Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOGARTY 140806 ******

Facility

$390.00

Hospital Charge Code	1608371
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CATH FOGARTY 140806 ******

Facility

$390.00

Hospital Charge Code	1608371
Hospital Revenue Code	272
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$195.00

CATH FOGARTY 140808 *******

Facility

$390.00

Hospital Charge Code	1608389
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CATH FOGARTY 140808 *******

Facility

$390.00

Hospital Charge Code	1608389
Hospital Revenue Code	272
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$195.00

CATH FOGARTY BILIARY PROBE 3FR

Facility

$272.60

Hospital Charge Code	270651002
Hospital Revenue Code	272
Min. Negotiated Rate	$40.89
Max. Negotiated Rate	$40.89
Rate for Payer: Qualcare PPO/HMO/WC	$40.89

CATH FOGARTY BILIARY PROBE 3FR

Facility

$272.60

Hospital Charge Code	270651002
Hospital Revenue Code	272
Min. Negotiated Rate	$35.44
Max. Negotiated Rate	$136.30
Rate for Payer: Aetna Commercial	$81.78
Rate for Payer: Aetna Medicare Advantage	$81.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$136.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.44
Rate for Payer: Oxford Commercial	$136.30
Rate for Payer: Qualcare PPO/HMO/WC	$40.89
Rate for Payer: UnitedHealthcare Commercial	$136.30

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$114.75
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$19.72

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$65.72
Rate for Payer: Aetna Commercial	$39.44
Rate for Payer: Aetna Medicare Advantage	$39.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.52
Rate for Payer: Cigna Commercial	$65.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.09
Rate for Payer: Oxford Commercial	$65.72
Rate for Payer: Qualcare PPO/HMO/WC	$19.72
Rate for Payer: UnitedHealthcare Commercial	$65.72

CATH FOGARTY IRRIG 6FR 220806F

Facility

$195.50

Hospital Charge Code	270600386
Hospital Revenue Code	272
Min. Negotiated Rate	$29.32
Max. Negotiated Rate	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$29.32

CATH FOGARTY IRRIG 6FR 220806F

Facility

$195.50

Hospital Charge Code	270600386
Hospital Revenue Code	272
Min. Negotiated Rate	$25.41
Max. Negotiated Rate	$97.75
Rate for Payer: Aetna Commercial	$58.65
Rate for Payer: Aetna Medicare Advantage	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.85
Rate for Payer: Cigna Commercial	$97.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Oxford Commercial	$97.75
Rate for Payer: Qualcare PPO/HMO/WC	$29.32
Rate for Payer: UnitedHealthcare Commercial	$97.75

CATH FOGATY TL 5F 0364LW405F35

Facility

$526.90

Hospital Charge Code	270636106V
Hospital Revenue Code	278
Min. Negotiated Rate	$79.03
Max. Negotiated Rate	$127.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.51
Rate for Payer: Qualcare PPO/HMO/WC	$79.03

CATH FOGATY TL 5F 0364LW405F35

Facility

$526.90

Hospital Charge Code	270636106V
Hospital Revenue Code	278
Min. Negotiated Rate	$79.03
Max. Negotiated Rate	$263.45
Rate for Payer: Aetna Commercial	$158.07
Rate for Payer: Aetna Medicare Advantage	$158.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.36
Rate for Payer: Cigna Commercial	$263.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.51
Rate for Payer: Qualcare PPO/HMO/WC	$79.03

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$66.38
Max. Negotiated Rate	$221.28
Rate for Payer: Aetna Commercial	$132.76
Rate for Payer: Aetna Medicare Advantage	$132.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.85
Rate for Payer: Cigna Commercial	$221.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: Qualcare PPO/HMO/WC	$66.38

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$66.38
Max. Negotiated Rate	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: Qualcare PPO/HMO/WC	$66.38

CATH FOLEY 16FR 3WAY 30cc

Facility

$63.18

Hospital Charge Code	270649432
Hospital Revenue Code	272
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$31.59
Rate for Payer: Aetna Commercial	$18.95
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.11
Rate for Payer: Cigna Commercial	$31.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.21
Rate for Payer: Oxford Commercial	$31.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Commercial	$31.59

CATH FOLEY 16FR 3WAY 30cc

Facility

$63.18

Hospital Charge Code	270649432
Hospital Revenue Code	272
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$9.48
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

CATH FOLEY 16FR 3WAY 5cc

Facility

$64.26

Hospital Charge Code	270649438
Hospital Revenue Code	272
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$32.13
Rate for Payer: Aetna Commercial	$19.28
Rate for Payer: Aetna Medicare Advantage	$19.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.39
Rate for Payer: Cigna Commercial	$32.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.35
Rate for Payer: Oxford Commercial	$32.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.64
Rate for Payer: UnitedHealthcare Commercial	$32.13

CATH FOLEY 16FR 3WAY 5cc

Facility

$64.26

Hospital Charge Code	270649438
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$9.64
Rate for Payer: Qualcare PPO/HMO/WC	$9.64

CATH FOLEY 18FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649433
Hospital Revenue Code	272
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

CATH FOLEY 18FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649433
Hospital Revenue Code	272
Min. Negotiated Rate	$8.42
Max. Negotiated Rate	$32.37
Rate for Payer: Aetna Commercial	$19.42
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.51
Rate for Payer: Cigna Commercial	$32.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.42
Rate for Payer: Oxford Commercial	$32.37
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$32.37

CATH FOLEY 18FR 3WAY 5cc

Facility

$64.26

Hospital Charge Code	270649439
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$9.64
Rate for Payer: Qualcare PPO/HMO/WC	$9.64

CATH FOLEY 18FR 3WAY 5cc

Facility

$64.26

Hospital Charge Code	270649439
Hospital Revenue Code	272
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$32.13
Rate for Payer: Aetna Commercial	$19.28
Rate for Payer: Aetna Medicare Advantage	$19.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.39
Rate for Payer: Cigna Commercial	$32.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.35
Rate for Payer: Oxford Commercial	$32.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.64
Rate for Payer: UnitedHealthcare Commercial	$32.13

CATH FOLEY 20FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649434
Hospital Revenue Code	272
Min. Negotiated Rate	$8.42
Max. Negotiated Rate	$32.37
Rate for Payer: Aetna Commercial	$19.42
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.51
Rate for Payer: Cigna Commercial	$32.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.42
Rate for Payer: Oxford Commercial	$32.37
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$32.37

Know your out-of-pocket cost for care.

All Charges