Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$298.35
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$298.35
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$298.35
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

CATHETER (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$44.07
Max. Negotiated Rate	$169.50
Rate for Payer: Aetna Commercial	$101.70
Rate for Payer: Aetna Medicare Advantage	$101.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.44
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.07
Rate for Payer: Oxford Commercial	$169.50
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$169.50

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$5,000.00

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$12,990.00
Max. Negotiated Rate	$43,300.00
Rate for Payer: Aetna Commercial	$25,980.00
Rate for Payer: Aetna Medicare Advantage	$25,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,083.00
Rate for Payer: Cigna Commercial	$43,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$12,990.00
Max. Negotiated Rate	$20,957.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00

CATHETER DRAINAGE 14FR

Facility

$401.25

Hospital Charge Code	270666823
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATHETER DRAINAGE 14FR

Facility

$401.25

Hospital Charge Code	270666823
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATHETER,DRAINAGE,BILIARY

Facility

$21.40

Service Code	HCPCS C1729
Hospital Charge Code	4800930
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,DRAINAGE,BILIARY

Facility

$21.40

Service Code	HCPCS C1729
Hospital Charge Code	4800930
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, DRAIN/MULTIPURPOSE

Facility

$545.00

Service Code	HCPCS C1729
Hospital Charge Code	2008115
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CATHETER, DRAIN/MULTIPURPOSE

Facility

$545.00

Service Code	HCPCS C1729
Hospital Charge Code	2008115
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CATHETER DXTERITY 6F 100CM

Facility

$41.25

Hospital Charge Code	270698803S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

CATHETER DXTERITY 6F 100CM

Facility

$41.25

Hospital Charge Code	270698803S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$12.38
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.36
Rate for Payer: Oxford Commercial	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$20.62

CATHETER ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191
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 ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191
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 ECHELON 10 MICRO 45 D

Facility

$4,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685191S
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

Know your out-of-pocket cost for care.

All Charges