Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH EKOSONIC MACH 500-55124

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270639437C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATHELER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0010
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

CATHELER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0010
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATH EMBOLECT 2FR 120602F

Facility

$440.00

Service Code	HCPCS C1757
Hospital Charge Code	270600382
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

CATH EMBOLECT 2FR 120602F

Facility

$440.00

Service Code	HCPCS C1757
Hospital Charge Code	270600382
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CATH EMBOLECT 3FR 120803F

Facility

$463.25

Service Code	HCPCS C1757
Hospital Charge Code	270600372N
Hospital Revenue Code	278
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$112.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.11
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CATH EMBOLECT 3FR 120803F

Facility

$463.25

Service Code	HCPCS C1757
Hospital Charge Code	270600372N
Hospital Revenue Code	278
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$231.62
Rate for Payer: Aetna Commercial	$138.97
Rate for Payer: Aetna Medicare Advantage	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.13
Rate for Payer: Cigna Commercial	$231.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.11
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

CATH EMBOLECT 4FR 120804F

Facility

$313.50

Service Code	HCPCS C1757
Hospital Charge Code	270600371
Hospital Revenue Code	278
Min. Negotiated Rate	$47.02
Max. Negotiated Rate	$75.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.87
Rate for Payer: Qualcare PPO/HMO/WC	$47.02

CATH EMBOLECT 4FR 120804F

Facility

$313.50

Service Code	HCPCS C1757
Hospital Charge Code	270600371
Hospital Revenue Code	278
Min. Negotiated Rate	$47.02
Max. Negotiated Rate	$156.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$94.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.94
Rate for Payer: Cigna Commercial	$156.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.87
Rate for Payer: Qualcare PPO/HMO/WC	$47.02

CATH EMBOLECT 5FR 120805F

Facility

$343.85

Service Code	HCPCS C1757
Hospital Charge Code	270600383
Hospital Revenue Code	278
Min. Negotiated Rate	$51.58
Max. Negotiated Rate	$83.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.21
Rate for Payer: Qualcare PPO/HMO/WC	$51.58

CATH EMBOLECT 5FR 120805F

Facility

$343.85

Service Code	HCPCS C1757
Hospital Charge Code	270600383
Hospital Revenue Code	278
Min. Negotiated Rate	$51.58
Max. Negotiated Rate	$171.93
Rate for Payer: Aetna Commercial	$103.16
Rate for Payer: Aetna Medicare Advantage	$103.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.68
Rate for Payer: Cigna Commercial	$171.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.21
Rate for Payer: Qualcare PPO/HMO/WC	$51.58

CATH EMBOLECT 5FR 50CM 160245F

Facility

$2,493.65

Hospital Charge Code	270601079
Hospital Revenue Code	278
Min. Negotiated Rate	$374.05
Max. Negotiated Rate	$603.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.46
Rate for Payer: Qualcare PPO/HMO/WC	$374.05

CATH EMBOLECT 5FR 50CM 160245F

Facility

$2,493.65

Hospital Charge Code	270601079
Hospital Revenue Code	278
Min. Negotiated Rate	$374.05
Max. Negotiated Rate	$1,246.83
Rate for Payer: Aetna Commercial	$748.10
Rate for Payer: Aetna Medicare Advantage	$748.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$635.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$635.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$635.88
Rate for Payer: Cigna Commercial	$1,246.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.46
Rate for Payer: Qualcare PPO/HMO/WC	$374.05

CATH EMBOLECT 6FR 120806F

Facility

$313.50

Service Code	HCPCS C1757
Hospital Charge Code	270600384
Hospital Revenue Code	278
Min. Negotiated Rate	$47.02
Max. Negotiated Rate	$156.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$94.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.94
Rate for Payer: Cigna Commercial	$156.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.87
Rate for Payer: Qualcare PPO/HMO/WC	$47.02

CATH EMBOLECT 6FR 120806F

Facility

$313.50

Service Code	HCPCS C1757
Hospital Charge Code	270600384
Hospital Revenue Code	278
Min. Negotiated Rate	$47.02
Max. Negotiated Rate	$75.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.87
Rate for Payer: Qualcare PPO/HMO/WC	$47.02

CATH EMBOLECT 7FR *********

Facility

$204.00

Hospital Charge Code	1600733
Hospital Revenue Code	272
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

CATH EMBOLECT 7FR *********

Facility

$204.00

Hospital Charge Code	1600733
Hospital Revenue Code	272
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$102.00
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$102.00

CATH EMBOLECT 7FR 120807F

Facility

$263.17

Hospital Charge Code	270600370
Hospital Revenue Code	278
Min. Negotiated Rate	$39.48
Max. Negotiated Rate	$131.59
Rate for Payer: Aetna Commercial	$78.95
Rate for Payer: Aetna Medicare Advantage	$78.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.11
Rate for Payer: Cigna Commercial	$131.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.69
Rate for Payer: Qualcare PPO/HMO/WC	$39.48

CATH EMBOLECT 7FR 120807F

Facility

$263.17

Hospital Charge Code	270600370
Hospital Revenue Code	278
Min. Negotiated Rate	$39.48
Max. Negotiated Rate	$63.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.69
Rate for Payer: Qualcare PPO/HMO/WC	$39.48

CATH EMBOLECT D6 4FR 140806

Facility

$2,395.25

Hospital Charge Code	270601075
Hospital Revenue Code	278
Min. Negotiated Rate	$359.29
Max. Negotiated Rate	$1,197.62
Rate for Payer: Aetna Commercial	$718.58
Rate for Payer: Aetna Medicare Advantage	$718.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$479.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.79
Rate for Payer: Cigna Commercial	$1,197.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.65
Rate for Payer: Qualcare PPO/HMO/WC	$359.29

CATH EMBOLECT D6 4FR 140806

Facility

$2,395.25

Hospital Charge Code	270601075
Hospital Revenue Code	278
Min. Negotiated Rate	$359.29
Max. Negotiated Rate	$579.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$479.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.65
Rate for Payer: Qualcare PPO/HMO/WC	$359.29

Know your out-of-pocket cost for care.

All Charges