Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOLEY 3-WAY 26FR 5CC

Facility

$99.25

Hospital Charge Code	270302593
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$49.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$49.62

CATH FOLEY 3-WAY 26FR 5CC

Facility

$99.25

Hospital Charge Code	270302593
Hospital Revenue Code	272
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

CATH FOLEY 3-WAY 5CC

Facility

$99.25

Hospital Charge Code	270302592
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$49.62
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$49.62

CATH FOLEY 3-WAY 5CC

Facility

$99.25

Hospital Charge Code	270302592
Hospital Revenue Code	272
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

CATH FOLEY 3 WAY-SET UP ******

Facility

$108.00

Hospital Charge Code	8000333
Hospital Revenue Code	279
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$32.40
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.04
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$54.00

CATH FOLEY 3 WAY-SET UP ******

Facility

$108.00

Hospital Charge Code	8000333
Hospital Revenue Code	279
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

CATH FOLEY 6FR HYDROGEL

Facility

$89.95

Hospital Charge Code	270676492
Hospital Revenue Code	272
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$44.98
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$26.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.94
Rate for Payer: Cigna Commercial	$44.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.69
Rate for Payer: Oxford Commercial	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.49
Rate for Payer: UnitedHealthcare Commercial	$44.98

CATH FOLEY 6FR HYDROGEL

Facility

$89.95

Hospital Charge Code	270676492
Hospital Revenue Code	272
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$13.49
Rate for Payer: Qualcare PPO/HMO/WC	$13.49

CATH FOLEY COUDE 12FR 5cc 2W

Facility

$133.18

Hospital Charge Code	270649858
Hospital Revenue Code	272
Min. Negotiated Rate	$19.98
Max. Negotiated Rate	$19.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.98

CATH FOLEY COUDE 12FR 5cc 2W

Facility

$133.18

Hospital Charge Code	270649858
Hospital Revenue Code	272
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$66.59
Rate for Payer: Aetna Commercial	$39.95
Rate for Payer: Aetna Medicare Advantage	$39.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.96
Rate for Payer: Cigna Commercial	$66.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.31
Rate for Payer: Oxford Commercial	$66.59
Rate for Payer: Qualcare PPO/HMO/WC	$19.98
Rate for Payer: UnitedHealthcare Commercial	$66.59

CATH FOLEY COUDE 14FR 2W 5cc

Facility

$75.66

Hospital Charge Code	270649022
Hospital Revenue Code	272
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$37.83
Rate for Payer: Aetna Commercial	$22.70
Rate for Payer: Aetna Medicare Advantage	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.29
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.84
Rate for Payer: Oxford Commercial	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$37.83

CATH FOLEY COUDE 14FR 2W 5cc

Facility

$75.66

Hospital Charge Code	270649022
Hospital Revenue Code	272
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

CATH FOLEY COUDE 16FR 5cc 2W

Facility

$75.66

Hospital Charge Code	270649854
Hospital Revenue Code	272
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

CATH FOLEY COUDE 16FR 5cc 2W

Facility

$75.66

Hospital Charge Code	270649854
Hospital Revenue Code	272
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$37.83
Rate for Payer: Aetna Commercial	$22.70
Rate for Payer: Aetna Medicare Advantage	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.29
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.84
Rate for Payer: Oxford Commercial	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$37.83

CATH FOLEY COUDE 18FR 5cc 2W

Facility

$75.66

Hospital Charge Code	270649855
Hospital Revenue Code	272
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

CATH FOLEY COUDE 18FR 5cc 2W

Facility

$75.66

Hospital Charge Code	270649855
Hospital Revenue Code	272
Min. Negotiated Rate	$9.84
Max. Negotiated Rate	$37.83
Rate for Payer: Aetna Commercial	$22.70
Rate for Payer: Aetna Medicare Advantage	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.29
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.84
Rate for Payer: Oxford Commercial	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$37.83

CATH FOLEY COUDE 20FR 5cc 2W

Facility

$76.38

Service Code	HCPCS C1887
Hospital Charge Code	270649856
Hospital Revenue Code	278
Min. Negotiated Rate	$11.46
Max. Negotiated Rate	$38.19
Rate for Payer: Aetna Commercial	$22.91
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.48
Rate for Payer: Cigna Commercial	$38.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.46

CATH FOLEY COUDE 20FR 5cc 2W

Facility

$76.38

Service Code	HCPCS C1887
Hospital Charge Code	270649856
Hospital Revenue Code	278
Min. Negotiated Rate	$11.46
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.46

CATH FOLEY COUDE 22FR 5cc 2W

Facility

$72.53

Hospital Charge Code	270650056
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

CATH FOLEY COUDE 22FR 5cc 2W

Facility

$72.53

Hospital Charge Code	270650056
Hospital Revenue Code	272
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$36.27
Rate for Payer: Aetna Commercial	$21.76
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.50
Rate for Payer: Cigna Commercial	$36.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.43
Rate for Payer: Oxford Commercial	$36.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$36.27

CATH FOLEY COUDE 24FR 2WAY

Facility

$72.53

Hospital Charge Code	270649859
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

CATH FOLEY COUDE 24FR 2WAY

Facility

$72.53

Hospital Charge Code	270649859
Hospital Revenue Code	272
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$36.27
Rate for Payer: Aetna Commercial	$21.76
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.50
Rate for Payer: Cigna Commercial	$36.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.43
Rate for Payer: Oxford Commercial	$36.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$36.27

CATH FOLEY COUDE 5CC 16FR 2W

Facility

$72.70

Hospital Charge Code	270649023
Hospital Revenue Code	270
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$10.90
Rate for Payer: Qualcare PPO/HMO/WC	$10.90

CATH FOLEY COUDE 5CC 16FR 2W

Facility

$72.70

Hospital Charge Code	270649023
Hospital Revenue Code	270
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$36.35
Rate for Payer: Aetna Commercial	$21.81
Rate for Payer: Aetna Medicare Advantage	$21.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.54
Rate for Payer: Cigna Commercial	$36.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.45
Rate for Payer: Oxford Commercial	$36.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.90
Rate for Payer: UnitedHealthcare Commercial	$36.35

CATH FOLEY COUDE 5CC 18FR 2W

Facility

$72.81

Hospital Charge Code	270649024
Hospital Revenue Code	270
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.92

Know your out-of-pocket cost for care.

All Charges