Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$379.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.94
Rate for Payer: Qualcare PPO/HMO/WC	$235.50

CATHETER GLIDECATH SIM3 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696680S
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 SIM3 5F40CM

Facility

$1,590.00

Service Code	HCPCS C1887
Hospital Charge Code	270696680S
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 GLIDEX 8FR 25CM

Facility

$436.50

Service Code	HCPCS C1729
Hospital Charge Code	270673021
Hospital Revenue Code	278
Min. Negotiated Rate	$65.47
Max. Negotiated Rate	$105.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.63
Rate for Payer: Qualcare PPO/HMO/WC	$65.47

CATHETER GLIDEX 8FR 25CM

Facility

$436.50

Service Code	HCPCS C1729
Hospital Charge Code	270673021
Hospital Revenue Code	278
Min. Negotiated Rate	$65.47
Max. Negotiated Rate	$218.25
Rate for Payer: Aetna Commercial	$130.95
Rate for Payer: Aetna Medicare Advantage	$130.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.31
Rate for Payer: Cigna Commercial	$218.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.63
Rate for Payer: Qualcare PPO/HMO/WC	$65.47

CATHETER GPC 5FR .038X100

Facility

$550.00

Hospital Charge Code	270658316
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATHETER GPC 5FR .038X100

Facility

$550.00

Hospital Charge Code	270658316
Hospital Revenue Code	272
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$275.00

CATHETER GUIDE 6FR XB 4.5

Facility

$217.50

Hospital Charge Code	270675271
Hospital Revenue Code	272
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$108.75
Rate for Payer: Aetna Commercial	$65.25
Rate for Payer: Aetna Medicare Advantage	$65.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.46
Rate for Payer: Cigna Commercial	$108.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.27
Rate for Payer: Oxford Commercial	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$32.62
Rate for Payer: UnitedHealthcare Commercial	$108.75

CATHETER GUIDE 6FR XB 4.5

Facility

$217.50

Hospital Charge Code	270675271
Hospital Revenue Code	272
Min. Negotiated Rate	$32.62
Max. Negotiated Rate	$32.62
Rate for Payer: Qualcare PPO/HMO/WC	$32.62

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270S
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$220.00

Hospital Charge Code	270675270N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$120.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$220.00

Hospital Charge Code	270675270N
Hospital Revenue Code	272
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$110.00

CATHETER GUIDE 6FR XBLAD 3 SH

Facility

$240.00

Hospital Charge Code	270675270S
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$120.00

CATHETER,GUIDING

Facility

$899.00

Service Code	HCPCS C1769
Hospital Charge Code	4800935
Hospital Revenue Code	278
Min. Negotiated Rate	$134.85
Max. Negotiated Rate	$449.50
Rate for Payer: Aetna Commercial	$269.70
Rate for Payer: Aetna Medicare Advantage	$269.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.25
Rate for Payer: Cigna Commercial	$449.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.56
Rate for Payer: Qualcare PPO/HMO/WC	$134.85

CATHETER,GUIDING

Facility

$899.00

Service Code	HCPCS C1769
Hospital Charge Code	4800935
Hospital Revenue Code	278
Min. Negotiated Rate	$134.85
Max. Negotiated Rate	$217.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.56
Rate for Payer: Qualcare PPO/HMO/WC	$134.85

CATHETER GUIDING C1

Facility

$437.75

Hospital Charge Code	270666825
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$105.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER GUIDING C1

Facility

$437.75

Hospital Charge Code	270666825
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$218.88
Rate for Payer: Aetna Commercial	$131.32
Rate for Payer: Aetna Medicare Advantage	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.63
Rate for Payer: Cigna Commercial	$218.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER GUIDING C2

Facility

$437.75

Hospital Charge Code	270666826
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$218.88
Rate for Payer: Aetna Commercial	$131.32
Rate for Payer: Aetna Medicare Advantage	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.63
Rate for Payer: Cigna Commercial	$218.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER GUIDING C2

Facility

$437.75

Hospital Charge Code	270666826
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$105.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER GUIDING LIMA

Facility

$437.75

Hospital Charge Code	270666827
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$218.88
Rate for Payer: Aetna Commercial	$131.32
Rate for Payer: Aetna Medicare Advantage	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.63
Rate for Payer: Cigna Commercial	$218.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER GUIDING LIMA

Facility

$437.75

Hospital Charge Code	270666827
Hospital Revenue Code	278
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$105.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.94
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

CATHETER HEADWAY DUO 167 STR

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270693916S
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CATHETER HEADWAY DUO 167 STR

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270693916S
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges