Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$40.00

Hospital Charge Code	2707400148
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 5FR JR4

Facility

$18.68

Service Code	HCPCS C1887
Hospital Charge Code	270654458N
Hospital Revenue Code	278
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$9.34
Rate for Payer: Aetna Commercial	$5.60
Rate for Payer: Aetna Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$18.68

Service Code	HCPCS C1887
Hospital Charge Code	270654458N
Hospital Revenue Code	278
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

CATHETER 5FR JR4

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270654458
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATHETER 5FR JR4

Facility

$40.00

Hospital Charge Code	2707400148
Hospital Revenue Code	272
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$20.00

CATHETER 5FR PIG TAIL 65CM

Facility

$56.65

Hospital Charge Code	270663792
Hospital Revenue Code	272
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.36
Rate for Payer: Oxford Commercial	$28.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$28.32

CATHETER 5FR PIG TAIL 65CM

Facility

$56.65

Hospital Charge Code	270663792
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223N
Hospital Revenue Code	272
Min. Negotiated Rate	$21.64
Max. Negotiated Rate	$83.25
Rate for Payer: Aetna Commercial	$49.95
Rate for Payer: Aetna Medicare Advantage	$49.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.46
Rate for Payer: Cigna Commercial	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.98
Rate for Payer: UnitedHealthcare Commercial	$83.25

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223N
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$24.98
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$24.98
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

CATHETER 5FR SOFT-VU 65CM X.03

Facility

$166.50

Hospital Charge Code	270672223
Hospital Revenue Code	272
Min. Negotiated Rate	$21.64
Max. Negotiated Rate	$83.25
Rate for Payer: Aetna Commercial	$49.95
Rate for Payer: Aetna Medicare Advantage	$49.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.46
Rate for Payer: Cigna Commercial	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.98
Rate for Payer: UnitedHealthcare Commercial	$83.25

CATHETER 5 FR URETHANE UMB

Facility

$659.20

Hospital Charge Code	270663692
Hospital Revenue Code	278
Min. Negotiated Rate	$98.88
Max. Negotiated Rate	$329.60
Rate for Payer: Aetna Commercial	$197.76
Rate for Payer: Aetna Medicare Advantage	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.10
Rate for Payer: Cigna Commercial	$329.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.53
Rate for Payer: Qualcare PPO/HMO/WC	$98.88

CATHETER 5 FR URETHANE UMB

Facility

$659.20

Hospital Charge Code	270663692
Hospital Revenue Code	278
Min. Negotiated Rate	$98.88
Max. Negotiated Rate	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.53
Rate for Payer: Qualcare PPO/HMO/WC	$98.88

CATHETER 5FR. X 100CM(.038) RA

Facility

$975.00

Hospital Charge Code	270CH0084
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER 5FR. X 100CM(.038) RA

Facility

$975.00

Hospital Charge Code	270CH0084
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

CATHETER 5FR.X 100CM(.038) RAC

Facility

$975.00

Hospital Charge Code	2706000681
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

CATHETER 5FR.X 100CM(.038) RAC

Facility

$975.00

Hospital Charge Code	2706000681
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER 6F AL2

Facility

$47.50

Hospital Charge Code	2709000320
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

CATHETER 6F AL2

Facility

$47.50

Hospital Charge Code	2709000320
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.17
Rate for Payer: Oxford Commercial	$23.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$23.75

CATHETER 6F JR 3.5

Facility

$47.50

Hospital Charge Code	2709000318
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.17
Rate for Payer: Oxford Commercial	$23.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$23.75

CATHETER 6F JR 3.5

Facility

$9.50

Service Code	HCPCS C1887
Hospital Charge Code	270658027N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$2.85
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.42
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

CATHETER 6F JR 3.5

Facility

$9.50

Service Code	HCPCS C1887
Hospital Charge Code	270658027N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

Know your out-of-pocket cost for care.

All Charges