727
Hospital Charge Code	270700818
Hospital Revenue Code	272
Min. Negotiated Rate	$60.40
Max. Negotiated Rate	$232.32
Rate for Payer: Aetna Commercial	$139.40
Rate for Payer: Aetna Medicare Advantage	$139.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.49
Rate for Payer: Cigna Commercial	$232.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.40
Rate for Payer: Oxford Commercial	$232.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.70
Rate for Payer: UnitedHealthcare Commercial	$232.32

CATH DUAL LMN & 10FR INTRO****

Facility

$885.00

Hospital Charge Code	1604297
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$265.50
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

CATH DUAL LMN & 10FR INTRO****

Facility

$885.00

Hospital Charge Code	1604297
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

CATH DUAL LMN HEM 13.5 AC190KC

Facility

$1,310.45

Hospital Charge Code	270608767
Hospital Revenue Code	272
Min. Negotiated Rate	$170.36
Max. Negotiated Rate	$655.23
Rate for Payer: Aetna Commercial	$393.13
Rate for Payer: Aetna Medicare Advantage	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.16
Rate for Payer: Cigna Commercial	$655.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.36
Rate for Payer: Oxford Commercial	$655.23
Rate for Payer: Qualcare PPO/HMO/WC	$196.57
Rate for Payer: UnitedHealthcare Commercial	$655.23

CATH DUAL LMN HEM 13.5 AC190KC

Facility

$1,310.45

Hospital Charge Code	270608767
Hospital Revenue Code	272
Min. Negotiated Rate	$196.57
Max. Negotiated Rate	$196.57
Rate for Payer: Qualcare PPO/HMO/WC	$196.57

CATH DUAL LMN HEM 13.5 AC230KC

Facility

$1,702.45

Hospital Charge Code	270608809
Hospital Revenue Code	272
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$255.37
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

CATH DUAL LMN HEM 13.5 AC230KC

Facility

$1,702.45

Hospital Charge Code	270608809
Hospital Revenue Code	272
Min. Negotiated Rate	$221.32
Max. Negotiated Rate	$851.23
Rate for Payer: Aetna Commercial	$510.74
Rate for Payer: Aetna Medicare Advantage	$510.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.12
Rate for Payer: Cigna Commercial	$851.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.32
Rate for Payer: Oxford Commercial	$851.23
Rate for Payer: Qualcare PPO/HMO/WC	$255.37
Rate for Payer: UnitedHealthcare Commercial	$851.23

CATH DUAL LMN HEM 13.5 AC280KC

Facility

$1,702.45

Hospital Charge Code	270608769
Hospital Revenue Code	278
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$851.23
Rate for Payer: Aetna Commercial	$510.74
Rate for Payer: Aetna Medicare Advantage	$510.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.12
Rate for Payer: Cigna Commercial	$851.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

CATH DUAL LMN HEM 13.5 AC280KC

Facility

$1,702.45

Hospital Charge Code	270608769
Hospital Revenue Code	278
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$411.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

CATH DUAL LMN HEM 6 AK22122-F

Facility

$984.85

Hospital Charge Code	270606876
Hospital Revenue Code	278
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$238.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.33
Rate for Payer: Qualcare PPO/HMO/WC	$147.73

CATH DUAL LMN HEM 6 AK22122-F

Facility

$984.85

Hospital Charge Code	270606876
Hospital Revenue Code	278
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$492.43
Rate for Payer: Aetna Commercial	$295.45
Rate for Payer: Aetna Medicare Advantage	$295.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.14
Rate for Payer: Cigna Commercial	$492.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.33
Rate for Payer: Qualcare PPO/HMO/WC	$147.73

CATH DUAL LMN HEM 6 DLC600-EC

Facility

$480.00

Hospital Charge Code	270607582
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$144.00
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

CATH DUAL LMN HEM 6 DLC600-EC

Facility

$480.00

Hospital Charge Code	270607582
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

CATH DUAL LMN MAHURKAR UDALL

Facility

$716.00

Hospital Charge Code	270300576
Hospital Revenue Code	272
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

CATH DUAL LMN MAHURKAR UDALL

Facility

$716.00

Hospital Charge Code	270300576
Hospital Revenue Code	272
Min. Negotiated Rate	$93.08
Max. Negotiated Rate	$358.00
Rate for Payer: Aetna Commercial	$214.80
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.08
Rate for Payer: Oxford Commercial	$358.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$358.00

CATH DUAL LUMEN URETERAL 10F .

Facility

$602.70

Service Code	HCPCS C1758
Hospital Charge Code	270601073
Hospital Revenue Code	278
Min. Negotiated Rate	$90.41
Max. Negotiated Rate	$301.35
Rate for Payer: Aetna Commercial	$180.81
Rate for Payer: Aetna Medicare Advantage	$180.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.69
Rate for Payer: Cigna Commercial	$301.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.85
Rate for Payer: Qualcare PPO/HMO/WC	$90.41

CATH DUAL LUMEN URETERAL 10F .

Facility

$602.70

Service Code	HCPCS C1758
Hospital Charge Code	270601073
Hospital Revenue Code	278
Min. Negotiated Rate	$90.41
Max. Negotiated Rate	$145.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.85
Rate for Payer: Qualcare PPO/HMO/WC	$90.41

CATH DUPEN EPIDURAL

Facility

$2,860.85

Hospital Charge Code	270600872
Hospital Revenue Code	278
Min. Negotiated Rate	$429.13
Max. Negotiated Rate	$692.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.33
Rate for Payer: Qualcare PPO/HMO/WC	$429.13

CATH DUPEN EPIDURAL

Facility

$2,860.85

Hospital Charge Code	270600872
Hospital Revenue Code	278
Min. Negotiated Rate	$429.13
Max. Negotiated Rate	$1,430.42
Rate for Payer: Aetna Commercial	$858.25
Rate for Payer: Aetna Medicare Advantage	$858.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.52
Rate for Payer: Cigna Commercial	$1,430.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.33
Rate for Payer: Qualcare PPO/HMO/WC	$429.13

CATH DX AXS CATALYST 5/132CM

Facility

$10,119.30

Service Code	HCPCS C1887
Hospital Charge Code	270694250S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,517.89
Max. Negotiated Rate	$2,448.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,023.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,448.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,517.89

CATH DX AXS CATALYST 5/132CM

Facility

$10,119.30

Service Code	HCPCS C1887
Hospital Charge Code	270694250S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,517.89
Max. Negotiated Rate	$5,059.65
Rate for Payer: Aetna Commercial	$3,035.79
Rate for Payer: Aetna Medicare Advantage	$3,035.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,580.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,580.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,580.42
Rate for Payer: Cigna Commercial	$5,059.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,448.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,517.89

CATH DXT 5F JL35 100 CM

Facility

$41.25

Hospital Charge Code	270683017N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$12.38
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.36
Rate for Payer: Oxford Commercial	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$20.62

CATH DXT 5F JL35 100 CM

Facility

$41.25

Hospital Charge Code	270683017N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

CATH DXT 5F JL35 100 CM

Facility

$41.25

Hospital Charge Code	270683017
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$12.38
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.36
Rate for Payer: Oxford Commercial	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$20.62

Know your out-of-pocket cost for care.

All Charges