Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER STEALTH SOLID CROWN 1

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647206S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID CROWN 2

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$5,092.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID CROWN 2

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID CROWN 2

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$5,092.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID CROWN 2

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID MICRO

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270654669
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$5,092.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH SOLID MICRO

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270654669
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STERLING 5X150X150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270669597
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$821.42
Rate for Payer: Aetna Commercial	$492.86
Rate for Payer: Aetna Medicare Advantage	$492.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.93
Rate for Payer: Cigna Commercial	$821.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

CATHETER STERLING 5X150X150MM

Facility

$1,642.85

Service Code	HCPCS C1725
Hospital Charge Code	270669597
Hospital Revenue Code	278
Min. Negotiated Rate	$246.43
Max. Negotiated Rate	$397.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.57
Rate for Payer: Qualcare PPO/HMO/WC	$246.43

CATHETER STRAIGHT THORACIC

Facility

$92.00

Hospital Charge Code	270330800
Hospital Revenue Code	272
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$46.00

CATHETER STRAIGHT THORACIC

Facility

$92.00

Hospital Charge Code	270330800
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CATHETER SUCTION 10FR T61C

Facility

$1.22

Hospital Charge Code	270649064
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.61
Rate for Payer: Aetna Commercial	$0.37
Rate for Payer: Aetna Medicare Advantage	$0.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.31
Rate for Payer: Cigna Commercial	$0.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.16
Rate for Payer: Oxford Commercial	$0.61
Rate for Payer: Qualcare PPO/HMO/WC	$0.18
Rate for Payer: UnitedHealthcare Commercial	$0.61

CATHETER SUCTION 10FR T61C

Facility

$1.22

Hospital Charge Code	270649064
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Qualcare PPO/HMO/WC	$0.18

CATHETER SUCTION 18FR 2 EYE

Facility

$14.00

Hospital Charge Code	270331537
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$7.00

CATHETER SUCTION 18FR 2 EYE

Facility

$14.00

Hospital Charge Code	270331537
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

CATHETER SUCTION 8FRX14

Facility

$1.20

Hospital Charge Code	270650217
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.60
Rate for Payer: Aetna Commercial	$0.36
Rate for Payer: Aetna Medicare Advantage	$0.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.31
Rate for Payer: Cigna Commercial	$0.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.16
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.18
Rate for Payer: UnitedHealthcare Commercial	$0.60

CATHETER SUCTION 8FRX14

Facility

$1.20

Hospital Charge Code	270650217
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Qualcare PPO/HMO/WC	$0.18

CATHETER SUCTION GRAD WITH

Facility

$3.25

Hospital Charge Code	270650255
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.49

CATHETER SUCTION GRAD WITH

Facility

$3.25

Hospital Charge Code	270650255
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.62
Rate for Payer: Aetna Commercial	$0.98
Rate for Payer: Aetna Medicare Advantage	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.83
Rate for Payer: Cigna Commercial	$1.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.49
Rate for Payer: UnitedHealthcare Commercial	$1.62

CATHETER SWAN GANZ 5FR TRUE SI

Facility

$670.30

Service Code	HCPCS C1751
Hospital Charge Code	270658685
Hospital Revenue Code	278
Min. Negotiated Rate	$100.55
Max. Negotiated Rate	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.21
Rate for Payer: Qualcare PPO/HMO/WC	$100.55

CATHETER SWAN GANZ 5FR TRUE SI

Facility

$670.30

Service Code	HCPCS C1751
Hospital Charge Code	270658685
Hospital Revenue Code	278
Min. Negotiated Rate	$100.55
Max. Negotiated Rate	$335.15
Rate for Payer: Aetna Commercial	$201.09
Rate for Payer: Aetna Medicare Advantage	$201.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.93
Rate for Payer: Cigna Commercial	$335.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.21
Rate for Payer: Qualcare PPO/HMO/WC	$100.55

CATHETER SWAN-GANZ S-TIP

Facility

$405.00

Hospital Charge Code	270331254
Hospital Revenue Code	272
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATHETER SWAN-GANZ S-TIP

Facility

$405.00

Hospital Charge Code	270331254
Hospital Revenue Code	272
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$121.50
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.65
Rate for Payer: Oxford Commercial	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$202.50

CATHETER SWAN GANZ VIP 7.5FR

Facility

$559.50

Hospital Charge Code	270649797
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$135.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.40
Rate for Payer: Qualcare PPO/HMO/WC	$83.92

CATHETER SWAN GANZ VIP 7.5FR

Facility

$559.50

Hospital Charge Code	270649797
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$279.75
Rate for Payer: Aetna Commercial	$167.85
Rate for Payer: Aetna Medicare Advantage	$167.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.67
Rate for Payer: Cigna Commercial	$279.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.40
Rate for Payer: Qualcare PPO/HMO/WC	$83.92

Know your out-of-pocket cost for care.

All Charges