Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER REPERFUSION ACE132

Facility

$11,450.00

Service Code	HCPCS C1725
Hospital Charge Code	270682971
Hospital Revenue Code	278
Min. Negotiated Rate	$1,717.50
Max. Negotiated Rate	$2,770.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.50

CATHETER REPERFUSION ACE132

Facility

$11,450.00

Service Code	HCPCS C1725
Hospital Charge Code	270682971N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,717.50
Max. Negotiated Rate	$2,770.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.50

CATHETER REPERFUSION ACE64

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682970N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE64

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682970N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE64

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682970
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE64

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682970
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE68

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682969N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE68

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682969
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE68

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682969
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION ACE68

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270682969N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATHETER REPERFUSION RED68

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693922
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$4,192.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER REPERFUSION RED68

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693922S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$3,381.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER REPERFUSION RED68

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693922S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$4,192.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER REPERFUSION RED68

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693922
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$3,381.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATHETER REPERF ZOOM 055 137CM

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694792S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$3,727.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER REPERF ZOOM 055 137CM

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694792S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER REPERF ZOOM 071 137CM

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694789S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$3,727.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER REPERF ZOOM 071 137CM

Facility

$12,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694789S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATHETER REPERF ZOOM 35 160CM

Facility

$8,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694791S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,263.75
Max. Negotiated Rate	$4,212.50
Rate for Payer: Aetna Commercial	$2,527.50
Rate for Payer: Aetna Medicare Advantage	$2,527.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,148.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,148.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,148.38
Rate for Payer: Cigna Commercial	$4,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,038.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,263.75

CATHETER REPERF ZOOM 35 160CM

Facility

$8,425.00

Service Code	HCPCS C1757
Hospital Charge Code	270694791S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,263.75
Max. Negotiated Rate	$2,038.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,038.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,263.75

CATHETER RHINO BLUE CIAGLINA

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270689139
Hospital Revenue Code	272
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CATHETER RHINO BLUE CIAGLINA

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270689139
Hospital Revenue Code	272
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$540.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$900.00

CATHETER RIGHTSIDE

Facility

$2,200.00

Service Code	HCPCS C1887
Hospital Charge Code	270699656S
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CATHETER RIGHTSIDE

Facility

$2,200.00

Service Code	HCPCS C1887
Hospital Charge Code	270699656S
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$660.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CATHETER ROYAL FLUSH 5FR 100cm

Facility

$550.00

Hospital Charge Code	270647398
Hospital Revenue Code	271
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

Know your out-of-pocket cost for care.

All Charges