Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER FOLEY COUNCIL 18FR5CC

Facility

$85.59

Hospital Charge Code	270653421
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 18FR5CC

Facility

$85.59

Hospital Charge Code	270653421
Hospital Revenue Code	272
Min. Negotiated Rate	$12.84
Max. Negotiated Rate	$12.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.84

CATHETER FOLEY COUNCIL 20FR5CC

Facility

$83.95

Hospital Charge Code	270653422
Hospital Revenue Code	272
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$12.59
Rate for Payer: Qualcare PPO/HMO/WC	$12.59

CATHETER FOLEY COUNCIL 20FR5CC

Facility

$83.95

Hospital Charge Code	270653422
Hospital Revenue Code	272
Min. Negotiated Rate	$10.91
Max. Negotiated Rate	$41.98
Rate for Payer: Aetna Commercial	$25.18
Rate for Payer: Aetna Medicare Advantage	$25.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.41
Rate for Payer: Cigna Commercial	$41.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.91
Rate for Payer: Oxford Commercial	$41.98
Rate for Payer: Qualcare PPO/HMO/WC	$12.59
Rate for Payer: UnitedHealthcare Commercial	$41.98

CATHETER FOR HYSTEROGRAPHY

Facility

$793.24

Service Code	HCPCS 58340
Hospital Charge Code	1600000549
Hospital Revenue Code	360
Min. Negotiated Rate	$118.99
Max. Negotiated Rate	$118.99
Rate for Payer: Qualcare PPO/HMO/WC	$118.99

CATHETER FOR HYSTEROGRAPHY

Facility

$793.24

Service Code	HCPCS 58340
Hospital Charge Code	1600000549
Hospital Revenue Code	360
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$237.97
Rate for Payer: Aetna Medicare Advantage	$237.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.28
Rate for Payer: Cigna Commercial	$57.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.12
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.99
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CATHETER FR TELESCOPE 6FR

Facility

$370.00

Service Code	HCPCS C1887
Hospital Charge Code	270689340
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

CATHETER FR TELESCOPE 6FR

Facility

$370.00

Service Code	HCPCS C1887
Hospital Charge Code	270689340
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

CATHETER FUBUKI XF 6F 100CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699393S
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 FUBUKI XF 6F 100CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699393S
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 FUBUKI XF 6F 90CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699392S
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 FUBUKI XF 6F 90CM

Facility

$2,745.00

Service Code	HCPCS C1887
Hospital Charge Code	270699392S
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 GC 7FR 078 HOCKEY STI

Facility

$290.00

Hospital Charge Code	270667183
Hospital Revenue Code	272
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$87.00
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$145.00

CATHETER GC 7FR 078 HOCKEY STI

Facility

$290.00

Hospital Charge Code	270667183
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CATHETER GLIDE 4FR C1 65CM

Facility

$360.00

Hospital Charge Code	270663773N
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

CATHETER GLIDE 4FR C1 65CM

Facility

$253.25

Hospital Charge Code	270663773
Hospital Revenue Code	272
Min. Negotiated Rate	$32.92
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$75.97
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$126.62
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Commercial	$126.62

CATHETER GLIDE 4FR C1 65CM

Facility

$253.25

Hospital Charge Code	270663773
Hospital Revenue Code	272
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$37.99
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATHETER GLIDE 4FR C1 65CM

Facility

$360.00

Hospital Charge Code	270663773N
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CATHETER GLIDE 4FR C2 65CM

Facility

$360.00

Hospital Charge Code	270669518N
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

CATHETER GLIDE 4FR C2 65CM

Facility

$1,775.00

Hospital Charge Code	270669518
Hospital Revenue Code	272
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$266.25
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATHETER GLIDE 4FR C2 65CM

Facility

$1,775.00

Hospital Charge Code	270669518
Hospital Revenue Code	272
Min. Negotiated Rate	$230.75
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$532.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.75
Rate for Payer: Oxford Commercial	$887.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Commercial	$887.50

CATHETER GLIDE 4FR C2 65CM

Facility

$360.00

Hospital Charge Code	270669518N
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

CATHETER GLIDECATH SIM1 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696678S
Hospital Revenue Code	278
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$795.00
Rate for Payer: Aetna Commercial	$477.00
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

CATHETER GLIDECATH SIM1 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696678S
Hospital Revenue Code	278
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$384.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.78
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

CATHETER GLIDECATH SIM2 5F40CM

Facility

$1,570.00

Service Code	HCPCS C1887
Hospital Charge Code	270696679S
Hospital Revenue Code	278
Min. Negotiated Rate	$235.50
Max. Negotiated Rate	$785.00
Rate for Payer: Aetna Commercial	$471.00
Rate for Payer: Aetna Medicare Advantage	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.35
Rate for Payer: Cigna Commercial	$785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.94
Rate for Payer: Qualcare PPO/HMO/WC	$235.50

Know your out-of-pocket cost for care.

All Charges