Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER BALLOON AMPHIRION 4.0

Facility

$1,650.00

Hospital Charge Code	270CH0038
Hospital Revenue Code	272
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$495.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$825.00

CATHETER BALLOON AMPHIRION 4.0

Facility

$1,650.00

Hospital Charge Code	270CH0038
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

CATHETER BALLOON AMPHIRON 2/40

Facility

$1,825.00

Hospital Charge Code	270CH0039
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATHETER BALLOON AMPHIRON 2/40

Facility

$1,825.00

Hospital Charge Code	270CH0039
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATHETER BALLOON AMPHIRON 2.5/

Facility

$1,615.00

Service Code	HCPCS C1725
Hospital Charge Code	270657907
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

CATHETER BALLOON AMPHIRON 2.5/

Facility

$1,615.00

Service Code	HCPCS C1725
Hospital Charge Code	270657907
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$390.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

CATHETER BALLOON AMPHIRON 2.5/

Facility

$1,825.00

Hospital Charge Code	270CH0040
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CATHETER BALLOON AMPHIRON 2.5/

Facility

$1,825.00

Hospital Charge Code	270CH0040
Hospital Revenue Code	272
Min. Negotiated Rate	$237.25
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.25
Rate for Payer: Oxford Commercial	$912.50
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$912.50

CATHETER BALLOON AMPHIRON 3/80

Facility

$1,615.00

Service Code	HCPCS C1725
Hospital Charge Code	270636983
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$390.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

CATHETER BALLOON AMPHIRON 3/80

Facility

$1,615.00

Service Code	HCPCS C1725
Hospital Charge Code	270636983
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

CATHETER BALLOON CHOCO 2.5 80

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270692308
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,147.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER BALLOON CHOCO 2.5 80

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270692308
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER BALLOON CHOCO 3.0 80

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270692309
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER BALLOON CHOCO 3.0 80

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270692309
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,147.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0029
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0033
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 BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0016
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0017
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0018
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0012
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 BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0016
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 BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0023
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

CATHETER BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0031
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 BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0011
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 BALLOON HIGH PRESSURE

Facility

$975.00

Hospital Charge Code	270CH0015
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

Know your out-of-pocket cost for care.

All Charges