Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH FETCH2 ASPIRATION 135C 6F

Facility

$1,875.00

Service Code	HCPCS C1757
Hospital Charge Code	270648202C
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

CATH FETCH2 ASPIRATION 135C 6F

Facility

$1,875.00

Service Code	HCPCS C1757
Hospital Charge Code	270648202C
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

CATH FILLIFORM 12/16 FR ****

Facility

$253.00

Hospital Charge Code	8000416
Hospital Revenue Code	279
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

CATH FILLIFORM 12/16 FR ****

Facility

$253.00

Hospital Charge Code	8000416
Hospital Revenue Code	279
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.89
Rate for Payer: Oxford Commercial	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$126.50

CATH FILLIFORM WOV ST 5FR

Facility

$135.05

Hospital Charge Code	270600151
Hospital Revenue Code	272
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$67.53
Rate for Payer: Aetna Commercial	$40.52
Rate for Payer: Aetna Medicare Advantage	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.44
Rate for Payer: Cigna Commercial	$67.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.56
Rate for Payer: Oxford Commercial	$67.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.26
Rate for Payer: UnitedHealthcare Commercial	$67.53

CATH FILLIFORM WOV ST 5FR

Facility

$135.05

Hospital Charge Code	270600151
Hospital Revenue Code	272
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$20.26
Rate for Payer: Qualcare PPO/HMO/WC	$20.26

CATH FLEXIMA ADP 8F 25CM

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270601330
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATH FLEXIMA ADP 8F 25CM

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270601330
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
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) NJ Health	$81.00
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	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATH FLEXIMA APD FIRM 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623970
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA APD FIRM 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270623970
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA APD REG 10FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270632347
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA APD REG 10FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270632347
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA APD REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270601333
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA APD REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270601333
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA APD REG 14FR

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270624218
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
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) NJ Health	$81.00
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	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATH FLEXIMA APD REG 14FR

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270624218
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CATH FLEXIMA BILIARY 10/35TT

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270652210
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY 10/35TT

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270652210
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270654389S
Hospital Revenue Code	278
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$119.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270654389N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270654389S
Hospital Revenue Code	278
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATH FLEXIMA BILIARY 10FR 35CM

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270654389N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$120.38
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA BILIARY REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624213
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA BILIARY REG 10FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624213
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CATH FLEXIMA BILIARY REG 12FR

Facility

$425.00

Service Code	HCPCS C1729
Hospital Charge Code	270624214
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Know your out-of-pocket cost for care.

All Charges