Heights University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOLEY COUDE 5CC 18FR 2W

Facility

$72.81

Hospital Charge Code	270649024
Hospital Revenue Code	270
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$36.41
Rate for Payer: Aetna Commercial	$21.84
Rate for Payer: Aetna Medicare Advantage	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.57
Rate for Payer: Cigna Commercial	$36.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.47
Rate for Payer: Oxford Commercial	$36.41
Rate for Payer: Qualcare PPO/HMO/WC	$10.92
Rate for Payer: UnitedHealthcare Commercial	$36.41

CATH FOLEY COUDE 5CC 2FR 2W

Facility

$72.20

Hospital Charge Code	270649025
Hospital Revenue Code	272
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$10.83

CATH FOLEY COUDE 5CC 2FR 2W

Facility

$72.20

Hospital Charge Code	270649025
Hospital Revenue Code	272
Min. Negotiated Rate	$9.39
Max. Negotiated Rate	$36.10
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$21.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.41
Rate for Payer: Cigna Commercial	$36.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.39
Rate for Payer: Oxford Commercial	$36.10
Rate for Payer: Qualcare PPO/HMO/WC	$10.83
Rate for Payer: UnitedHealthcare Commercial	$36.10

CATH FOLEY EDELMAN 18FR

Facility

$97.71

Hospital Charge Code	270605609
Hospital Revenue Code	272
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$48.85
Rate for Payer: Aetna Commercial	$29.31
Rate for Payer: Aetna Medicare Advantage	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.92
Rate for Payer: Cigna Commercial	$48.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.70
Rate for Payer: Oxford Commercial	$48.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.66
Rate for Payer: UnitedHealthcare Commercial	$48.85

CATH FOLEY EDELMAN 18FR

Facility

$97.71

Hospital Charge Code	270605609
Hospital Revenue Code	272
Min. Negotiated Rate	$14.66
Max. Negotiated Rate	$14.66
Rate for Payer: Qualcare PPO/HMO/WC	$14.66

CATH FOLEY EDELMAN 18FR 5CC***

Facility

$259.00

Hospital Charge Code	1607209
Hospital Revenue Code	272
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Oxford Commercial	$129.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$129.50

CATH FOLEY EDELMAN 18FR 5CC***

Facility

$259.00

Hospital Charge Code	1607209
Hospital Revenue Code	272
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

CATH FOLEY IC SILVER 12FR 5cc

Facility

$25.77

Hospital Charge Code	270649841
Hospital Revenue Code	272
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$12.88
Rate for Payer: Aetna Commercial	$7.73
Rate for Payer: Aetna Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.57
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.35
Rate for Payer: Oxford Commercial	$12.88
Rate for Payer: Qualcare PPO/HMO/WC	$3.87
Rate for Payer: UnitedHealthcare Commercial	$12.88

CATH FOLEY IC SILVER 12FR 5cc

Facility

$25.77

Hospital Charge Code	270649841
Hospital Revenue Code	272
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$3.87

CATH FOLEY IC SILVER 5CC 14FR

Facility

$64.79

Hospital Charge Code	270650204
Hospital Revenue Code	272
Min. Negotiated Rate	$9.72
Max. Negotiated Rate	$9.72
Rate for Payer: Qualcare PPO/HMO/WC	$9.72

CATH FOLEY IC SILVER 5CC 14FR

Facility

$64.79

Hospital Charge Code	270650204
Hospital Revenue Code	272
Min. Negotiated Rate	$8.42
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna Commercial	$19.44
Rate for Payer: Aetna Medicare Advantage	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.52
Rate for Payer: Cigna Commercial	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.42
Rate for Payer: Oxford Commercial	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.72
Rate for Payer: UnitedHealthcare Commercial	$32.40

CATH FOLEY IC SILVER 5CC 18FR

Facility

$39.35

Hospital Charge Code	270650202
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$19.68
Rate for Payer: Aetna Commercial	$11.80
Rate for Payer: Aetna Medicare Advantage	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.03
Rate for Payer: Cigna Commercial	$19.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.12
Rate for Payer: Oxford Commercial	$19.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.90
Rate for Payer: UnitedHealthcare Commercial	$19.68

