Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657626
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657626
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657625
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657625
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERITONEAL 120CM

Facility

$1,495.00

Hospital Charge Code	270647031
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$448.50
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

CATHETER PERITONEAL 120CM

Facility

$1,495.00

Hospital Charge Code	270647031
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

CATHETER PERITONEAL BARDPORT

Facility

$4,115.00

Service Code	HCPCS C1752
Hospital Charge Code	270660589
Hospital Revenue Code	278
Min. Negotiated Rate	$617.25
Max. Negotiated Rate	$995.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25

CATHETER PERITONEAL BARDPORT

Facility

$4,115.00

Service Code	HCPCS C1752
Hospital Charge Code	270660589
Hospital Revenue Code	278
Min. Negotiated Rate	$617.25
Max. Negotiated Rate	$2,057.50
Rate for Payer: Aetna Commercial	$1,234.50
Rate for Payer: Aetna Medicare Advantage	$1,234.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,049.33
Rate for Payer: Cigna Commercial	$2,057.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25

CATHETER PERITONEAL W/SLITS

Facility

$880.00

Service Code	HCPCS C1752
Hospital Charge Code	270628769
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$264.00
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PERITONEAL W/SLITS

Facility

$880.00

Service Code	HCPCS C1752
Hospital Charge Code	270628769
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PERITONEL IMPLANT

Facility

$880.00

Service Code	HCPCS C1729
Hospital Charge Code	270659526
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$264.00
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PERITONEL IMPLANT

Facility

$880.00

Service Code	HCPCS C1729
Hospital Charge Code	270659526
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148S
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148S
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PICC LINE 5FR DUAL L

Facility

$1,975.00

Hospital Charge Code	270CH0063
Hospital Revenue Code	272
Min. Negotiated Rate	$256.75
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.75
Rate for Payer: Oxford Commercial	$987.50
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$987.50

CATHETER PICC LINE 5FR DUAL L

Facility

$1,975.00

Hospital Charge Code	270CH0063
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$249.00
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER PIG TAIL 5FR 65CM

Facility

$27.91

Hospital Charge Code	270669872
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

Know your out-of-pocket cost for care.

All Charges