Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER ARES PERITONEAL 120

Facility

$4,500.00

Service Code	HCPCS C1729
Hospital Charge Code	270695009
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER ARES PERITONEAL 120

Facility

$4,500.00

Service Code	HCPCS C1729
Hospital Charge Code	270695009
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

CATHETER ASAHI BLK 90D 200CM

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270694476S
Hospital Revenue Code	278
Min. Negotiated Rate	$411.75
Max. Negotiated Rate	$1,372.50
Rate for Payer: Aetna Commercial	$823.50
Rate for Payer: Aetna Medicare Advantage	$823.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.98
Rate for Payer: Cigna Commercial	$1,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: Qualcare PPO/HMO/WC	$411.75

CATHETER ASAHI BLK 90D 200CM

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270694476S
Hospital Revenue Code	278
Min. Negotiated Rate	$411.75
Max. Negotiated Rate	$664.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: Qualcare PPO/HMO/WC	$411.75

CATHETER ASH SPLIT 14F X 24CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661445
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 24CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661445N
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 24CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661445
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 24CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661445N
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14FX32CM

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270661327
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$462.00
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATHETER ASH SPLIT 14FX32CM

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270661327
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$372.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATHETER ASH SPLIT 14F X 36CM

Facility

$1,800.00

Hospital Charge Code	270661306
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 36CM

Facility

$1,800.00

Hospital Charge Code	270661306
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307S
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307S
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307N
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 14F X 40CM

Facility

$1,800.00

Service Code	HCPCS C1750
Hospital Charge Code	270661307N
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER ASH SPLIT 32FR

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270650776
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASH SPLIT 32FR

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270650776
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATHETER ASPIRA PERITON15.5FR

Facility

$2,500.00

Hospital Charge Code	270679381
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

CATHETER ASPIRA PERITON15.5FR

Facility

$2,500.00

Hospital Charge Code	270679381
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CATHETER ASPIRA PLEURL 4992506

Facility

$2,537.50

Service Code	HCPCS C1729
Hospital Charge Code	270649128
Hospital Revenue Code	278
Min. Negotiated Rate	$380.62
Max. Negotiated Rate	$1,268.75
Rate for Payer: Aetna Commercial	$761.25
Rate for Payer: Aetna Medicare Advantage	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$647.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$647.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$647.06
Rate for Payer: Cigna Commercial	$1,268.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$614.08
Rate for Payer: Qualcare PPO/HMO/WC	$380.62

CATHETER ASPIRA PLEURL 4992506

Facility

$2,537.50

Service Code	HCPCS C1729
Hospital Charge Code	270649128
Hospital Revenue Code	278
Min. Negotiated Rate	$380.62
Max. Negotiated Rate	$614.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$614.08
Rate for Payer: Qualcare PPO/HMO/WC	$380.62

CATHETER ASPIRATION SEPARATOR7

Facility

$8,400.00

Service Code	HCPCS C1757
Hospital Charge Code	270693838S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$2,032.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

Know your out-of-pocket cost for care.

All Charges