CATH FOLEY IC SILVER 5CC 18FR

Facility

$39.35

Hospital Charge Code	270650202
Hospital Revenue Code	272
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$5.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.90

CATH FOLEY IC SILVER 5CC 22FR

Facility

$51.85

Hospital Charge Code	270650196
Hospital Revenue Code	270
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$7.78
Rate for Payer: Qualcare PPO/HMO/WC	$7.78

CATH FOLEY IC SILVER 5CC 22FR

Facility

$51.85

Hospital Charge Code	270650196
Hospital Revenue Code	270
Min. Negotiated Rate	$6.74
Max. Negotiated Rate	$25.93
Rate for Payer: Aetna Commercial	$15.55
Rate for Payer: Aetna Medicare Advantage	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.22
Rate for Payer: Cigna Commercial	$25.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$25.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.78
Rate for Payer: UnitedHealthcare Commercial	$25.93

CATH FOLEY IC SLVR 3W18FR 30cc

Facility

$87.97

Service Code	HCPCS A4346
Hospital Charge Code	270649845
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

CATH FOLEY IC SLVR 3W18FR 30cc

Facility

$87.97

Service Code	HCPCS A4346
Hospital Charge Code	270649845
Hospital Revenue Code	272
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$43.98
Rate for Payer: Aetna Commercial	$26.39
Rate for Payer: Aetna Medicare Advantage	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.43
Rate for Payer: Cigna Commercial	$24.29
Rate for Payer: Cigna Medicare Advantage	$14.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$43.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$43.98

CATH FOLEY IC SLVR 3W20FR 30cc

Facility

$65.35

Hospital Charge Code	270649846
Hospital Revenue Code	270
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

CATH FOLEY IC SLVR 3W20FR 30cc

Facility

$65.35

Hospital Charge Code	270649846
Hospital Revenue Code	270
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$32.67
Rate for Payer: Aetna Commercial	$19.61
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.66
Rate for Payer: Cigna Commercial	$32.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.50
Rate for Payer: Oxford Commercial	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$9.80
Rate for Payer: UnitedHealthcare Commercial	$32.67

CATH FOLEY L/F 14 FR 2W 5CC

Facility

$50.85

Hospital Charge Code	270649030
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

CATH FOLEY L/F 14 FR 2W 5CC

Facility

$50.85

Hospital Charge Code	270649030
Hospital Revenue Code	272
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$25.43
Rate for Payer: Aetna Commercial	$15.26
Rate for Payer: Aetna Medicare Advantage	$15.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.97
Rate for Payer: Cigna Commercial	$25.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.61
Rate for Payer: Oxford Commercial	$25.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$25.43

CATH FOLEY L/F 16FR 2W 5CC

Facility

$48.54

Hospital Charge Code	270649031
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$7.28
Rate for Payer: Qualcare PPO/HMO/WC	$7.28

CATH FOLEY L/F 16FR 2W 5CC

Facility

$48.54

Hospital Charge Code	270649031
Hospital Revenue Code	272
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$24.27
Rate for Payer: Aetna Commercial	$14.56
Rate for Payer: Aetna Medicare Advantage	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.38
Rate for Payer: Cigna Commercial	$24.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.31
Rate for Payer: Oxford Commercial	$24.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.28
Rate for Payer: UnitedHealthcare Commercial	$24.27

CATH FOLEY LF 24FR

Facility

$47.61

Hospital Charge Code	270649853
Hospital Revenue Code	270
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$23.80
Rate for Payer: Aetna Commercial	$14.28
Rate for Payer: Aetna Medicare Advantage	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.14
Rate for Payer: Cigna Commercial	$23.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.19
Rate for Payer: Oxford Commercial	$23.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.14
Rate for Payer: UnitedHealthcare Commercial	$23.80

CATH FOLEY LF 24FR

Facility

$47.61

Hospital Charge Code	270649853
Hospital Revenue Code	270
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$7.14
Rate for Payer: Qualcare PPO/HMO/WC	$7.14

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