Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$4,200.00
Rate for Payer: Aetna Commercial	$2,520.00
Rate for Payer: Aetna Medicare Advantage	$2,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.00
Rate for Payer: Cigna Commercial	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

CATHETER ASPIRATION ZOOM 45M

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694802S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER ASPIRATION ZOOM 45M

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694802S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$3,727.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER ASP LIGHTNING BOLT

Facility

$40,100.00

Service Code	HCPCS C1887
Hospital Charge Code	270700572S
Hospital Revenue Code	278
Min. Negotiated Rate	$6,015.00
Max. Negotiated Rate	$20,050.00
Rate for Payer: Aetna Commercial	$12,030.00
Rate for Payer: Aetna Medicare Advantage	$12,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,225.50
Rate for Payer: Cigna Commercial	$20,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,704.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,015.00

CATHETER ASP LIGHTNING BOLT

Facility

$40,100.00

Service Code	HCPCS C1887
Hospital Charge Code	270700572S
Hospital Revenue Code	278
Min. Negotiated Rate	$6,015.00
Max. Negotiated Rate	$9,704.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,704.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,015.00

CATHETER AVIATOR PTA 6X30MM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270688838S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$413.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

CATHETER AVIATOR PTA 6X30MM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270688838S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.05
Rate for Payer: Cigna Commercial	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

CATHETER AXS CAT 5

Facility

$10,901.25

Service Code	HCPCS C1887
Hospital Charge Code	270690864
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.19
Max. Negotiated Rate	$5,450.62
Rate for Payer: Aetna Commercial	$3,270.38
Rate for Payer: Aetna Medicare Advantage	$3,270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,779.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,779.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,779.82
Rate for Payer: Cigna Commercial	$5,450.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,638.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.19

CATHETER AXS CAT 5

Facility

$10,901.25

Service Code	HCPCS C1887
Hospital Charge Code	270690864
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.19
Max. Negotiated Rate	$2,638.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,638.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.19

CATHETER AXS CATALST 6

Facility

$11,475.00

Hospital Charge Code	270685067
Hospital Revenue Code	272
Min. Negotiated Rate	$1,721.25
Max. Negotiated Rate	$1,721.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25

CATHETER AXS CATALST 6

Facility

$11,475.00

Hospital Charge Code	270685067
Hospital Revenue Code	272
Min. Negotiated Rate	$1,491.75
Max. Negotiated Rate	$5,737.50
Rate for Payer: Aetna Commercial	$3,442.50
Rate for Payer: Aetna Medicare Advantage	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,926.12
Rate for Payer: Cigna Commercial	$5,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,491.75
Rate for Payer: Oxford Commercial	$5,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25
Rate for Payer: UnitedHealthcare Commercial	$5,737.50

CATHETER BAL ECLIPSE 2L 6X12MM

Facility

$9,250.00

Service Code	HCPCS C2628
Hospital Charge Code	270698131S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER BAL ECLIPSE 2L 6X12MM

Facility

$9,250.00

Service Code	HCPCS C2628
Hospital Charge Code	270698131S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER BAL ECLIPSE 2L 6X9

Facility

$9,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270697721S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER BAL ECLIPSE 2L 6X9

Facility

$9,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270697721S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER BALLON UDT/4-4/5/75

Facility

$1,058.40

Hospital Charge Code	2703100588
Hospital Revenue Code	272
Min. Negotiated Rate	$137.59
Max. Negotiated Rate	$529.20
Rate for Payer: Aetna Commercial	$317.52
Rate for Payer: Aetna Medicare Advantage	$317.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.89
Rate for Payer: Cigna Commercial	$529.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.59
Rate for Payer: Oxford Commercial	$529.20
Rate for Payer: Qualcare PPO/HMO/WC	$158.76
Rate for Payer: UnitedHealthcare Commercial	$529.20

CATHETER BALLON UDT/4-4/5/75

Facility

$1,058.40

Hospital Charge Code	2703100588
Hospital Revenue Code	272
Min. Negotiated Rate	$158.76
Max. Negotiated Rate	$158.76
Rate for Payer: Qualcare PPO/HMO/WC	$158.76

CATHETER BALLOON

Facility

$1,000.00

Hospital Charge Code	2709000515
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHETER BALLOON

Facility

$1,000.00

Hospital Charge Code	270900412
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CATHETER BALLOON

Facility

$1,000.00

Hospital Charge Code	270900412
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CATHETER BALLOON

Facility

$1,000.00

Hospital Charge Code	2709000515
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CATHETER,BALLOON

Facility

$21.40

Service Code	HCPCS C1725
Hospital Charge Code	4800925
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$6.42
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

CATHETER,BALLOON

Facility

$21.40

Service Code	HCPCS C1725
Hospital Charge Code	4800925
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

CATHETER BALLOON .035/5/20/130

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657902
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHETER BALLOON .035/5/20/130

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657902
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

Know your out-of-pocket cost for care.

All Charges