Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER FOGARTY IRR.5FR/80CM

Facility

$110.00

Hospital Charge Code	270650854
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

CATHETER: FOGARTY OCCLUSION

Facility

$392.00

Hospital Charge Code	270331862
Hospital Revenue Code	278
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$196.00
Rate for Payer: Aetna Commercial	$117.60
Rate for Payer: Aetna Medicare Advantage	$117.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.96
Rate for Payer: Cigna Commercial	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.86
Rate for Payer: Qualcare PPO/HMO/WC	$58.80

CATHETER: FOGARTY OCCLUSION

Facility

$392.00

Hospital Charge Code	270331862
Hospital Revenue Code	278
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.86
Rate for Payer: Qualcare PPO/HMO/WC	$58.80

CATHETER FOLEY 20FR. 5CC 2 EYE

Facility

$106.00

Hospital Charge Code	270331926
Hospital Revenue Code	272
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

CATHETER FOLEY 20FR. 5CC 2 EYE

Facility

$106.00

Hospital Charge Code	270331926
Hospital Revenue Code	272
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$53.00

CATHETER FOLEY 22FR 30CC 2-WAY

Facility

$99.00

Hospital Charge Code	270331119
Hospital Revenue Code	272
Min. Negotiated Rate	$12.87
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna Commercial	$29.70
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$49.50

CATHETER FOLEY 22FR 30CC 2-WAY

Facility

$99.00

Hospital Charge Code	270331119
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

CATHETER FOLEY 26FR 30CC 2 WAY

Facility

$118.00

Hospital Charge Code	270331101
Hospital Revenue Code	272
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

CATHETER FOLEY 26FR 30CC 2 WAY

Facility

$118.00

Hospital Charge Code	270331101
Hospital Revenue Code	272
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

CATHETER FOLEY 26FR 3-WAY

Facility

$258.00

Hospital Charge Code	270332043
Hospital Revenue Code	272
Min. Negotiated Rate	$33.54
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$77.40
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.54
Rate for Payer: Oxford Commercial	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$129.00

CATHETER FOLEY 26FR 3-WAY

Facility

$258.00

Hospital Charge Code	270332043
Hospital Revenue Code	272
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

CATHETER FOLEY 26FR 5CC 2 WAY

Facility

$92.00

Hospital Charge Code	270331099
Hospital Revenue Code	272
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$46.00

CATHETER FOLEY 26FR 5CC 2 WAY

Facility

$92.00

Hospital Charge Code	270331099
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CATHETER FOLEY 28FR 2 EYE

Facility

$92.00

Hospital Charge Code	270331477
Hospital Revenue Code	272
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$46.00

CATHETER FOLEY 28FR 2 EYE

Facility

$92.00

Hospital Charge Code	270331477
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CATHETER FOLEY 30CC

Facility

$398.95

Hospital Charge Code	270663718
Hospital Revenue Code	272
Min. Negotiated Rate	$51.86
Max. Negotiated Rate	$199.47
Rate for Payer: Aetna Commercial	$119.69
Rate for Payer: Aetna Medicare Advantage	$119.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.73
Rate for Payer: Cigna Commercial	$199.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.86
Rate for Payer: Oxford Commercial	$199.47
Rate for Payer: Qualcare PPO/HMO/WC	$59.84
Rate for Payer: UnitedHealthcare Commercial	$199.47

CATHETER FOLEY 30CC

Facility

$398.95

Hospital Charge Code	270663718
Hospital Revenue Code	272
Min. Negotiated Rate	$59.84
Max. Negotiated Rate	$59.84
Rate for Payer: Qualcare PPO/HMO/WC	$59.84

CATHETER FOLEY 30FR 5CC 2 WAY

Facility

$94.00

Hospital Charge Code	270331626
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

CATHETER FOLEY 30FR 5CC 2 WAY

Facility

$94.00

Hospital Charge Code	270331626
Hospital Revenue Code	272
Min. Negotiated Rate	$12.22
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$28.20
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$47.00

CATHETER FOLEY 3 WAY 28FR 30CC

Facility

$120.00

Hospital Charge Code	270331251
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

CATHETER FOLEY 3 WAY 28FR 30CC

Facility

$120.00

Hospital Charge Code	270331251
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

CATHETER FOLEY 5CC 24FR SILIC.

Facility

$103.00

Hospital Charge Code	270331548
Hospital Revenue Code	272
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

CATHETER FOLEY 5CC 24FR SILIC.

Facility

$103.00

Hospital Charge Code	270331548
Hospital Revenue Code	272
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$51.50
Rate for Payer: Aetna Commercial	$30.90
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.39
Rate for Payer: Oxford Commercial	$51.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$51.50

CATHETER FOLEY COUNCIL 16FR5CC

Facility

$85.59

Hospital Charge Code	270653419
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$42.80
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.83
Rate for Payer: Cigna Commercial	$42.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.13
Rate for Payer: Oxford Commercial	$42.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.84
Rate for Payer: UnitedHealthcare Commercial	$42.80

CATHETER FOLEY COUNCIL 16FR5CC

Facility

$85.59

Hospital Charge Code	270653419
Hospital Revenue Code	272
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$12.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.84

Know your out-of-pocket cost for care.

All Charges