Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER IMPR BRAIDED 5FR 65CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675626
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPR BRAIDED 5FR 65CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675626
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPR BRAIDED 5FR 65CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675626S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPR BRAIDED 5FR 65CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675626S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPR BRAIDED 5FR 90CM

Facility

$66.00

Hospital Charge Code	675627
Hospital Revenue Code	278
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CATHETER IMPR BRAIDED 5FR 90CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675627
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPR BRAIDED 5FR 90CM

Facility

$66.00

Hospital Charge Code	675627
Hospital Revenue Code	278
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$15.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CATHETER IMPR BRAIDED 5FR 90CM

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270675627
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS BERENSTEIN 5

Facility

$337.50

Hospital Charge Code	270657622
Hospital Revenue Code	278
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$81.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.67
Rate for Payer: Qualcare PPO/HMO/WC	$50.62

CATHETER IMPRESS BERENSTEIN 5

Facility

$337.50

Hospital Charge Code	270657622
Hospital Revenue Code	278
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$168.75
Rate for Payer: Aetna Commercial	$101.25
Rate for Payer: Aetna Medicare Advantage	$101.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.06
Rate for Payer: Cigna Commercial	$168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.67
Rate for Payer: Qualcare PPO/HMO/WC	$50.62

CATHETER IMPRESS BERENSTEIN 5F

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270658011
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS BERENSTEIN 5F

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270658011S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS BERENSTEIN 5F

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270658011
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS BERENSTEIN 5F

Facility

$60.00

Service Code	HCPCS C1725
Hospital Charge Code	270658011S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS KA2 FR5

Facility

$51.79

Service Code	HCPCS C1725
Hospital Charge Code	270652004
Hospital Revenue Code	278
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$25.89
Rate for Payer: Aetna Commercial	$15.54
Rate for Payer: Aetna Medicare Advantage	$15.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.21
Rate for Payer: Cigna Commercial	$25.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.77

CATHETER IMPRESS KA2 FR5

Facility

$60.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS KA2 FR5

Facility

$51.79

Service Code	HCPCS C1725
Hospital Charge Code	270652004
Hospital Revenue Code	278
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.77

CATHETER IMPRESS KA2 FR5

Facility

$60.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CATHETER IMPRESS KA2 FR5

Facility

$66.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$15.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CATHETER IMPRESS KA2 FR5

Facility

$13.50

Service Code	HCPCS C1887
Hospital Charge Code	270658017
Hospital Revenue Code	278
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna Medicare Advantage	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

CATHETER IMPRESS KA2 FR5

Facility

$13.50

Service Code	HCPCS C1887
Hospital Charge Code	270658017
Hospital Revenue Code	278
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

CATHETER IMPRESS KA2 FR5

Facility

$66.00

Service Code	HCPCS C1887
Hospital Charge Code	270658004S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CATHETER INDURA 5.64 8709

Facility

$2,604.00

Hospital Charge Code	270633447
Hospital Revenue Code	272
Min. Negotiated Rate	$338.52
Max. Negotiated Rate	$1,302.00
Rate for Payer: Aetna Commercial	$781.20
Rate for Payer: Aetna Medicare Advantage	$781.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.02
Rate for Payer: Cigna Commercial	$1,302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.52
Rate for Payer: Oxford Commercial	$1,302.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.60
Rate for Payer: UnitedHealthcare Commercial	$1,302.00

CATHETER INDURA 5.64 8709

Facility

$2,604.00

Hospital Charge Code	270633447
Hospital Revenue Code	272
Min. Negotiated Rate	$390.60
Max. Negotiated Rate	$390.60
Rate for Payer: Qualcare PPO/HMO/WC	$390.60

CATHETER INFUSION 2.25I 20 GA

Facility

$210.00

Service Code	HCPCS C1751
Hospital Charge Code	270682903
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

Know your out-of-pocket cost for care.

All Charges